American Health Care Reform Act of 2013

H.R. 4, Jobs for America Act H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 523, Protect Medical Innovation Act of 2013 H.R. 581, First Responder Medical Device Tax Relief Act H.R. 582, Healthcare Tax Relief and Mandate Repeal Act H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 781, Medicare Identity Theft Prevention Act of 2013 H.R. 903 / S. 399, American Job Protection Act H.R. 1248 / S. 610, Family Health Care Flexibility Act H.R. 1254, Auto Enroll Repeal Act H.R. 1295, Medical Device Tax Elimination Act H.R. 1558 / S. 24, Small Business Health Relief Act of 2013 H.R. 1735, In It All Together Act H.R. 1780, To provide that the only health plans that the Federal Government may make available to the President, Vice President, Members of Congress, and Federal employees are those created under the Patient Protection and Affordable Care Act or offered through a health insurance exchange H.R. 2575, Save American Workers Act H.R. 2667, Authority for Mandate Delay Act H.R. 2668, Fairness for American Families Act H.R. 2674, Job Creation Act of 2013 H.R. 2835, Restoring Access to Medication Act of 2013 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013 H.R. 2988 / S. 701 / S. 1188, Forty Hours Is Full Time Act of 2013 H.R. 3077, TELE-MED Act of 2013 H.R. 3121, American Health Care Reform Act of 2013 H.R. 3124, Investing in Permanency for Youth in Foster Care Act H.R. 3204, Drug Quality and Security Act H.R. 3367, To amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 or 2015 H.R. 3419, Small Business Fairness in Obamacare Act H.R. 3462 / S. 1735, Self-Insurance Protection Act H.R. 3522, Employee Health Care Protection Act of 2013 H.R. 4118, Suspending the Individual Mandate Penalty Law Equals Fairness (SIMPLE) Act H.R. 4160, Keep the Promise to Seniors Act of 2014 H.R. 4302, Protecting Access to Medicare Act of 2014 H.R. 4414, Expatriate Health Coverage Clarification Act of 2014 H.R. 5183 / S. 2783, Value Based Insurance Design for Better Care Act of 2014 H.R. 5557, Streamlining Verification for Americans Act H.R. 5860, Small Business Healthcare Relief Act of 2014 S. 232, Medical Device Access and Innovation Protection Act S. 603, Jobs and Premium Protection Act S. 612, Social Security Number Protection Act of 2011 S. 1031, Family and Retirement Health Investment Act of 2013 S. 1488, A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes S. 1647, Restoring Access to Medication Act Final Regulation on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (78 Fed. Reg. 33,157-33,176, June 3, 2013) (to be codified at 26 C.F.R. pt. 54) Proposed Regulation on the Patient Protection and Affordable Care Act; standards related to Essential Health Benefits, Actuarial Value, and Accreditation (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts. 147, 155, 156) Proposed Regulation on the Health Insurance Market Rules; Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012) (to be codified at 45 C.F.R. pts. 144, 147, 150) Proposed Regulation on the HHS Notice of Benefit and Payment Parameters for 2014 (77 Fed. Reg. 73,118-73,218, December 7, 2012) (to be codified at 45 C.F.R. pts. 153, 155, 156, 157, 158) Proposed Regulation on Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing (78 Fed. Reg. 4,594-4,724, January 22, 2013) (to be codified at 42 C.F.R. Parts 430, 431, 433, 435, 440, 447, 457) Proposed Regulation on Shared Responsibility for Employers Regarding Health Coverage (78 Fed. Reg. 218-253, January 2, 2013) (to be codified at 26 C.F.R. pts. 1, 54, 301) Proposed Regulation on Information Reporting of Minimum Essential Coverage (78 Fed. Reg. 54,986-54,996, September 9, 2013) (to be codified at 26 C.F.R. pts. 1, 301) Proposed Regulation on Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans (78 Fed. Reg. 54,996-55,013, September 9, 2013) (to be codified at 26 C.F.R. pt. 301) Proposed Regulation regarding the Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program (78 Fed. Reg. 15,553-15,558, March 11, 2013) (to be codified at 45 C.F.R. pts. 155, 156) Proposed Regulation on the Health Insurance Providers Fee (78 Fed. Reg. 14,034-14,046, March 4, 2013) (to be codified at 26 C.F.R. pt. 57) Proposed Regulation on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit (78 Fed. Reg. 25,909-25,916, May 3, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Regulation on Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Program, (79 Fed. Reg. 1,918-2,073, January 10, 2014) (to be codified at 42 C.F.R. pts. 409, 417, 422 et al.) Proposed Regulation on Exchange and Insurance Market Standards for 2015 and Beyond (79 Fed. Reg. 15,808-15,879, March 21, 2014) (to be codified at 45 C.F.R. pts. 146, 147, 148 et al.) Proposed Regulation on Minimum Essential Coverage and Other Rules Regarding Shared Responsibility Payment for Individuals (79 Fed. Reg. 4,302-4,308, January 27, 2014) (to be codified at 26 C.F.R. pt. 1) Proposed Regulation on HHS Notice of Benefit and Payment Parameters for 2016 (79 Fed. Reg. 70,674-70,760, November 26, 2014) (to be codified at 45 C.F.R. pts. 144, 147 et al.) Various issues relating to the Patient Protection and Affordable Care Act (P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152), including caps on compensation deductibility required under section 9014, implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, Grandfathering, health savings accounts (HSAs) and flexible spending accounts (FSAs) changes, CMS claims database, IPAB, CLASS program, employer mandate, medical loss ratio, medical malpractice reform, exchanges, impact on small business, provider network adequacy, definition of small group market, reporting requirements for issuers and applicable large employers, premium stabilization programs, the Small Business Tax Credit, incompleteness or inaccuracy of cost impact analyses, lack of quantified benefit analysis, need for empirical data sources on which to base costs and benefits, ERISA preemption, HSA and FSA accounts; Public Health Service Act (P.L. 78-410), Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) (P.L. 93-406), including regulatory process and legislative corrections to the ERISA preemption; deliver reform changes to Medicare Advantage and Medicare Prescription Drug (Part D) programs, including rebates and non-interference with prescription drug prices; entitlement reform; health information technology; legal protections against certain self-referral to physician owned hospitals

Client expense: $21,250,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Deposit Insurance Corporation (FDIC), Federal Housing Finance Agency (FHFA), Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), General Services Administration (GSA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Fish & Wildlife Service (USFWS), U.S. Forest Service, U.S. Trade Representative (USTR), White House Office

P.L.112-25, The Budget Control Act (Sections regarding the impact of Medicare sequestration on hospitals) H.R.351, Protecting Seniors Access to Medicare Act of 2013 (All sections of full text) H.R.2027, Expanding Patients Access to Quality Care Act of 2013 (All sections of full text) H.R.3121, American Health Care Reform Act of 2013 (All sections of full text)H.R.3698, Two-Midnight Rule Delay Act of 2013 (All sections of full text) H.R.3796, Comprehensive Care Payment Innovation Act (All sections of full text) S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014 (All sections of full text) Draft Senate legislation known as the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act. Discussions involving group purchasing organizations. Discussions regarding the status of construction of new veteran's affairs facility in the Denver metro area.

Client expense: Not reported · Firm income: $130,000

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

P.L.112-25, The Budget Control Act (Sections regarding the impact of Medicare sequestration on hospitals) H.R.351, Protecting Seniors' Access to Medicare Act of 2013 (All sections of full text) H.R.2027, Expanding Patients' Access to Quality Care Act of 2013 (All sections of full text) H.R.3121, American Health Care Reform Act of 2013 (All sections of full text) H.R.3698, Two-Midnight Rule Delay Act of 2013 (All sections of full text) H.R.3796 Comprehensive Care Payment Innovation Act (All sections of full text) S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014 (All sections of full text) Draft Senate legislation known as the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act Discussions involving group purchasing organizations Discussions regarding the status of construction of new veteran's affairs facility in the Denver metro area. P.L.113-146, Veterans Access, Choice, and Accountability Act of 2014 (Section 105. Prompt Payment by Department of Veterans Affairs) Monitored legislative branch oversight of executive branch-led Ebola treatment protocol for hospitals. Monitored draft House Ways and Means legislation entitled "The Hospital Improvements for Payment Act of 2014."

Client expense: Not reported · Firm income: $40,000

Government targets: Environmental Protection Agency (EPA), HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Health care coverage and payment options in tax reform discussions Policies affecting nurse practitioner education and workforce Definition of essential health benefits Health information technology and electronic health records Mental health services and violence prevention Draft legislation on reauthorization of the National Quality Forum Coverage and payment for health care services furnished to undocumented immigrant children H.R. 297/S. 1557 - Childrens Hospital GME Support Reauthorization Act H.R. 628/S. 195 - Mental Health in Schools Act H.R. 647 - Achieving a Better Life Experience (ABLE) Act H.R. 669 - Sudden Unexpected Death Data Enhancement and Awareness Act H.R. 1249/S. 1756 - Common Sense Nutrition Disclosure Act H.R. 1281/S. 1417 - Newborn Screening Saves Lives Reauthorization Act H.R. 1427 - Truth in Healthcare Marketing Act H.R. 1791 - Medical Preparedness Allowable Use Act H.R. 1947/H.R. 2642 - Federal Agriculture Reform and Risk Management (FARRM) Act H.R. 2019 - Gabriella Miller Kids First Research Act H.R. 2285 - Strategies to Address Antimicrobial Resistance Act H.R. 2575 - Save American Workers Act H.R. 2663/S. 1422 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings H.R. 2833/S. 2278 - Safeguarding Care of Patients Everywhere (SCOPE) Act H.R. 2986 - Protecting Access to Primary Care Act H.R. 3102 - Nutrition Reform and Work Opportunity Act H.R. 3121 - American Health Care Reform Act H.R. 3147 - Food Labeling Modernization Act H.R. 3306/S. 2662 - Telehealth Enhancement Act H.R. 3471/S. 1696 - Women's Health Protection Act H.R. 3527 - Poison Center Network Act H.R. 3717 - Helping Families in Mental Health Crisis Act H.R. 3742 - Antibiotic Development to Advance Patient Treatment (ADAPT) Act H.R. 4118 - Suspending the Individual Mandate Penalty Law Equals (SIMPLE) Fairness Act H.R. 4290 - Wakefield Act H.R. 4574 - Strengthening Mental Health in Our Communities Act H.R. 4631/S. 2449 - Autism Collaboration, Accountability, Research, Education and Support (Autism CARES) Act H.R. 4673 - Bundling and Coordinating Post-Acute Care (BACPAC) Act H.R. 4783 - Promoting Healthy Minds for Safer Communities Act H.R. 4888 - Coordinated Recovery Initiative for Babies (CRIB) Act H.R. 5279 - Sugar-Sweetened Beverages Tax (SWEET) Act S. 264/H.R. 1263 - Excellence in Mental Health Act S. 689 - Mental Health Awareness and Improvement Act S. 696 - Safe Chemicals Act S. 744/H.R. 15 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 954 - Agriculture Reform, Food, and Jobs Act S. 1009 - Chemical Safety Improvement Act S. 1014 - Youth Sports Concussion Act S. 1086 - Safe Child Care Act/Child Care and Development Block Grant Reauthorization Act S. 1152 - Building a Health Care Workforce for the Future Act S. 1417 - Newborn Screening Saves Lives Act S. 1697 - Strong Start for Americas Children Act S. 1758 - Quality Data, Quality Healthcare Act S. 1932/H.R. 3890 - Better Care, Lower Cost Act S. 2047 - Protecting Children from Electronic Cigarette Advertising Act S. 2154 - Emergency Medical Services for Children Reauthorization Act S. 2229 - Expanding Primary Care Access and Workforce Act S. 2434/H.R. 4865 - Family Coverage Act S. 2491 - Medicare Protection Act S. 2581 - Child Nicotine Poisoning Prevention Act S. 2728 - Community-Based Medical Education Act S. 2804 - Family Asthma Act

