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1 defined in section 733(a)) for purposes of this title,
2 subject to section 151 of the America’s Affordable
3 Health Choices Act of 2009, and
4 ‘‘(2) the health coverage participation require-
5 ments shall be deemed to be included as terms and
6 conditions of such plan.
7 ‘‘(b) PERIODIC INVESTIGATIONS TO DISCOVER NON-
8 COMPLIANCE.—The Secretary shall regularly audit a rep-
9 resentative sampling of employers and group health plans
10 and conduct investigations and other activities under sec-
11 tion 504 with respect to such sampling of plans so as to
12 discover noncompliance with the health coverage participa-
13 tion requirements in connection with such plans. The Sec-
14 retary shall communicate findings of noncompliance made
15 by the Secretary under this subsection to the Secretary
16 of the Treasury and the Health Choices Commissioner.
17 The Secretary shall take such timely enforcement action
18 as appropriate to achieve compliance.
19 ‘‘SEC. 803. HEALTH COVERAGE PARTICIPATION REQUIRE-

20 MENTS.

21 ‘‘For purposes of this part, the term ‘health coverage

22 participation requirements’ means the requirements of
23 part 1 of subtitle B of title III of division A of America’s
24 Affordable Health Choices Act of 2009 (as in effect on
25 the date of the enactment of such Act).

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1 ‘‘SEC. 804. RULES FOR APPLYING REQUIREMENTS.

2 ‘‘(a) AFFILIATED GROUPS.—In the case of any em-

3 ployer which is part of a group of employers who are treat-
4 ed as a single employer under subsection (b), (c), (m), or
5 (o) of section 414 of the Internal Revenue Code of 1986,
6 the election under section 801 shall be made by such em-
7 ployer as the Secretary may provide. Any such election,
8 once made, shall apply to all members of such group.
9 ‘‘(b) SEPARATE ELECTIONS.—Under regulations pre-
10 scribed by the Secretary, separate elections may be made
11 under section 801 with respect to—
12 ‘‘(1) separate lines of business, and
13 ‘‘(2) full-time employees and employees who are
14 not full-time employees.
15 ‘‘SEC. 805. TERMINATION OF ELECTION IN CASES OF SUB-

16 STANTIAL NONCOMPLIANCE.

17 ‘‘The Secretary may terminate the election of any em-

18 ployer under section 801 if the Secretary (in coordination
19 with the Health Choices Commissioner) determines that
20 such employer is in substantial noncompliance with the
21 health coverage participation requirements and shall refer
22 any such determination to the Secretary of the Treasury
23 as appropriate.
24 ‘‘SEC. 806. REGULATIONS.

25 ‘‘The Secretary may promulgate such regulations as

26 may be necessary or appropriate to carry out the provi-
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1 sions of this part, in accordance with section 324(a) of
2 the America’s Affordable Health Choices Act of 2009. The
3 Secretary may promulgate any interim final rules as the
4 Secretary determines are appropriate to carry out this
5 part.’’.
6 (b) ENFORCEMENT OF HEALTH COVERAGE PARTICI-
7 PATION REQUIREMENTS.—Section 502 of such Act (29
8 U.S.C. 1132) is amended—
9 (1) in subsection (a)(6), by striking ‘‘para-
10 graph’’ and all that follows through ‘‘subsection (c)’’
11 and inserting ‘‘paragraph (2), (4), (5), (6), (7), (8),
12 (9), (10), or (11) of subsection (c)’’; and
13 (2) in subsection (c), by redesignating the sec-
14 ond paragraph (10) as paragraph (12) and by in-
15 serting after the first paragraph (10) the following
16 new paragraph:
17 ‘‘(11) HEALTH COVERAGE PARTICIPATION RE-

18 QUIREMENTS.—

19 ‘‘(A) CIVIL PENALTIES.—In the case of

20 any employer who fails (during any period with
21 respect to which an election under section
22 801(a) is in effect) to satisfy the health cov-
23 erage participation requirements with respect to
24 any employee, the Secretary may assess a civil
25 penalty against the employer of $100 for each

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1 day in the period beginning on the date such
2 failure first occurs and ending on the date such
3 failure is corrected.
4 ‘‘(B) HEALTH COVERAGE PARTICIPATION

5 REQUIREMENTS.—For purposes of this para-

6 graph, the term ‘health coverage participation
7 requirements’ has the meaning provided in sec-
8 tion 803.
9 ‘‘(C) LIMITATIONS ON AMOUNT OF PEN-

10 ALTY.—

11 ‘‘(i) PENALTY NOT TO APPLY WHERE

12 FAILURE NOT DISCOVERED EXERCISING

13 REASONABLE DILIGENCE.—No penalty

14 shall be assessed under subparagraph (A)
15 with respect to any failure during any pe-
16 riod for which it is established to the satis-
17 faction of the Secretary that the employer
18 did not know, or exercising reasonable dili-
19 gence would not have known, that such
20 failure existed.
21 ‘‘(ii) PENALTY NOT TO APPLY TO