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions and Global Capital Standards. H.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019. Issue: Terrorism Insurance H.R. 911, Competitive Health Insurance Reform Act of 2013. Issue: McCarran-Ferguson Act Issues H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues. H.R. 4510 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R. 4871 - TRIA Reform Act of 2014. To reauthorize the Terrorism Risk Insurance Act of 2002. Issue: Terrorism Insurance H.R. 5461, a bill to clarify the application of certain leverage and risk-based requirements under the Dodd-Frank Wall Street Reform and Consumer Protection Act, to improve upon the definitions provided for points and fees in connection with a mortgage transaction. Issue: Capital Standards, Basel III S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards S. 2244, a bill to extend the termination date of the Terrorism Insurance Program established under the Terrorism Insurance Act of 2002. Issue: Terrorism Insurance S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III Tracking: H.R. 1155, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing S. 534, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing

Client expense: $1,440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions and Global Capital Standards. H.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019. Issue: Terrorism Insurance S. 2244, a bill to extend the termination date of the Terrorism Insurance Program established under the Terrorism Insurance Act of 2002. Issue: Terrorism Insurance H.R. 4871 - TRIA Reform Act of 2014. To reauthorize the Terrorism Risk Insurance Act of 2002. Issue: Terrorism Insurance H.R. 911, Competitive Health Insurance Reform Act of 2013. Issue: McCarran-Ferguson Act Issues H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues. H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 4510 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R. 5461, a bill to clarify the application of certain leverage and risk-based requirements under the Dodd-Frank Wall Street Reform and Consumer Protection Act, to improve upon the definitions provided for points and fees in connection with a mortgage transaction. Issue: Capital Standards, Basel III Tracking: H.R. 1155, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing S. 534, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

INS - Third Quarter Report - 2014 Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions and Global Capital Standards. H.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019 (under current law the Program expires on December 31, 2014). Issue: Terrorism Insurance H.R. 911, Competitive Health Insurance Reform Act of 201. Issue: McCarran-Ferguson Act Issues H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues. H.R. 4510 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R. 4871 - TRIA Reform Act of 2014. To reauthorize the Terrorism Risk Insurance Act of 2002. Issue: Terrorism Insurance H.R. 5461, a bill to clarify the application of certain leverage and risk-based requirements under the Dodd-Frank Wall Street Reform and Consumer Protection Act, to improve upon the definitions provided for points and fees in connection with a mortgage transaction. Issue: Capital Standards, Basel III S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards S. 2244, a bill to extend the termination date of the Terrorism Insurance Program established under the Terrorism Insurance Act of 2002. Issue: Terrorism Insurance S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III Tracking: H.R. 1155, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing S. 534, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing

Client expense: $1,690,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Health care coverage and payment options in tax reform discussions Policies affecting nurse practitioner education and workforce Definition of essential health benefits Health information technology and electronic health records Mental health services and violence prevention Draft legislation on reauthorization of the National Quality Forum Coverage and payment for health care services furnished to undocumented immigrant children H.R. 297/S. 1557 - Childrens Hospital GME Support Reauthorization Act H.R. 628/S. 195 - Mental Health in Schools Act H.R. 669 - Sudden Unexpected Death Data Enhancement and Awareness Act H.R. 1249/S. 1756 - Common Sense Nutrition Disclosure Act H.R. 1281/S. 1417 - Newborn Screening Saves Lives Reauthorization Act H.R. 1427 - Truth in Healthcare Marketing Act H.R. 1791 - Medical Preparedness Allowable Use Act H.R. 1947/H.R. 2642 - Federal Agriculture Reform and Risk Management (FARRM) Act H.R. 2019 - Gabriella Miller Kids First Research Act H.R. 2285 - Strategies to Address Antimicrobial Resistance Act H.R. 2575 - Save American Workers Act H.R. 2663/S. 1422 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings H.R. 2833/S. 2278 - Safeguarding Care of Patients Everywhere (SCOPE) Act H.R. 2986 - Protecting Access to Primary Care Act H.R. 3102 - Nutrition Reform and Work Opportunity Act H.R. 3121 - American Health Care Reform Act H.R. 3147 - Food Labeling Modernization Act H.R. 3306/S. 2662 - Telehealth Enhancement Act H.R. 3471/S. 1696 - Women's Health Protection Act H.R. 3527 - Poison Center Network Act H.R. 3717 - Helping Families in Mental Health Crisis Act H.R. 3742 - Antibiotic Development to Advance Patient Treatment (ADAPT) Act H.R. 4118 - Suspending the Individual Mandate Penalty Law Equals (SIMPLE) Fairness Act H.R. 4290 - Wakefield Act H.R. 4574 - Strengthening Mental Health in Our Communities Act H.R. 4631/S. 2449 - Autism Collaboration, Accountability, Research, Education and Support (Autism CARES) Act H.R. 4673 - Bundling and Coordinating Post-Acute Care (BACPAC) Act H.R. 4783 - Promoting Healthy Minds for Safer Communities Act H.R. 4888 - Coordinated Recovery Initiative for Babies (CRIB) Act H.R. 5279 - Sugar-Sweetened Beverages Tax (SWEET) Act S. 264/H.R. 1263 - Excellence in Mental Health Act S. 689 - Mental Health Awareness and Improvement Act S. 696 - Safe Chemicals Act S. 744/H.R. 15 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 954 - Agriculture Reform, Food, and Jobs Act S. 1009 - Chemical Safety Improvement Act S. 1014 - Youth Sports Concussion Act S. 1086 - Safe Child Care Act/Child Care and Development Block Grant Reauthorization Act S. 1152 - Building a Health Care Workforce for the Future Act S. 1417 - Newborn Screening Saves Lives Act S. 1697 - Strong Start for Americas Children Act S. 1758 - Quality Data, Quality Healthcare Act S. 1932/H.R. 3890 - Better Care, Lower Cost Act S. 2047 - Protecting Children from Electronic Cigarette Advertising Act S. 2154 - Emergency Medical Services for Children Reauthorization Act S. 2229 - Expanding Primary Care Access and Workforce Act S. 2434/H.R. 4865 - Family Coverage Act S. 2491 - Medicare Protection Act S. 2581 - Child Nicotine Poisoning Prevention Act S. 2728 - Community-Based Medical Education Act S. 2804 - Family Asthma Act

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

H.R. 4, Jobs for America Act H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 523, Protect Medical Innovation Act of 2013 H.R. 581, First Responder Medical Device Tax Relief Act H.R. 582, Healthcare Tax Relief and Mandate Repeal Act H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 781, Medicare Identity Theft Prevention Act of 2013 H.R. 903 / S. 399, American Job Protection Act H.R. 1248 / S. 610, Family Health Care Flexibility Act H.R. 1254 /S. 2546, Auto Enroll Repeal Act H.R. 1295, Medical Device Tax Elimination Act H.R. 1558 / S. 24, Small Business Health Relief Act of 2013 H.R. 1735, In It All Together Act H.R. 1780, To provide that the only health plans that the Federal Government may make available to the President, Vice President, Members of Congress, and Federal employees are those created under the Patient Protection and Affordable Care Act or offered through a health insurance exchange H.R. 2194 / S. 1031, Family and Retirement Health Investment Act of 2013 H.R. 2575, Save American Workers Act H.R. 2667, Authority for Mandate Delay Act H.R. 2668, Fairness for American Families Act H.R. 2674, Job Creation Act of 2013 H.R. 2835, Restoring Access to Medication Act of 2013 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013 H.R. 2988 / S. 701 / S. 1188, Forty Hours Is Full Time Act of 2013 H.R. 3077, TELE-MED Act of 2013 H.R. 3121, American Health Care Reform Act of 2013 H.R. 3124, Investing in Permanency for Youth in Foster Care Act H.R. 3204, Drug Quality and Security Act H.R. 3367, To amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 or 2015 H.R. 3419, Small Business Fairness in Obamacare Act H.R. 3462 / S. 1735, Self-Insurance Protection Act H.R. 3522, Employee Health Care Protection Act of 2013 H.R. 4118, Suspending the Individual Mandate Penalty Law Equals Fairness (SIMPLE) Act H.R. 4160, Keep the Promise to Seniors Act of 2014 H.R. 4302, Protecting Access to Medicare Act of 2014 H.R. 4414, Expatriate Health Coverage Clarification Act of 2014 H.R. 5183 / S. 2783, Value Based Insurance Design for Better Care Act of 2014 H.R. 5213, Simplifying Technical Aspects Regarding Seasonality (STARS) Act of 2014 H.R. 5557, Streamlining Verification for Americans Act S. 232, Medical Device Access and Innovation Protection Act S. 603, Jobs and Premium Protection Act S. 612, Social Security Number Protection Act of 2011 S. 1031, Family and Retirement Health Investment Act of 2013 S. 1488, A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes S. 1647, Restoring Access to Medication Act Proposed Regulation on the Patient Protection and Affordable Care Act; standards related to Essential Health Benefits, Actuarial Value, and Accreditation (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts. 147, 155, 156) Proposed Regulation on the Health Insurance Market Rules; Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012) (to be codified at 45 C.F.R. pts. 144, 147, 150) Proposed Regulation on the HHS Notice of Benefit and Payment Parameters for 2014 (77 Fed. Reg. 73,118-73,218, December 7, 2012) (to be codified at 45 C.F.R. pts. 153, 155, 156, 157, 158) Proposed Regulation on the Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation, (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts. 147, 155, 156) Proposed Regulation on Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing (78 Fed. Reg. 4,594-4,724, January 22, 2013) (to be codified at 42 C.F.R. pts. 430, 431, 433, 435, 440, 447, 457) Proposed Regulation on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (77 Fed. Reg. 70,620-70,642, November 26, 2012) (to be codified at 26 C.F.R. pt. 54) Proposed Regulation on Shared Responsibility for Employers Regarding Health Coverage (78 Fed. Reg. 218-253, January 2, 2013) (to be codified at 26 C.F.R. pts. 1, 54, 301) Proposed Regulation on Information Reporting of Minimum Essential Coverage (78 Fed. Reg. 54,986-54,996, September 9, 2013) (to be codified at 26 C.F.R. pts. 1, 301) Proposed Regulation on Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans (78 Fed. Reg. 54,996-55,013, September 9, 2013) (to be codified at 26 C.F.R. pt. 301) Proposed Regulation regarding the Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program (78 Fed. Reg. 15,553-15,558, March 11, 2013) (to be codified at 45 C.F.R. pts. 155, 156) Proposed Regulation on the Health Insurance Providers Fee (78 Fed. Reg. 14,034-14,046, March 4, 2013) (to be codified at 26 C.F.R. pt. 57) Proposed Regulation on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit (78 Fed. Reg. 25,909-25,916, May 3, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Regulation on HHS Notice of Benefit and Payment Parameters for 2015 (78 Fed. Reg. 72,322-72,392, December 2, 2013) (to be codified at 45 C.F.R. pts. 144, 147, 153, 155, 156) Proposed Regulation on Amendments to Excepted Benefits (78 Fed. Reg. 77,632-77,642, December 24, 2013) (to be codified at 29 C.F.R. pt. 2590) Proposed Regulation on Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Program, (79 Fed. Reg. 1,918-2,073, January 10, 2014) (to be codified at 42 C.F.R. pts. 409, 417, 422 et. al.) Proposed Regulation on Exchange and Insurance Market Standards for 2015 and Beyond (79 Fed. Reg. 15,808-15,879, March 21, 2014) (to be codified at 45 C.F.R. pts. 146, 147, 148 et al.) Proposed Regulation on Ninety-Day Waiting Period Limitation (79 Fed. Reg. 10,320-10,325, February 24, 2014) (to be codified at 29 C.F.R. pt. 2590; 45 C.F.R. pt. 147; and 26 C.F.R. pt. 147) Proposed Regulation on Minimum Essential Coverage and Other Rules Regarding Shared Responsibility Payment for Individuals (79 Fed. Reg. 4,302-4,308, January 27, 2014) (to be codified at 26 C.F.R. pt. 1) Draft Guidance Notices on Self-Monitoring Blood Glucose Test Systems for Over-the-Counter Use (79 Fed. Reg. 829-830, January 7, 2014) Statement for the Record in Response to a Notice of Meeting on Employee welfare and Pension Benefit Plans (79 Fed. Reg. 28,555-28,556, May 16, 2014) Various issues relating to the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, ERISA preemption, Grandfathering, health savings accounts (HSAs), health reimbursement accounts (HRAs), and flexible spending accounts (FSAs) changes, CMS claims database, IPAB, CLASS program, employer mandate, reporting requirements, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, caps on compensation deductibility required under section 9014; Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including regulatory process and legislative corrections to the ERISA preemption, the impact on small business, the small business tax credit, insurance coverage, financing, delivery reform; changes to Medicare Advantage and Medicare Prescription Drug (Part D) programs non-interference with prescription drug prices; entitlement reform; forty-hour work week; health information technology

Client expense: $28,350,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Deposit Insurance Corporation (FDIC), Federal Housing Finance Agency (FHFA), Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Occupational Safety & Health Administration (OSHA), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Fish & Wildlife Service (USFWS), U.S. Forest Service, U.S. Trade Representative (USTR), White House Office

P.L.113-146, Veterans Access, Choice, and Accountability Act of 2014 (Section 105. Prompt Payment by Department of Veterans Affairs) H.R.2450, Veterans Access to Care through Choice, Accountability, and Transparency (All sections of full text) H.R.4810, Veterans Access to Care Act of 2014 (All sections of full text) Discussions pertaining to hospital-centric U.S. job creation as tabulated by DOL Bureau of Labor Statistics. Discussions regarding FAA regulations impacting a health care facility in Virginia P.L.112-25, The Budget Control Act (Sections regarding the impact of Medicare sequestration on hospitals) H.R.351, Protecting Seniors Access to Medicare Act of 2013 (All sections of full text) H.R.2027, Expanding Patients Access to Quality Care Act of 2013 (All sections of full text) H.R.3121, American Health Care Reform Act of 2013 (All sections of full text) H.R.3698, Two-Midnight Rule Delay Act of 2013 (All sections of full text) H.R.3796, Comprehensive Care Payment Innovation Act (All sections of full text) S.2082, Two-Midnight Rule Coordination and Improvement Act of 2014 (All sections of full text) Draft Senate legislation known as the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act. Monitored discussions involving group purchasing organizations

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1254 - Auto Enroll Repeal ActPatient Protection and Affordable Care Act (P.L. 111148) - Sections 1201, 1301, 1302, 1303, 1304, 1311, 1401, 1411, 1412, 1414, 1502, 1512, 1513, 1514, 4205 Section 4980H Budget Resolution - HConRes25; SConRes8 (SNAP provisions) S. 701 - Forty Hours Is Full Time Act of 2013 H.R. 2988 - Forty Hours Is Full Time Act of 2013 S. 1188 - Forty Hours Is Full Time Act of 2013 H.R. 2575 - Save American Workers Act of 2013 H.ConRes25 - Establishing the budget for the United States Government for fiscal year 2014 and setting forth appropriate budgetary levels for fiscal years 2015 through 2023 S.ConRes 8 - An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2014, revising the appropriate budgetary levels for fiscal year 2013, and setting forth the appropriate budgetary levels for fiscal years 2015 through 2023 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2014 H.R. 2667 - Authority for Mandate Delay Act H.R. 3367 - Small Business and Family Relief Act H.R. 3522 Employee Health Protection Act H.R. 3489 To Amend Sec. 1341 of the Patient Protection and Affordable Care Act to repeal the funding mechanism for the transitional reinsurance program H.J.Res. 77 Food Drug and Administration Continuing Appropriations Resolution, 2014 H.R. 3121 American Health Care Reform Act H.R. 3419 Small Business Fairness in Obamacare Act S. 1735 Self-Insurance Protection Act S. 1724 - Union Tax Fairness Act of 2013 S. 2176 To revise reporting requirements under the Patient Protection and Affordable Care Act to preserve the privacy of individuals, and for other purposes. S. 2168 Small Business Stability Act H.R. 4302 - Protecting Access to Medicare Act of 2014 S.2546 - A bill to repeal a requirement that new employees of certain employers be automatically enrolled in the employer's health benefits H.R. 4735/S.2253 - Health Care Fairness and Stability Act S.2205 - Small Business Fairness in Health Care Act S.2191 A bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage, and for other purposes Senate Draft - Financial Services and General Government Appropriations Act, 2015 Senate Draft - Departments Of Labor, Health And Human Services, And Education, And Related Agencies Fiscal Year 2015 Appropriations Bill H.R. 5557 - Streamlining Verification for Americans Act H.R.4 Jobs for America Act

Client expense: $140,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

H.R. 4, Jobs for America Act (Camp) - ACA provisions H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program H.R. 3598, Catastrophic Plan Bill (Fortenberry) - expanded access to catastrophic plans H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) - ACA risk corridor program H.R. 4406, Taxpayer Bailout Protection Act (Lance) - ACA risk corridor program H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) - relief from ACA for expatriate health plans H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) - ACA transitional reinsurance program H.R. 5175, Protecting Americans from Illegal Bailouts Act (Lance) - ACA risk corridor program S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes S. 482, Health Insurance Rate Review Act (Feinstein) - rate review S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements S. 1671, (Manchin-Kirk) - individual mandate delay S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) - ACA risk corridor program S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) - ACA transitional reinsurance program S. 2578, Protect Women's Health From Corporate Interference Act (Murray) - contraceptive coverage S. 2733, Obamacare Opt-Out Act (McCain-Barrasso) - certification process for opting out of ACA individual mandate S. 2801, Health Care Consumer Choices Preservation Act (Enzi) - conditions on automatic renewals Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to the continuation of reporting requirements for state LTCI partnership programs; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; and issues related to supplemental products, and other issues relating to health care reform implementation.

Client expense: $2,010,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

H.R. 4, Jobs for America Act (Camp) - ACA provisions. H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy. H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules. H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy. H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage. H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy. H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review. H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy. H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents. H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes. H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers. H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate. H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees. H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms. H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans. H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties. H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee. H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review. H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay. H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage. H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program. H.R. 3598, Catastrophic Plan Bill (Fortenberry) - expanded access to catastrophic plans. H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs. H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs. H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs. H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs. H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties. H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market. H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) - ACA risk corridor program. H.R. 4406, Taxpayer Bailout Protection Act (Lance) - ACA risk corridor program. H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) - relief from ACA for expatriate health plans. H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) - ACA transitional reinsurance program. H.R. 5175, Protecting Americans from Illegal Bailouts Act (Lance) - ACA risk corridor program. S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes. S. 482, Health Insurance Rate Review Act (Feinstein) - rate review. S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers. S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents. S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms. S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims. S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements. S. 1671, (Manchin-Kirk) - individual mandate delay. S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties. S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans. S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program. S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges. S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage. S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees. S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer. S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment. S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines. S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment. S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements. S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) - ACA risk corridor program. S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) - ACA transitional reinsurance program. S. 2578, Protect Women's Health From Corporate Interference Act (Murray) - contraceptive coverage. S. 2733, Obamacare Opt-Out Act (McCain-Barrasso) - certification process for opting out of ACA individual mandate. S. 2801, Health Care Consumer Choices Preservation Act (Enzi) - conditions on automatic renewals.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions and Global Capital Standards. H.R. 911, Competitive Health Insurance Reform Act of 201. Issue: McCarran-Ferguson Act IssuesH.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019 (under current law the Program expires on December 31, 2014). Issue: Terrorism Insurance H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards H.R. 5461, Draft bill pertaining to insurance capital standards. Issue: Capital Standards for Insurers. H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues.

Client expense: $1,030,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions and Global Capital Standards. H.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019 (under current law the Program expires on December 31, 2014). Issue: Terrorism Insurance H.R. 911, Competitive Health Insurance Reform Act of 201. Issue: McCarran-Ferguson Act Issues H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues. H.R. 4510 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III S. 2244, a bill to extend the termination date of the Terrorism Insurance Program established under the Terrorism Insurance Act of 2002. Issue: Terrorism Insurance H.R. 4871 - TRIA Reform Act of 2014. To reauthorize the Terrorism Risk Insurance Act of 2002. Issue: Terrorism Insurance H.R. 5461, a bill to clarify the application of certain leverage and risk-based requirements under the Dodd-Frank Wall Street Reform and Consumer Protection Act, to improve upon the definitions provided for points and fees in connection with a mortgage transaction. Issue: Capital Standards, Basel III Tracking: H.R. 1155, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing S. 534, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Contacts in support of No Taxpayer Funding for Abortion Act (H.R. 7, S. 946), to codify government-wide policy against funding abortion. Contacts in support of Abortion Insurance Full Disclosure Act (H.R. 3279, S. 1848), legislation to correct concealment practices pertaining to abortion coverage in exchange-participating health plans. (continued)Contacts in support of the Pain-Capable Unborn Child Protection Act (H.R. 1797), to protect pain-capable unborn children beginning at 20 weeks fetal age (passed by the House of Representatives on June 18, 2013), and Senate companion legislation (S. 1670). Contacts in support of Prenatal Nondiscrimination Act (PRENDA), to ban sex-selection abortions (S. 138, HR 447). Contacts in support of Child Interstate Abortion Notification Act (CIANA)(S. 369, HR 732), to require an abortionist to notify a parent before performing an abortion on a minor from a different state, with certain exceptions. Contacts in support of the Health Care Conscience Rights Act (HR 940, S. 1204), to prevent the imposition of regulatory mandates that violate the religious or moral convictions of those who purchase or provide health insurance, to prevent any level of government from discriminating against health care providers who decline to participate in abortions, and to empower victims to seek relief in court for violations of the federal conscience laws. Contacts in opposition to the "Protect Women's Health from Corporate Interference Act" (S. 2578/H.R. 5051), legislation which would further empower the Obama Administration to mandate that certain insurance plans cover abortion pills such as RU-486, surgical abortion (including late abortions), assisted suicide, or anything else the Administration chooses to classify as preventive services, overriding all existing federal laws that protect religious freedom and conscience rights; the Senate refused to invoke cloture to proceed to this legislation on July 16, 2014. Contacts in support of carrying over abortion-related limitation provisions in FY 2015 appropriations bills, including Hyde Amendment in HHS appropriations bill, and other abortion limitation provisions in Commerce-Justice-Science (H.R. 4660/S. 2437), Financial Services (H.R. 5016), and State-Foreign Operations (H.R. 5013/S. 2499) appropriations bills; no position on State-Foreign Operations provision conforming language related to the Peace Corps to comparable HHS language. Contacts in support of curtailing U.S. funding of UNFPA. Contacts in opposition to language proposed by Sen. Shaheen to State/Foreign Operations appropriations bill (S. 2499) to preclude a president from re-applying pro-life conditions to private organizations that receive foreign aid grants (e.g., "Mexico City Policy"), as adopted in Senate Appropriations Committee June 19, 2014; no position on State-Foreign Operations provision conforming language related to the Peace Corps to comparable HHS language. Contacts in support of the Homeland Security Respect for Life Act (H.R. 493), to prevent federal funding of abortion under programs within the Department of Homeland Security, with certain exceptions, and comparable limitation language ("Aderholt-Carter Amendment") to FY 2015 Homeland Security appropriations bill (H.R. 4903); the Aderholt amendment was adopted in House Appropriations Committee, June 11, 2014, 29-18. Contacts in support of S. 154/HR 346, to prevent coverage of abortion, with certain exceptions, in "multi-state" (national) health plans, created by PL 111-148, to be administered by the Office of Personnel Management, and comparable language ("Harris-Nunnelee Amendment"), added to FY 2015 Financial Services appropriations bill (H.R. 5016) at House Appropriation Committee markup, June 25, 2014, 29-21. H.R. 5016 passed the House July 16, 2014, without challenge to this provision. Contacts in support of the Title X Abortion Provider Prohibition Act (HR 217/S. 135). Consultations regarding other legislative concepts relating to Title X, including legislation dealing with adoption-counseling requirements with respect to Title X, including H.R. 3062, S. 1539, and other draft legislation not introduced; NRLC took no position on these measures. Consultations regarding abortion-related components of "American Health Care Reform Act" (H.R. 3121). See HCR page for additional information on contacts on this legislation. Consultations regarding proposed rule published by Office of Personnel Management in August 8, 2013 Federal Register, 78 Fed. Reg. 48337 (2013), concerning subsidies for health plans to be purchased by members of Congress and certain congressional staff on Obamacare exchanges. (Final Rule published Oct. 2, 2013.) The OPM proposal would allow payments to flow through OPM to plans that cover elective abortion, in violation of the Smith Amendment, a limitation amendment contained in the Financial Services appropriations bill (H.R. 5016). (continued)Contacts in support of H.R. 4698, the Every Child is a Blessing Act (legislation to curb use of wrongful birth and wrongful life causes of action), introduced by Rep. Palazzo on May 21, 2014. Consultations regarding possible offering of related provisions as amendment to H.R. 5016 (not offered). Consultations regarding anti-trafficking legislation, H.R. 3530; no position taken on substitute as reported by the House Judiciary Committee on May 15, 2014, and approved by the House on May 20, 2014. Consultations regarding H.R. 2772, "Rape Survivor Child Custody Act"; no position. Contacts in opposition to "Women's Health Protection Act" (H.R. 3471, S. 1696), a proposed federal statute to invalidate virtually all state and federal regulations pertaining to abortion, including testimony by National Right to Life president at hearing on S. 1696 before the Senate Judiciary Committee, July 15, 2014. Contacts explaining nonsupport for H.R. 1091/S. 583 and H.R. 2764, based on lack of clarity and erroneous legal premises. Consultations regarding possible abortion-related revisions to: Empowering Patients First Act (H.R. 2300, Rep. Price); H.R. 3121, Rep. Roe); and conceptual outline of health-care legislation (not introduced) by Senators Hatch/Coburn/Burr. Contacts in support of "Heartbeat Informed Consent Act" (H.R. 5551), legislation to require that if an abortionist performs an ultrasound, the pregnant woman is offered an opportunity to view the ultrasound.