22 FAILURES CORRECTED WITHIN 30 DAYS.—

23 No penalty shall be assessed under sub-

24 paragraph (A) with respect to any failure
25 if—

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1 ‘‘(I) such failure was due to rea-
2 sonable cause and not to willful ne-
3 glect, and
4 ‘‘(II) such failure is corrected
5 during the 30-day period beginning on
6 the 1st date that the employer knew,
7 or exercising reasonable diligence
8 would have known, that such failure
9 existed.
10 ‘‘(iii) OVERALL LIMITATION FOR UN-

11 INTENTIONAL FAILURES.—In the case of

12 failures which are due to reasonable cause
13 and not to willful neglect, the penalty as-
14 sessed under subparagraph (A) for failures
15 during any 1-year period shall not exceed
16 the amount equal to the lesser of—
17 ‘‘(I) 10 percent of the aggregate
18 amount paid or incurred by the em-
19 ployer (or predecessor employer) dur-
20 ing the preceding 1-year period for
21 group health plans, or
22 ‘‘(II) $500,000.
23 ‘‘(D) ADVANCE NOTIFICATION OF FAILURE

24 PRIOR TO ASSESSMENT.—Before a reasonable

25 time prior to the assessment of any penalty

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1 under this paragraph with respect to any failure
2 by an employer, the Secretary shall inform the
3 employer in writing of such failure and shall
4 provide the employer information regarding ef-
5 forts and procedures which may be undertaken
6 by the employer to correct such failure.
7 ‘‘(E) COORDINATION WITH EXCISE TAX.—

8 Under regulations prescribed in accordance

9 with section 324 of the America’s Affordable
10 Health Choices Act of 2009, the Secretary and
11 the Secretary of the Treasury shall coordinate
12 the assessment of penalties under this section
13 in connection with failures to satisfy health cov-
14 erage participation requirements with the impo-
15 sition of excise taxes on such failures under sec-
16 tion 4980H(b) of the Internal Revenue Code of
17 1986 so as to avoid duplication of penalties
18 with respect to such failures.
19 ‘‘(F) DEPOSIT OF PENALTY COLLECTED.—

20 Any amount of penalty collected under this

21 paragraph shall be deposited as miscellaneous
22 receipts in the Treasury of the United States.’’.
23 (c) CLERICAL AMENDMENTS.—The table of contents
24 in section 1 of such Act is amended by inserting after the
25 item relating to section 734 the following new items:
‘‘PART 8—NATIONAL HEALTH COVERAGE PARTICIPATION REQUIREMENTS

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‘‘Sec. 801. Election of employer to be subject to national health coverage par-
ticipation requirements.
‘‘Sec. 802. Treatment of coverage resulting from election.
‘‘Sec. 803. Health coverage participation requirements.
‘‘Sec. 804. Rules for applying requirements.
‘‘Sec. 805. Termination of election in cases of substantial noncompliance.
‘‘Sec. 806. Regulations.’’.

1 (d) EFFECTIVE DATE.—The amendments made by

2 this section shall apply to periods beginning after Decem-
3 ber 31, 2012.
4 SEC. 322. SATISFACTION OF HEALTH COVERAGE PARTICI-

5 PATION REQUIREMENTS UNDER THE INTER-

6 NAL REVENUE CODE OF 1986.

7 (a) FAILURE TO ELECT, OR SUBSTANTIALLY COM-

8 PLY WITH, HEALTH COVERAGE PARTICIPATION RE-
9 QUIREMENTS.—For employment tax on employers who fail
10 to elect, or substantially comply with, the health coverage
11 participation requirements described in part 1, see section
12 3111(c) of the Internal Revenue Code of 1986 (as added
13 by section 412 of this Act).
14 (b) OTHER FAILURES.—For excise tax on other fail-
15 ures of electing employers to comply with such require-
16 ments, see section 4980H of the Internal Revenue Code
17 of 1986 (as added by section 411 of this Act).

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1 SEC. 323. SATISFACTION OF HEALTH COVERAGE PARTICI-

2 PATION REQUIREMENTS UNDER THE PUBLIC

3 HEALTH SERVICE ACT.

4 (a) IN GENERAL.—Part C of title XXVII of the Pub-

5 lic Health Service Act is amended by adding at the end
6 the following new section:
7 ‘‘SEC. 2793. NATIONAL HEALTH COVERAGE PARTICIPATION

8 REQUIREMENTS.

9 ‘‘(a) ELECTION OF EMPLOYER TO BE SUBJECT TO

10 NATIONAL HEALTH COVERAGE PARTICIPATION REQUIRE-

11 MENTS.—

12 ‘‘(1) IN GENERAL.—An employer may make an

13 election with the Secretary to be subject to the
14 health coverage participation requirements.
15 ‘‘(2) TIME AND MANNER.—An election under
16 paragraph (1) may be made at such time and in
17 such form and manner as the Secretary may pre-
18 scribe.
19 ‘‘(b) TREATMENT OF COVERAGE RESULTING FROM
20 ELECTION.—
21 ‘‘(1) IN GENERAL.—If an employer makes an
22 election to the Secretary under subsection (a)—
23 ‘‘(A) such election shall be treated as the
24 establishment and maintenance of a group
25 health plan for purposes of this title, subject to

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