Client expense: $106,475 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) antitrust policy16. Specific Lobbying Issues (continued): H.R. 544, LIBERTY Act (Gingrey-Matheson) age rating rules H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) antitrust policy H.R. 762, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 911, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R. 1019, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) antitrust policy H.R. 1205, Patients Right to Know Act (Walden) disclosures on SBC documents H.R. 1558, Small Business Health Relief Act (Collins) HIT repeal, other ACA changes H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) MLR impact on agents and brokers H.R. 2668, Fairness for American Families Act (Young) delay of ACA individual mandate H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) short-term disability program for federal employees H.R. 3121, American Health Care Reform Act (Roe) replacement health reforms H.R. 3350, Keep Your Health Plan Act (Upton) continuation of existing plans H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) delay of open enrollment and individual mandate penalties H.R. 3489, (Tiberi) repeal of ACA transitional reinsurance fee H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) rate review H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) individual mandate delay H.R. 3522, Employee Health Care Protection Act (Cassidy) continuation of current group coverage H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) repeal of ACA risk corridor program H.R. 3598, Catastrophic Plan Bill (Fortenberry) expanded access to catastrophic plans H.R. 3745, Coverage Protection Act (Kirkpatrick) continuation of coverage for consumers unable to enroll in QHPs H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) ACA reinsurance and risk corridor programs H.R. 3851, No Bailouts for Insurance Industry Act (Lance) ACA reinsurance and risk corridor programs H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) ACAs reinsurance, risk corridor, and risk adjustment programs H.R. 4118, SIMPLE Fairness Act (Jenkins) delay in ACA individual mandate penalties H.R. 4302, Protecting Access to Medicare Act (Pitts) ACA Limits on Deductibles for Plans in Small Group Market H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) ACA risk corridor program H.R. 4406, Taxpayer Bailout Protection Act (Lance) ACA risk corridor program H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) relief from ACA for expatriate health plans H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) ACA transitional reinsurance program S. 24, Small Business Health Relief Act (Portman) HIT repeal, other ACA changes S. 482, Health Insurance Rate Review Act (Feinstein) rate review S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) MLR impact on agents and brokers S. 764, Patients Right to Know Act (Cornyn) disclosures on SBC documents S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) model disclosure forms S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) third party review of disputed claims S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) continuation of existing plans, notification requirements S. 1671, (Manchin-Kirk) individual mandate delay S. 1693, ACA Enrollment Extension Act (Shaheen) extending open enrollment, delaying individual mandate penalties S. 1699, Continuous Coverage Act (Mark Udall) continuation of existing plans S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) repeal of ACA risk corridor program S. 1729, Expanded Consumer Choice Act (Begich) adding copper level of coverage to ACA Exchanges S. 1866, Coverage Protection Act (Merkley) continuation of coverage, retroactive coverage S. 2166, Treating Families Fairly Act (Manchin) ACA determinations of full-time equivalent employees S. 2168, Small Business Stability Act (Heitkamp) ACA definition of a large employer S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) ACA direct enrollment16. Specific Lobbying Issues (continued): S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) offering health insurance coverage across state lines S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) access for independent agents and brokers to information about Exchange enrollments. S. 2176, Commonsense Reporting Act (Warner) ACA reporting requirements S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) ACA risk corridor program S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) ACA transitional reinsurance program Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to the continuation of reporting requirements for state LTCI partnership programs; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; and issues related to supplemental products, and other issues relating to health care reform implementation.

Client expense: $2,530,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Social Security Administration (SSA), Treasury, Dept of, White House Office

HR 3698 Two-Midnight Rule Delay Act of 2013 (all sections of full text) (support) S 2082 Two-Midnight Rule Coordination and Improvement Act of 2014 (all sections of full text)(support) PL 112-25 The Budget Control Act (sections regarding the impact of Medicare sequestration on hospitals) Draft Senate legislation known as the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act Monitored discussions involving group purchasing organizations HR 351 Protecting Seniors' Access to Medicare Act of 2013 (all sections of full text) HR 3796 Comprehensive Care Innovation Act (all sections of full text) HR 3121 American Health Care Reform Act of 2013 (all sections of full text) S 1845 Emergency Unemployment Compensation Extension Act (sections pertaining to pay-for proposals) HR 2027 Expanding Patients' Access to Quality Care Act of 2013 (all sections of full text)(Oppose) S. 2450 Veterans' Access to Care through Choice, Accountability, and Transparency (sections pertaining to prompt-pay provisions for non-VA providers) HR 3230 Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014 (sections pertaining to prompt-pay provisions for non-VA providers) HR 4810 Veteran Access to Care Act of 2014 (sections pertaining to prompt-pay provisions for non-VA providers) Discussions pertaining to hospital centric U.S. job creation as tabulated by DOL Bureau of Labor Statistics

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1254 - Auto Enroll Repeal ActPatient Protection and Affordable Care Act (P.L. 111148) - Sections 1201, 1301, 1302, 1303, 1304, 1311, 1401, 1411, 1412, 1414, 1502, 1512, 1513, 1514, 4205 Section 4980H Budget Resolution - HConRes25; SConRes8 (SNAP provisions) S. 701 - Forty Hours Is Full Time Act of 2013 H.R. 2988 - Forty Hours Is Full Time Act of 2013 S. 1188 - Forty Hours Is Full Time Act of 2013 H.R. 2575 - Save American Workers Act of 2013 H.ConRes25 - Establishing the budget for the United States Government for fiscal year 2014 and setting forth appropriate budgetary levels for fiscal years 2015 through 2023 S.ConRes 8 - An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2014, revising the appropriate budgetary levels for fiscal year 2013, and setting forth the appropriate budgetary levels for fiscal years 2015 through 2023 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2014 H.R. 2667 - Authority for Mandate Delay Act H.R. 3367, the Small Business and Family Relief Act H.R. 3522 Employee Health Protection Act H.R. 3489 To Amend Sec. 1341 of the Patient Protection and Affordable Care Act to repeal the funding mechanism for the transitional reinsurance program H.J.Res. 77 Food Drug and Administration Continuing Appropriations Resolution, 2014 H.R. 3121 American Health Care Reform Act H.R. 3419 Small Business Fairness in Obamacare Act S. 1735 Self-Insurance Protection Act S. 1724 - Union Tax Fairness Act of 2013 S. 2176 To revise reporting requirements under the Patient Protection and Affordable Care Act to preserve the privacy of individuals, and for other purposes. S. 2168 Small Business Stability Act H.R. 4302 - Protecting Access to Medicare Act of 2014 S.2546 - A bill to repeal a requirement that new employees of certain employers be automatically enrolled in the employer's health benefits H.R. 4735/S.2253 - Health Care Fairness and Stability Act S.2205 - Small Business Fairness in Health Care Act S.2191 A bill to amend the Internal Revenue Code of 1986 to repeal the excise tax on high cost employer-sponsored health coverage, and for other purposes Senate Draft - Financial Services and General Government Appropriations Act, 2015 Senate Draft - Departments Of Labor, Health And Human Services, And Education, And Related Agencies Fiscal Year 2015 Appropriations Bill

Client expense: $220,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

U.S. HOUSE OF REPRESENTATIVES Contacts in support of repealing the Patient Protection and Affordable Care Act, Public Law 111-148, because repeal would (continued)1) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 2) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment, and 6) eliminate the provisions related to shared decisionmaking because they are likely to be used, on balance, to dissuade patients from choosing life-saving treatment. Contacts in response to inquiries regarding implementation of certain elements of The Patient Protection and Affordable Care Act, Public Law 111-148, related to the denial of life-saving medical treatments. Contacts in regards to H.R. 3121, The American Health Care Reform Act of 2013 because of concerns it 1) replaces tax preference for employer-provided health insurance with a deduction for health insurance premiums and indexes the deductibility limit for health insurance to general inflation measured by the Consumer Price Index (CPI), rather than to medical inflation, which could lead to reduction in health insurance plan benefits, and 2) may suppress private, nongovernmental, health care spending beyond a governmentally imposed limit. Contacts regarding H.R.2300, the Empowering Patients First Act of 2013, because 1) the use of best practices guidelines could establish a federally managed limit on what medical treatment is expected to be provided, and set a bureaucratically dictated standard of care and 2) clarification is needed to ensure malpractice limits are not being made applicable to intentional denial of treatment for discriminatory reasons. Contacts regarding H.R. 1173, the Personalize Your Care Act of 2013, because 1) it provides for inadequate oversight regarding the creation of advance planning materials, websites, etc. in order to protect against the materials being crafted in a way that persuades patients to reject treatment they might otherwise choose, 2) unmonitored practitioner consultations could lead to patients forgoing treatment they would otherwise have wanted, and 3) it includes adverse changes to the Assisted Suicide Funding and Restriction Act. Contacts in regard to potential health reform legislation (not introduced) over concerns related to 1) the authority of any sort of health care commissions ability to restrict access to life-saving care, 2) premium price controls that might reduce the ability of insurance to cover life-saving care, 3) tax increases on health care or health insurance that create incentives for employers to significantly reduce health insurance plans, 4) efforts to prevent private health care spending from keeping up with medical inflation, and 5) malpractice limits being made applicable to intentional denial of treatment for discriminatory reasons. (continued)U.S. Senate Contacts in support of repealing The Patient Protection and Affordable Care Act, Public Law 111-148, because repeal would 1) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 2) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment, and 6) eliminate the provisions related to shared decisionmaking because they are likely to be used, on balance, to dissuade patients from choosing life-saving treatment. Contacts in response to inquiries regarding implementation of certain elements of The Patient Protection and Affordable Care Act, Public Law 111-148, related to the denial of life-saving medical treatments. Contacts in support of S. 2064, the Four Rationiners Repeal Act of 2014, because it would 1) eliminate the Independent Payment Advisory Boards duty to make recommendations to limit growth in private, nongovernmental spending on health to below the rate of medical inflation, 2) eliminate the excise tax on high cost employer-sponsored health coverage which would discourage businesses from offering plans less likely to deny life-saving medical treatment, 3) eliminate the authority of the Department of Health and Human Services to implement those recommendations by imposing quality and efficiency measures on health care providers, limiting the circumstances in which treatments can be given to their patients, 4) eliminate the authority of the Center for Medicare and Medicaid Services effectively to limit the amount of funds senior citizens may voluntarily add on top of the government contribution in order to obtain Medicare Advantage private-fee-for-service health insurance less likely to deny care and more likely to offer health care providers reimbursement rates high enough to induce them to accept Medicare patients, 5) eliminate the requirement that state health insurance exchanges administrators exclude from their exchanges insurance plans offered by any insurers the administrators believe allow their policyholders inside or outside the exchange to spend what the administrators consider an excessive or unjustified amount on their own health care, thereby restricting the medical treatment. (continued)Contacts regarding legislation (not introduced) regarding encouraging advance directives for Medicare recipients so long as legislation is not used to dissuade patients from choosing life-saving treatment, nutrition and hydration. Contacts regarding legislation S.1439, the Care Planning Act of 2013, regarding advance care planning because of 1) the inadequacy of oversight regarding the creation of advance planning materials, websites, etc. in order to protection against the materials being crafted in a way that persuades patients to reject treatment they might otherwise choose, and 2) the creation of interdisciplinary teams under Medicare and Medicaid to engage in advance care planning and counseling without adequate oversight that they could seek influence patients or their representative to forego life-saving medical treatment because of a bias toward a quality of life ideology and/or to save money. Contacts regarding legislation S.2240 Medicare Choices Empowerment and Protection Act because of 1) the need for a neutral website where all the various advance directive forms would be available and 2) the potential that portability provisions could force states to recognize directives inconsistent with their substantive law. Contacts regarding the Patient Choice, Affordability, Responsibility, and Empowerment Act (or Patient Care Act) because of concerns it 1) replaces tax preference for employer-provided health insurance with a deduction for health insurance premiums and indexes the deductibility limit for health insurance to general inflation measured by the Consumer Price Index (CPI), rather than to medical inflation, which could lead to reduction in health insurance plan benefits, and 2) may suppress private, nongovernmental, health care spending beyond a governmentally imposed limit. Contacts in regard to potential health reform legislation (not introduced) over concerns related to 1) the authority of any sort of health care commissions ability to restrict access to life-saving care, 2) premium price controls that might reduce the ability of insurance to cover expensive life-saving care, 3) tax increases on health care or health insurance that create incentives for employers to significantly reduce health insurance plans, 4) efforts to prevent private health care spending from keeping up with medical inflation, and 5) malpractice limits being made applicable to intentional denial of treatment for discriminatory reasons. Contacts regarding legislation (not introduced) regarding advance directives to ensure that legislation is not used to dissuade patients from choosing life-saving treatment, nutrition and hydration. Contacts regarding legislation (not introduced) regarding advance directives to ensure that legislation is not used to dissuade patients from choosing life-saving treatment, nutrition and hydration.

Client expense: $79,421 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Contacts in support of No Taxpayer Funding for Abortion Act (H.R. 7, S. 946), to codify government-wide policy against funding abortion. Contacts in support of Abortion Insurance Full Disclosure Act (H.R. 3279, S. 1848), legislation to correct concealment practices pertaining to abortion coverage in exchange-participating health plans. H.R. 7 (modified to include components (continued)of H.R. 3279) passed the House of Representatives on January 28, 2014, 227-188. Contacts in support of the Pain-Capable Unborn Child Protection Act (H.R. 1797), to protect pain-capable unborn children beginning at 20 weeks fetal age (passed by the House of Representatives on June 18, 2013), and Senate companion legislation (S. 1670). Contacts in support of Prenatal Nondiscrimination Act (PRENDA), to ban sex-selection abortions (S. 138, HR 447). Contacts in support of Child Interstate Abortion Notification Act (CIANA)(S. 369, HR 732), to require an abortionist to notify a parent before performing an abortion on a minor from a different state, with certain exceptions. Contacts in support of the Health Care Conscience Rights Act (HR 940, S. 1204), to prevent the imposition of regulatory mandates that violate the religious or moral convictions of those who purchase or provide health insurance, to prevent any level of government from discriminating against health care providers who decline to participate in abortions, and to empower victims to seek relief in court for violations of the federal conscience laws. Contacts in support of carrying over abortion-related limitation provisions in FY 2015 appropriations bills, including Hyde Amendment in HHS appropriations bill, and other abortion limitation provisions in Commerce-Justice-Science (H.R. 4660/S. 2437), Financial Services (H.R. 5016), and State-Foreign Operations (H.R. 5013/S. 2499) appropriations bills; no position on State-Foreign Operations provision conforming language related to the Peace Corps to comparable HHS language. Contacts in support of curtailing U.S. funding of UNFPA. Contacts in opposition to language proposed by Sen. Shaheen to State/Foreign Operations appropriations bill (S. 2499) to preclude a president from re-applying pro-life conditions to private organizations that receive foreign aid grants (e.g., "Mexico City Policy"), as adopted in Senate Appropriations Committee June 19, 2014; no position on State-Foreign Operations provision conforming language related to the Peace Corps to comparable HHS language. Contacts in support of the Homeland Security Respect for Life Act (H.R. 493), to prevent federal funding of abortion under programs within the Department of Homeland Security, with certain exceptions, and comparable limitation language ("Aderholt-Carter Amendment") to FY 2015 Homeland Security appropriations bill (H.R. 4903). Contacts in support of S. 154/HR 346, to prevent coverage of abortion, with certain exceptions, in "multi-state" (national) health plans, created by PL 111-148, to be administered by the Office of Personnel Management, and comparable language ("Harris-Nunnelee Amendment") in FY 2015 Financial Services appropriations bill (H.R. 5016). Contacts in support of the Title X Abortion Provider Prohibition Act (HR 217/S. 135). Consultations regarding other legislative concepts relating to Title X, including legislation dealing with adoption-counseling requirements with respect to Title X, including H.R. 3062, S. 1539, and other draft legislation not introduced; NRLC took no position on these measures. Consultations regarding abortion-related components of "American Health Care Reform Act" (H.R. 3121). See HCR page for additional information on contacts on this legislation. Consultations regarding proposed rule published by Office of Personnel Management in August 8, 2013 Federal Register, 78 Fed. Reg. 48337 (2013), concerning subsidies for health plans to be purchased by members of Congress and certain congressional staff on Obamacare exchanges. (Final Rule published Oct. 2, 2013.) The OPM proposal would allow payments to flow through OPM to plans that cover elective abortion, in violation of the Smith Amendment, a limitation amendment contained in the Financial Services appropriations bill (H.R. 5016). (continued)Consultations regarding draft language of legislation to curb "wrongful birth" and "wrongful life" causes of action, and contacts in support of H.R. 4698, the Every Child is a Blessing Act, introduced by Rep. Palazzo on May 21, 2014. Consultations regarding anti-trafficking legislation, H.R. 3530; no position taken on substitute as reported by the House Judiciary Committee on May 15, 2014, and approved by the House on May 20, 2014. Consultations regarding H.R. 2772, "Rape Survivor Child Custody Act"; no position. Contacts in opposition to "Women's Health Protection Act" (H.R. 3471, S. 1696), a proposed federal statute to invalidate virtually all state and federal regulations pertaining to abortion. Contacts explaining nonsupport for H.R. 1091/S. 583 and H.R. 2764, based on lack of clarity and erroneous legal premises. Consultations regarding possible abortion-related revisions to: Empowering Patients First Act (H.R. 2300, Rep. Price); H.R. 3121, Rep. Roe); and conceptual outline of health-care legislation (not introduced) by Senators Hatch/Coburn/Burr.

Client expense: $79,421 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 523, Protect Medical Innovation Act of 2013 H.R. 581, First Responder Medical Device Tax Relief Act H.R. 582, Healthcare Tax Relief and Mandate Repeal Act H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 781, Medicare Identity Theft Prevention Act of 2013 H.R. 903 / S. 399, American Job Protection Act H.R. 1248 / S. 610, Family Health Care Flexibility Act H.R. 1254, Auto Enroll Repeal Act H.R. 1295, Medical Device Tax Elimination Act H.R. 1558 / S. 24, Small Business Health Relief Act of 2013 H.R. 1735, In It All Together Act H.R. 1780, To provide that the only health plans that the Federal Government may make available to the President, Vice President, Members of Congress, and Federal employees are those created under the Patient Protection and Affordable Care Act or offered through a health insurance exchange H.R. 2575, Save American Workers Act H.R. 2667, Authority for Mandate Delay Act H.R. 2668, Fairness for American Families Act H.R. 2674, Job Creation Act of 2013 H.R. 2835 / S. 1647, Restoring Access to Medication Act of 2013 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013 H.R. 2988 / S. 701 / S. 1188, Forty Hours Is Full Time Act of 2013 H.R. 3077, TELE-MED Act of 2013 H.R. 3121, American Health Care Reform Act of 2013 H.R. 3124, Investing in Permanency for Youth in Foster Care Act H.R. 3204, Drug Quality and Security Act H.R. 3367, To amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 or 2015 H.R. 3419, Small Business Fairness in Obamacare Act H.R. 3462 / S. 1735, Self-Insurance Protection Act H.R. 4118, SIMPLE Fairness Act H.R. 4160, Keep the Promise to Seniors Act of 2014 H.R. 4302, Protecting Access to Medicare Act of 2014 H.R. 4414, Expatriate Health Coverage Clarification Act of 2014 S. 232, Medical Device Access and Innovation Protection Act S. 603, Jobs and Premium Protection Act S. 612, Social Security Number Protection Act of 2011 S. 1031, Family and Retirement Health Investment Act of 2013 S. 1488, A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes S. 1647, Restoring Access to Medication Act Proposed Regulation on the Patient Protection and Affordable Care Act: standards related to Essential Health Benefits, Actuarial Value, and Accreditation (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts. 147, 155, 156) Proposed Regulation on the Health Insurance Market Rules: Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012) (to be codified at 45 C.F.R. pts. 144, 147, 150) Proposed Regulation on the HHS Notice of Benefit and Payment Parameters for 2014 (77 Fed. Reg. 73,118-73,218, December 7, 2012) (to be codified at 45 C.F.R. pts. 153, 155, 156, 157, 158) Proposed Regulation on the Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts. 147, 155, 156) Proposed Regulation on Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing (78 Fed. Reg. 4,594-4,724, January 22, 2013) (to be codified at 42 C.F.R. pts. 430, 431, 433, 435, 440, 447, 457) Proposed Regulation on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans (77 Fed. Reg. 70,620-70,642, November 26, 2012) (to be codified at 26 C.F.R. pt. 54) Proposed Regulation on Shared Responsibility for Employers Regarding Health Coverage (78 Fed. Reg. 218-253, January 2, 2013) (to be codified at 26 C.F.R. pts. 1, 54, 301) Proposed Rule on Information Reporting of Minimum Essential Coverage (78 Fed. Reg. 54,986-54,996, September 9, 2013) (to be codified at 26 C.F.R. pts. 1, 301) Proposed Rule on Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans (78 Fed. Reg. 54,996-55,013, September 9, 2013) (to be codified at 26 C.F.R. pt. 301) Proposed Rule regarding the Establishment of Exchanges and Qualified Health Plans: Small Business Health Options Program (78 Fed. Reg. 15,553-15,558, March 11, 2013) (to be codified at 45 C.F.R. pts. 155, 156) Interim Final Rule on Procedures for the Handling of Retaliation Complaints under Section 1558 of the Affordable Care Act (78 Fed. Reg. 13,222-13,236, February 27, 2013) (to be codified at 29 C.F.R. pt. 1984) Response to the Department of Labors document FAQs about Affordable Care Act Implementation Part XI issued on January 24, 2013, regarding the Patient Protection and Affordable Care Act, on the Legality of Employer Subsidies for Individual Health Insurance Proposed Rule on the Health Insurance Providers Fee (78 Fed. Reg. 14,034-14,046, March 4, 2013) (to be codified at 26 C.F.R. pt. 57) Proposed Rule on The $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers (78 Fed. Reg. 19,950-19,977, April 2, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Rule on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit (78 Fed. Reg. 25,909-25,916, May 3, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Rule on Federal Employees Health Benefits Program: Members of Congress and Congressional Staff (78 Fed. Reg. 48,337-48,339, August 8, 2013) (to be codified at 5 C.F.R. pt. 890) Proposed Rule on HHS Notice of Benefit and Payment Parameters for 2015 (78 Fed. Reg. 72,322-72,392, December 2, 2013) (to be codified at 45 C.F.R. pts. 144, 147, 153, 155, 156) Proposed Rule on Amendments to Excepted Benefits (78 Fed. Reg. 77,632-77,642, December 24, 2013) (to be codified at 29 C.F.R. pt. 2590) Draft 2015 Letter to Issuers in the Federally-facilitated Marketplace (issued on February 4, 2014, from the Center for Consumer Information and Insurance Oversight, Centers for Medicare and Medicaid Services) Proposed Rule on Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Program (79 Fed. Reg. 1,918-2,073, January 10, 2014) (to be codified at 42 C.F.R. pts. 409, 417, 422 et. al.) Proposed Rule on Administrative Simplification: Certification of Compliance for Health Plans (79 Fed. Reg. 298-324, January 2, 2014) (to be codified at 45 C.F.R. pts. 160, 162) Proposed Rule on Exchange and Insurance Market Standards for 2015 and Beyond (79 Fed. Reg. 15,808-15,879, March 21, 2014) (to be codified at 45 C.F.R. pts. 146, 147, 148 et al.) Proposed Rule on Ninety-Day Waiting Period Limitation (79 Fed. Reg. 10,320-10,325, February 24, 2014) (to be codified at 29 C.F.R. pt. 2590; 45 C.F.R. pt. 147; and 26 C.F.R. pt. 54) Proposed Rule on Minimum Essential Coverage and Other Rules Regarding Shared Responsibility Payment for Individuals (79 Fed. Reg. 4,302-4,308, January 27, 2014) (to be codified at 26 C.F.R. pt. 1) Draft Guidance Notices on Self-Monitoring Blood Glucose Test Systems for Over-the-Counter Use (79 Fed. Reg. 829-830, January 7, 2014) Statement for the Record in Response to a Notice of Meeting on Employee Welfare and Pension Benefit Plans (79 Fed. Reg. 28,555-28,556, May 16, 2014) Various issues relating to the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, Grandfathering, HSA and FSA changes, CMS claims database, IPAB, CLASS program, employer mandate, reporting requirements, medical loss ratio, medical malpractice reform, exchanges, the impact on small business, the Small Business Tax Credit, caps on compensation deductibility required under section 9014, incompleteness or inaccuracy of cost impact analyses, lack of quantified benefit analysis, and need for empirical data sources on which to base costs and benefits; the Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including regulatory process and legislative corrections to the ERISA preemption, the impact on small business, the small business tax credit, insurance coverage, financing, delivery reform; changes to Medicare Advantage and Medicare Prescription Drug (Part D) programs including rebates and non-interference with prescription drug prices; entitlement reform; health information technology

Client expense: $21,610,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Federal Deposit Insurance Corporation (FDIC), Federal Housing Finance Agency (FHFA), Federal Reserve System, Federal Trade Commission (FTC), Food & Drug Administration (FDA), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Fish & Wildlife Service (USFWS), U.S. Trade Representative (USTR), White House Office

Legislation and policies relating to: Provisions of the Patient Protection & Affordable Care Act (P.L. 111-148) Section 2706 of the ACA regarding provider non-discrimination Health care coverage and payment options in tax reform discussions Policies affecting nurse practitioner education and workforce Definition of essential health benefits Health information technology and electronic health records Mental health services and violence prevention Draft legislation on reauthorization of the National Quality Forum Coverage and payment for health care services furnished to undocumented immigrant children H.R. 297/S. 1557 - Childrens Hospital GME Support Reauthorization Act H.R. 628/S. 195 - Mental Health in Schools Act H.R. 669 - Sudden Unexpected Death Data Enhancement and Awareness Act H.R. 1249/S. 1756 - Common Sense Nutrition Disclosure Act H.R. 1281/S. 1417 - Newborn Screening Saves Lives Reauthorization Act H.R. 1427 - Truth in Healthcare Marketing Act H.R. 1791 - Medical Preparedness Allowable Use Act H.R. 1947/H.R. 2642 - Federal Agriculture Reform and Risk Management (FARRM) Act H.R. 2019 - Gabriella Miller Kids First Research Act H.R. 2285 - Strategies to Address Antimicrobial Resistance Act H.R. 2575 - Save American Workers Act H.R. 2663/S. 1422 - To amend the Congressional Budget Act of 1974 respecting the scoring of preventive health savings H.R. 2833/S. 2278 - Safeguarding Care of Patients Everywhere (SCOPE) Act H.R. 2986 - Protecting Access to Primary Care Act H.R. 3102 - Nutrition Reform and Work Opportunity Act H.R. 3121 - American Health Care Reform Act H.R. 3147 - Food Labeling Modernization Act H.R. 3306 - Telehealth Enhancement Act H.R. 3527 - Poison Center Network Act H.R. 3717 - Helping Families in Mental Health Crisis Act H.R. 3742 - Antibiotic Development to Advance Patient Treatment (ADAPT) Act H.R. 4118 - Suspending the Individual Mandate Penalty Law Equals (SIMPLE) Fairness Act H.R. 4290 - Wakefield Act H.R. 4574 - Strengthening Mental Health in Our Communities Act H.R. 4631/S. 2449 - Autism Collaboration, Accountability, Research, Education and Support (Autism CARES) Act H.R. 4663 - Protect Patient Access and Promote Hospital Efficiency Act H.R. 4673 - Bundling and Coordinating Post-Acute Care (BACPAC) Act H.R. 4783 - Promoting Healthy Minds for Safer Communities Act H.R. 4888 - Coordinated Recovery Initiative for Babies (CRIB) Act S. 264/H.R. 1263 - Excellence in Mental Health Act S. 689 - Mental Health Awareness and Improvement Act S. 696 - Safe Chemicals Act S. 744/H.R. 15 - Border Security, Economic Opportunity, and Immigration Modernization Act S. 954 - Agriculture Reform, Food, and Jobs Act S. 1009 - Chemical Safety Improvement Act S. 1014 - Youth Sports Concussion Act S. 1086 - Safe Child Care Act/Child Care and Development Block Grant Reauthorization Act S. 1152 - Building a Health Care Workforce for the Future Act S. 1417 - Newborn Screening Saves Lives Act S. 1697 - Strong Start for Americas Children Act S. 1758 - Quality Data, Quality Healthcare Act S. 1932/H.R. 3890 - Better Care, Lower Cost Act S. 2154 - Emergency Medical Services for Children Reauthorization Act S. 2229 - Expanding Primary Care Access and Workforce Act S. 2434/H.R. 4865 - Family Coverage Act S. 2461 - Childrens Health Insurance Program Reauthorization Act S. 2491 - Medicare Protection Act

Client expense: Not reported · Firm income: $23,450

Government targets: Centers For Medicare and Medicaid Services (CMS), Drug Enforcement Administration (DEA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Medicare Payment Advisory Commission (MedPAC), Natl Institutes of Health (NIH), Office of Management & Budget (OMB), SENATE, Veterans Affairs, Dept of (VA), White House Office

See attachment.INS Second Quarter Report - 2014 Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions and Global Capital Standards. H.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019 (under current law the Program expires on December 31, 2014). Issue: Terrorism Insurance H.R. 911, Competitive Health Insurance Reform Act of 201. Issue: McCarran-Ferguson Act Issues H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues. H.R. 4510 Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R. 4871 - TRIA Reform Act of 2014. To reauthorize the Terrorism Risk Insurance Act of 2002. Issue: Terrorism Insurance S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards S. 2244, a bill to extend the termination date of the Terrorism Insurance Program established under the Terrorism Insurance Act of 2002. Issue: Terrorism Insurance S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III Tracking: H.R. 1155, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing S. 534, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing

Client expense: $860,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions and Global Capital Standards. H.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019 (under current law the Program expires on December 31, 2014). Issue: Terrorism Insurance H.R. 911, Competitive Health Insurance Reform Act of 201. Issue: McCarran-Ferguson Act Issues H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues. S. 2244, a bill to extend the termination date of the Terrorism Insurance Program established under the Terrorism Insurance Act of 2002. Issue: Terrorism Insurance H.R. 4510 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III S. 2270 - Insurance Capital Standards Clarification Act of 2014. The bill would give the Federal Reserve the authority to tailor capital standards for insurance companies subject to Fed supervision. Issue: Capital Standards, Basel III H.R. 4871 - TRIA Reform Act of 2014. To reauthorize the Terrorism Risk Insurance Act of 2002. Issue: Terrorism Insurance Tracking: H.R. 1155, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing S. 534, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions and Global Capital Standards. H.R. 911, Competitive Health Insurance Reform Act of 201. Issue: McCarran-Ferguson Act IssuesH.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019 (under current law the Program expires on December 31, 2014). Issue: Terrorism Insurance H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards S. ____, Draft bill pertaining to insurance capital standards under Basel III rules. Issue: Capital Standards, Basel III H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues.

Client expense: $440,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy. H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules. H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy. H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage. H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy. H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review. H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy. H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents. H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes. H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers. H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate. H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees. H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms. H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans. H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties. H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee. H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review. H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay. H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage. H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program. H.R. 3598, Catastrophic Plan Bill (Fortenberry) - expanded access to catastrophic plans. H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs. H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs. H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs. H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs. H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties. H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market. H.R. 4354, ACA Taxpayer Bailout Protection Act (Griffin) - ACA risk corridor program. H.R. 4406, Taxpayer Bailout Protection Act (Lance) - ACA risk corridor program. H.R. 4414, Expatriate Health Coverage Clarification Act (Carney) - relief from ACA for expatriate health plans. H.R. 4735, Health Care Fairness and Stability Act (Nolan-McKinley) - ACA transitional reinsurance program. S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes. S. 482, Health Insurance Rate Review Act (Feinstein) - rate review. S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers. S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents. S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms. S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims. S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements. S. 1671, (Manchin-Kirk) - individual mandate delay. S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties. S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans. S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program. S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges. S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage. S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees. S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer. S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment. S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines. S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment. S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements. S. 2214, ACA Taxpayer Bailout Protection Act (Rubio) - ACA risk corridor program. S. 2253, Health Care Fairness and Stability Act (Franken-Kirk) - ACA transitional reinsurance program.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 3698 Two-Midnight Rule Delay Act of 2013 (all sections of full text) S 2082 Two-Midnight Rule Coordination and Improvement Act of 2014 (all sections of full text) HR 4302 Protecting Access to Medicare Act of 2014 (all sections of full text) Draft legislation pertaining to the Patient Choice, Affordability, Responsibility, and Empowerment (CARE) Act Monitored discussions involving group purchasing organizations HR 351 Protecting Seniors' Access to Medicare Act of 2013 (all sections of full text) HR 3796 Comprehensive Care Innovation Act (all sections of full text) HR 3121 American Health Care Reform Act of 2013 (all sections of full text) S 1845 Emergency Unemployment Compensation Extension Act (all sections of full text) HR 2027 Expanding Patients' Access to Quality Care Act of 2013 (all sections of full text)(Oppose) Discussions related to Medicare Administrative Contractors (MACs) and Recovery Audit Contractors (RACs) under the jurisdiction of CMS Discussions involving trauma care

Client expense: Not reported · Firm income: $40,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1254 - Auto Enroll Repeal ActPatient Protection and Affordable Care Act (P.L. 111148) - Sections 1201, 1301, 1302, 1303, 1304, 1311, 1401, 1411, 1412, 1414, 1502, 1512, 1513, 1514, 4205 Section 4980H Budget Resolution - HConRes25; SConRes8 (SNAP provisions) S. 701 - Forty Hours Is Full Time Act of 2013 H.R. 2988 - Forty Hours Is Full Time Act of 2013 S. 1188 - Forty Hours Is Full Time Act of 2013 H.R. 2575 - Save American Workers Act of 2013 H.ConRes25 - Establishing the budget for the United States Government for fiscal year 2014 and setting forth appropriate budgetary levels for fiscal years 2015 through 2023 S.ConRes 8 - An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2014, revising the appropriate budgetary levels for fiscal year 2013, and setting forth the appropriate budgetary levels for fiscal years 2015 through 2023 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2014 H.R. 2667 - Authority for Mandate Delay Act H.R. 3367, the Small Business and Family Relief Act H.R. 3522 Employee Health Protection Act H.R. 3489 To Amend Sec. 1341 of the Patient Protection and Affordable Care Act to repeal the funding mechanism for the transitional reinsurance program H.J.Res. 77 Food Drug and Administration Continuing Appropriations Resolution, 2014 H.R. 3121 American Health Care Reform Act H.R. 3419 Small Business Fairness in Obamacare Act S. 1735 Self-Insurance Protection Act S. 1724 - Union Tax Fairness Act of 2013 S. 2176 To revise reporting requirements under the Patient Protection and Affordable Care Act to preserve the privacy of individuals, and for other purposes. S. 2168 Small Business Stability Act H.R. 4302 - Protecting Access to Medicare Act of 2014

Client expense: $160,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

See attachment.INS First Quarter Report - 2014 H.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019 (under current law the Program expires on December 31, 2014). Issue: Terrorism Insurance H.R. 911, Competitive Health Insurance Reform Act of 201. Issue: McCarran-Ferguson Act Issues H.R. 1155, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues. Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions and Global Capital Standards. S. 534, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards S. 2244, a bill to extend the termination date of the Terrorism Insurance Program established under the Terrorism Insurance Act of 2002. Issue: Terrorism Insurance

Client expense: $1,110,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 523, Protect Medical Innovation Act of 2013 H.R. 581, First Responder Medical Device Tax Relief Act H.R. 582, Healthcare Tax Relief and Mandate Repeal Act H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 781, Medicare Identity Theft Prevention Act of 2013 H.R. 903 / S. 399, American Job Protection Act H.R. 1248 / S. 610, Family Health Care Flexibility Act H.R. 1254, Auto Enroll Repeal Act H.R. 1295, Medical Device Tax Elimination Act H.R. 1558 / S. 24, Small Business Health Relief Act of 2013 H.R. 1735, In It All Together Act H.R. 1780, To provide that the only health plans that the Federal Government may make available to the President, Vice President, Members of Congress, and Federal employees are those created under the Patient Protection and Affordable Care Act or offered through a health insurance exchange H.R. 2575, Save American Workers Act H.R. 2667, Authority for Mandate Delay Act H.R. 2668, Fairness for American Families Act H.R. 2674, Job Creation Act of 2013 H.R. 2835 / S. 1647, Restoring Access to Medication Act of 2013 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013 H.R. 2988 / S. 701 / S. 1188, Forty Hours Is Full Time Act of 2013 H.R. 3121, American Health Care Reform Act of 2013 H.R. 3124, Investing in Permanency for Youth in Foster Care Act H.R. 3204, Drug Quality and Security Act H.R. 3367, To amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 or 2015 H.R. 3419, Small Business Fairness in Obamacare Act H.R. 3462 / S. 1735, Self-Insurance Protection Act H.R. 3541 / S. 1726, Obamacare Taxpayer Bailout Prevention Act H.R. 3812, No Bailouts for Insurance Industry Act of 2014 H.R. 4118, SIMPLE Fairness Act H.R. 4160, Keep the Promise to Seniors Act of 2014 H.R. 4302, Protecting Access to Medicare Act of 2014, including provisions relating to section 213 S. 232, Medical Device Access and Innovation Protection Act S. 603, Jobs and Premium Protection Act S. 612, Social Security Number Protection Act of 2011 S. 1031, Family and Retirement Health Investment Act of 2013 S. 1488, A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes Proposed Regulation on the Patient Protection and Affordable Care Act; standards related to Essential Health Benefits, Actuarial Value, and Accreditation, (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts 147, 155, and 156) Proposed Regulation on the Health Insurance Market Rules; Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012) (to be codified at 45 C.F.R. pts 144, 147, and 150) Proposed Regulation on the HHS Notice of Benefit and Payment Parameters for 2014 (77 Fed. Reg. 73,118-73,218, December 7, 2012) (to be codified at 45 C.F.R. pts 153, 155, 156, 157 and 158) Proposed Regulation on the Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation, (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 C.F.R. pts 147, 155, and 156) Proposed Regulation on Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing ( 78 Fed. Reg. 4,594-4,724, January 22, 2013) (to be codified at 42 C.F.R. pts 430, 431, 433, 435, 440, 447, and 457) Proposed Regulation on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans, (77 Fed. Reg. 70,620-70,642, November 26, 2012) (to be codified at 26 C.F.R. pt 54) Proposed Regulation on Shared Responsibility for Employers Regarding Health Coverage, (78 Fed. Reg. 218-253, January 2, 2013) (to be codified at 26 C.F.R. pts 1, 54 and 301) Proposed Rule on Information Reporting of Minimum Essential Coverage, (78 Fed. Reg. 54,986-54,996, September 9, 2013) (to be codified at 26 C.F.R. pts 1 and 301) Proposed Rule on Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans, (78 Fed. Reg. 54,996-55,013, September 9, 2013) (to be codified at 26 C.F.R. pt 301) Proposed Rule regarding the Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program, (78 Fed. Reg. 15,553-15,558, March 11, 2013) (to be codified at 45 C.F.R. pts 155 and 156) Interim Final Rule on Procedures for the Handling of Retaliation Complaints under Section 1558 of the Affordable Care Act, (78 Fed. Reg. 13,222-13,236, February 27, 2013) (to be codified at 29 C.F.R. pt 1984) Response to the Department of Labors document FAQs about Affordable Care Act Implementation Part XI issued on January 24, 2013, regarding the Patient Protection and Affordable Care Act, on the Legality of Employer Subsidies for Individual Health Insurance Comments for the Record on the Equal Employment Opportunity Commissions public meeting on Wellness Programs under Federal Equal Employment Opportunity Laws, held on May 8, 2013 Proposed Rule on the Health Insurance Providers Fee, (78 Fed. Reg. 14,034-14,046, March 4, 2013) (to be codified at 26 C.F.R. pt 57) Proposed Rule on The $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers, (78 Fed. Reg. 19,950-19,977, April 2, 2013) (to be codified at 26 C.F.R. pt 1) Proposed Rule on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit, (78 Fed. Reg. 25,909-25,916, May 3, 2013) (to be codified at 26 C.F.R. pt 1) Proposed Rule on Federal Employees Health Benefits Program: Members of Congress and Congressional Staff, (78 Fed. Reg. 48,337-48,339, August 8, 2013) (to be codified at 5 C.F.R. pt 890) Proposed Rule on HHS Notice of Benefit and Payment Parameters for 2015, (78 Fed. Reg. 72,322-72,392, December 2, 2013) (to be codified at 45 C.F.R. pts 144, 147, 153, 155, and 156). Proposed Rule on Amendments to Excepted Benefits, (78 Fed. Reg. 77,632-77,642, December 24, 2013) (to be codified at 29 C.F.R. pt 2590) Draft 2015 Letter to Issuers in the Federally-facilitated Marketplace (issued on February 4, 2014, from the Center for Consumer Information and Insurance Oversight, Centers for Medicare and Medicaid Services) Proposed Rule on Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Program, (79 Fed. Reg. 1918-2073, January 10, 2014) (to be codified at 42 C.F.R. pts 409, 417, 422 et. al.) Various issues relating to proposed and final regulations (HHS and IRS) implementing provisions of the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, insurance coverage, financing, delivery reform, 1099 reporting, grandfathering, HSA and FSA changes, CMS claims database, IPAB, CLASS program, employer mandate, medical loss ratio, full time worker definition, 30 hour work week, reporting requirements, medical malpractice reform, exchanges, incompleteness or inaccuracy of cost impact analyses, lack of quantified benefit analysis, need for empirical data sources on which to base costs and benefits, the impact on small business, the Small Business Tax Credit, caps on compensation deductibility required under section 9014, repeal of risk mitigation programs including the risk corridor transitional reinsurance and risk adjustment programs; changes to Medicare Advantage; Medicare Part D including rebates and non-interference with prescription drug prices; entitlement reform; regulatory process and legislative corrections to Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including ERISA preemption and the impact on small business

Client expense: $18,960,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Consumer Product Safety Commission (CPSC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Aviation Administration (FAA), Federal Deposit Insurance Corporation (FDIC), Federal Housing Finance Agency (FHFA), Federal Reserve System, Federal Trade Commission (FTC), General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Housing & Urban Development, Dept of (HUD), Interior, Dept of (DOI), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Office of Management & Budget (OMB), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) antitrust policy16. Specific Lobbying Issues (continued): H.R. 544, LIBERTY Act (Gingrey-Matheson) age rating rules H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) antitrust policy H.R. 762, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 911, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R. 1019, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) antitrust policy H.R. 1205, Patients Right to Know Act (Walden) disclosures on SBC documents H.R. 1558, Small Business Health Relief Act (Collins) HIT repeal, other ACA changes H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) MLR impact on agents and brokers H.R. 2668, Fairness for American Families Act (Young) delay of ACA individual mandate H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) short-term disability program for federal employees H.R. 3121, American Health Care Reform Act (Roe) replacement health reforms H.R. 3350, Keep Your Health Plan Act (Upton) continuation of existing plans H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) delay of open enrollment and individual mandate penalties H.R. 3489, (Tiberi) repeal of ACA transitional reinsurance fee H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) rate review H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) individual mandate delay H.R. 3522, Employee Health Care Protection Act (Cassidy) continuation of current group coverage H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) repeal of ACA risk corridor program H.R. 3745, Coverage Protection Act (Kirkpatrick) continuation of coverage for consumers unable to enroll in QHPs H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) ACA reinsurance and risk corridor programs H.R. 3851, No Bailouts for Insurance Industry Act (Lance) ACA reinsurance and risk corridor programs H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) ACAs reinsurance, risk corridor, and risk adjustment programs H.R. 4118, SIMPLE Fairness Act (Jenkins) delay in ACA individual mandate penalties H.R. 4302, Protecting Access to Medicare Act (Pitts) ACA Limits on Deductibles for Plans in Small Group Market S. 24, Small Business Health Relief Act (Portman) HIT repeal, other ACA changes S. 482, Health Insurance Rate Review Act (Feinstein) rate review S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) MLR impact on agents and brokers S. 764, Patients Right to Know Act (Cornyn) disclosures on SBC documents S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) model disclosure forms S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) third party review of disputed claims S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) continuation of existing plans, notification requirements S. 1671, (Manchin-Kirk) individual mandate delay S. 1693, ACA Enrollment Extension Act (Shaheen) extending open enrollment, delaying individual mandate penalties S. 1699, Continuous Coverage Act (Mark Udall) continuation of existing plans S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) repeal of ACA risk corridor program S. 1729, Expanded Consumer Choice Act (Begich) adding copper level of coverage to ACA Exchanges S. 1866, Coverage Protection Act (Merkley) continuation of coverage, retroactive coverage S. 2166, Treating Families Fairly Act (Manchin) ACA determinations of full-time equivalent employees S. 2168, Small Business Stability Act (Heitkamp) ACA definition of a large employer S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) ACA direct enrollment S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) offering health insurance coverage across state lines S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) access for independent agents and brokers to information about Exchange enrollment S. 2176, Commonsense Reporting Act (Warner) ACA reporting requirements16. Specific Lobbying Issues (continued): Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; disability income insurance enrollment and awareness; issues related to the continuation of reporting requirements for state LTCI partnership programs; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; and issues related to supplemental products, and other issues relating to health care reform implementation. 18. Name of Lobbyists (continued): C. Lawrence: Assistant, Legislative Director for Rep. Bill Cassidy (LA-6); May 2008-July 200: Staff Assistant, Legislative Correspondent for Rep. Tom Price (GA-6)

Client expense: $2,430,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Trade Commission (FTC), Food & Drug Administration (FDA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office

Contacts in support of No Taxpayer Funding for Abortion Act (H.R. 7, S. 946), to codify government-wide policy against funding abortion. Contacts in support of Abortion Insurance Full Disclosure Act (H.R. 3279, S. 1848), legislation to correct concealment practices pertaining to abortion coverage in exchange-participating health plans. H.R. 7 (modified to include components (continued)of H.R. 3279) passed the House of Representatives on January 28, 2014, 227-188. Contacts in support of the Pain-Capable Unborn Child Protection Act (H.R. 1797), to protect pain-capable unborn children beginning at 20 weeks fetal age (passed by the House of Representatives on June 18, 2013), and Senate companion legislation (S. 1670). Consultations on various draft legislative proposals (not introduced) to tighten qualifications for abortion providers. Contacts in support of Prenatal Nondiscrimination Act (PRENDA), to ban sex-selection abortions (S. 138, HR 447). Contacts in support of Child Interstate Abortion Notification Act (CIANA)(S. 369, HR 732), to require an abortionist to notify a parent before performing an abortion on a minor from a different state, with certain exceptions. Contacts in support of the Health Care Conscience Rights Act (HR 940, S. 1204), to prevent the imposition of regulatory mandates that violate the religious or moral convictions of those who purchase or provide health insurance, to prevent any level of government from discriminating against health care providers who decline to participate in abortions, and to empower victims to seek relief in court for violations of the federal conscience laws. Contacts in support of carrying over abortion-related limitation provisions in FY 2015 appropriations bills, including Hyde Amendment in HHS appropriations bill, and other carry-over abortion limitation provisions in Commerce-Justice-Science, Financial Services, and State-Foreign Operations. Contacts in support of curtailing U.S. funding of UNFPA. Contacts in support of the Homeland Security Respect for Life Act (H.R. 493), to prevent federal funding of abortion under programs within the Department of Homeland Security, with certain exceptions, and comparable limitation language to FY 2015 Homeland Security appropriations bill. Contacts in support of S. 154/HR 346, to prevent coverage of abortion, with certain exceptions, in "multi-state" (national) health plans, created by PL 111-148, to be administered by the Office of Personnel Management, and comparable language ("Nunnelee Amendment") in FY 2015 Financial Services appropriations bill. Contacts in support of the Title X Abortion Provider Prohibition Act (HR 217/S. 135). Consultations regarding other legislative concepts relating to Title X, including legislation dealing with adoption-counseling requirements with respect to Title X, including H.R. 3062, S. 1539, and other draft legislation not introduced; NRLC took no position on these measures. Consultations regarding abortion-related components of "American Health Care Reform Act" (H.R. 3121). See HCR page for additional information on contacts on this legislation. Consultations regarding proposed rule published by Office of Personnel Management in August 8, 2013 Federal Register, 78 Fed. Reg. 48337 (2013), concerning subsidies for health plans to be purchased by members of Congress and certain congressional staff on Obamacare exchanges. The OPM proposal would allow payments to flow through OPM to plans that cover elective abortion, in violation of the Smith Amendment, a limitation amendment to the Financial Services appropriations bill. Contacts in opposition to "Women's Health Protection Act" (H.R. 3471, S. 1696), a proposed federal statute to invalidate virtually all state and federal regulations pertaining to abortion. Consultations regarding possible abortion-related revisions to: Empowering Patients First Act (H.R. 2300, Rep. Price); H.R. 3121, Rep. Roe); and conceptual outline of health-care legislation (not introduced) by Senators Hatch/Coburn/Burr. (continued)

Client expense: $106,119 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

HR 2575 "Save American Workers Act of 2014," all provisions. HR 3121 "American Health Care Reform Act of 2013," all provisions. HR 2300 "Empowering Patients First Act of 2013," all provisions. Issues relating to health insurance reform and an alternative plan.

Client expense: $90,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions and Global Capital Standards.H.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019 (under current law the Program expires on December 31, 2014). Issue: Terrorism Insurance H.R. 911, Competitive Health Insurance Reform Act of 201. Issue: McCarran-Ferguson Act Issues H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards S. ____, Draft bill pertaining to insurance capital standards under Basel III rules. Issue: Capital Standards, Basel III H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues. Tracking: H.R. 1155, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing S. 534, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing

Client expense: $800,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) - antitrust policy; H.R. 544, LIBERTY Act (Gingrey-Matheson) - age rating rules; H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) - antitrust policy; H.R. 762, Health Care Choice Act (Blackburn) - national marketplace for individual coverage; H.R. 911, Competitive Health Insurance Reform Act (Gosar) - antitrust policy; H.R. 1019, Health Insurance Rate Review Act (Schakowsky) - rate review; H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) - antitrust policy; H.R. 1205, Patients Right to Know Act (Walden) - disclosures on SBC documents; H.R. 1558, Small Business Health Relief Act (Collins) - HIT repeal, other ACA changes; H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) - MLR impact on agents and brokers; H.R. 2668, Fairness for American Families Act (Young) - delay of ACA individual mandate; H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) - short-term disability program for federal employees; H.R. 3121, American Health Care Reform Act (Roe) - replacement health reforms; H.R. 3350, Keep Your Health Plan Act (Upton) - continuation of existing plans; H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) - delay of open enrollment and individual mandate penalties; H.R. 3489, (Tiberi) - repeal of ACA transitional reinsurance fee; H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) - rate review; H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) - individual mandate delay; H.R. 3522, Employee Health Care Protection Act (Cassidy) - continuation of current group coverage; H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) - repeal of ACA risk corridor program; H.R. 3745, Coverage Protection Act (Kirkpatrick) - continuation of coverage for consumers unable to enroll in QHPs; H.R. 3812, No Bailouts for Insurance Industry Act (Coffman) - ACA reinsurance and risk corridor programs; H.R. 3851, No Bailouts for Insurance Industry Act (Lance) - ACA reinsurance and risk corridor programs; H.R. 3985, Stop ACA's Risky Provisions Act (Westmoreland) - ACAs reinsurance, risk corridor, and risk adjustment programs; H.R. 4118, SIMPLE Fairness Act (Jenkins) - delay in ACA individual mandate penalties; H.R. 4302, Protecting Access to Medicare Act (Pitts) - ACA Limits on Deductibles for Plans in Small Group Market; S. 24, Small Business Health Relief Act (Portman) - HIT repeal, other ACA changes; S. 482, Health Insurance Rate Review Act (Feinstein) - rate review; S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) - MLR impact on agents and brokers; S. 764, Patients Right to Know Act (Cornyn) - disclosures on SBC documents; S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) - model disclosure forms; S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) - third party review of disputed claims; S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) - continuation of existing plans, notification requirements; S. 1671, (Manchin-Kirk) - individual mandate delay; S. 1693, ACA Enrollment Extension Act (Shaheen) - extending open enrollment, delaying individual mandate penalties; S. 1699, Continuous Coverage Act (Mark Udall) - continuation of existing plans; S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) - repeal of ACA risk corridor program; S. 1729, Expanded Consumer Choice Act (Begich) - adding copper level of coverage to ACA Exchanges; S. 1866, Coverage Protection Act (Merkley) - continuation of coverage, retroactive coverage; S. 2166, Treating Families Fairly Act (Manchin) - ACA determinations of full-time equivalent employees; S. 2168, Small Business Stability Act (Heitkamp) - ACA definition of a large employer; S. 2173, Consumers Having Options in Choosing Enrollment Act (Landrieu) - ACA direct enrollment; S. 2174, Commonsense Competition and Access to Health Insurance Act (Warner) - offering health insurance coverage across state lines; S. 2175, Enhancing Access for Agents and Brokers Act (Landrieu) - access for independent agents and brokers to information about Exchange enrollment; S. 2176, Commonsense Reporting Act (Warner) - ACA reporting requirements.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions and Global Capital Standards.H.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019 (under current law the Program expires on December 31, 2014). Issue: Terrorism Insurance H.R. 911, Competitive Health Insurance Reform Act of 201. Issue: McCarran-Ferguson Act Issues H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues. S. 2244, a bill to extend the termination date of the Terrorism Insurance Program established under the Terrorism Insurance Act of 2002. Issue: Terrorism Insurance Tracking: H.R. 1155, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing S. 534, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing

Client expense: $1,511,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 99, Health Insurance Industry Antitrust Enforcement Act (Conyers) antitrust policy16. Specific Lobbying Issues (continued): H.R. 544, LIBERTY Act (Gingrey-Matheson) age rating rules H.R. 743, Health Insurance Industry Fair Competition Act (DeFazio) antitrust policy H.R. 762, Health Care Choice Act (Blackburn) national marketplace for individual coverage H.R. 911, Competitive Health Insurance Reform Act (Gosar) antitrust policy H.R. 1019, Health Insurance Rate Review Act (Schakowsky) rate review H.R. 1188, Preserving Our Hometown Independent Pharmacies Act (Marino) antitrust policy H.R. 1205, Patients Right to Know Act (Walden) disclosures on SBC documents H.R. 1558, Small Business Health Relief Act (Collins) HIT repeal, other ACA changes H.R. 2328, Access to Professional Health Insurance Advisors Act (Rogers-Barrow) MLR impact on agents and brokers H.R. 2668, Fairness for American Families Act (Young) delay of ACA individual mandate H.R. 2698, Federal Employee Short-Term Disability Insurance Act (Norton) short-term disability program for federal employees H.R. 3121, American Health Care Reform Act (Roe) replacement health reforms H.R. 3350, Keep Your Health Plan Act (Upton) continuation of existing plans H.R. 3425, Health Care Access Fairness and Penalty Delay Act (Lipinski-Sinema) delay of open enrollment and individual mandate penalties H.R. 3489, (Tiberi) repeal of ACA transitional reinsurance fee H.R. 3504, Consumer Protection and Rate Review Act (Schakowsky) rate review H.R. 3517, Federal and State Insurance Exchange Access Fairness and Penalty Delay Act (Schrader) individual mandate delay H.R. 3522, Employee Health Care Protection Act (Cassidy) continuation of current group coverage H.R. 3541, Obamacare Taxpayer Bailout Prevention Act (Griffin) repeal of ACA risk corridor program H.R. 3745, Coverage Protection Act (Kirkpatrick) continuation of coverage for consumers unable to enroll in QHPs S. 24, Small Business Health Relief Act (Portman) HIT repeal, other ACA changes S. 482, Health Insurance Rate Review Act (Feinstein) rate review S. 650, Access to Independent Health Insurance Advisors Act (Landrieu) MLR impact on agents and brokers S. 764, Patients Right to Know Act (Cornyn) disclosures on SBC documents S. 1473, Long-Term Care Insurance Consumer Right-to-Know Act (Klobuchar) model disclosure forms S. 1481, Long Term Care Insurance Integrity Act (Klobuchar) third party review of disputed claims S. 1642, Keeping the ACA Promise Act (Landrieu-Manchin) continuation of existing plans, notification requirements S. 1671, (Manchin-Kirk) individual mandate delay S. 1693, ACA Enrollment Extension Act (Shaheen) extending open enrollment, delaying individual mandate penalties S. 1699, Continuous Coverage Act (Mark Udall) continuation of existing plans S. 1726, Obamacare Taxpayer Bailout Prevention Act (Rubio) repeal of ACA risk corridor program S. 1729, Expanded Consumer Choice Act (Begich) adding copper level of coverage to ACA Exchanges S. 1866, Coverage Protection Act (Merkley) continuation of coverage, retroactive coverage Regulatory Issues: Insurance regulatory reform; issues related to the coordination of private and public disability income benefits; disability risk management; issues related to the continuation of reporting requirements for state LTCI partnership programs; issues relating to the coordination of benefits between private health insurance plans and Medicaid; Medigap claims processing and crossover fees; Medigap cross-over claim issues, Medigap coverage, implementation of Medigap standardized plan offerings; Medigap carrier recoveries related to CMS fraud and abuse enforcement activities, and issues related to Medigap educational materials, and other Medigap issues; fraud and abuse issues affecting public and private insurance coverage; issues relating to antitrust; implementation of the Mental Health Parity Act requirements; summary of benefits and coverage disclosures; medical loss ratios; review of rates for reasonableness; health insurance exchanges; pre-existing condition insurance plans; accountable care organizations; coverage of preventive services; preexisting condition exclusions; lifetime and annual dollar limits on benefits; patient protections; grandfathered health plan provisions; health insurance web portal requirements; dependent coverage; treatment of expatriate plans; compliance with the transitional reinsurance program; issues related to fraud, waste, abuse, Stark/Anti-Kickback laws and regulations, non-discriminatory wellness programs; and issues related to supplemental products, and other issues relating to health care reform implementation.

Client expense: $3,630,000 · Firm income: Not reported

Government targets: Agency for Healthcare Research & Quality (AHRQ), Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), Federal Bureau of Investigation (FBI), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Health Resources & Services Administration (HRSA), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Medicare Payment Advisory Commission (MedPAC), Office of Management & Budget (OMB), Office of Personnel Management (OPM), Pension & Welfare Benefits Administration, SENATE, Treasury, Dept of, White House Office

Lobbying with regard to medical malpractice reform proposals generally. H.R. 3121 (American Health Reform Act); specific interest in provisions establishing national civil liability limitations for medical professionals.

Client expense: Not reported · Firm income: $50,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Contacts in support of No Taxpayer Funding for Abortion Act (H.R. 7, S. 946), to codify government-wide policy against funding abortion. Contacts in support of Abortion Insurance Full Disclosure Act (H.R. 3279, S. 1848), legislation to correct concealment practices pertaining to abortion coverage in exchange-participating health plans. (continued)Contacts in support of the Pain-Capable Unborn Child Protection Act (H.R. 1797), to protect pain-capable unborn children beginning at 20 weeks fetal age (passed by the House of Representatives on June 18, 2013), and Senate companion legislation (S. 1670). Consultations on various draft legislative proposals (not introduced) to tighten qualifications for abortion providers. Contacts in support of Prenatal Nondiscrimination Act (PRENDA), to ban sex-selection abortions (S. 138, HR 447). Contacts in support of Child Interstate Abortion Notification Act (CIANA)(S. 369, HR 732), to require an abortionist to notify a parent before performing an abortion on a minor from a different state, with certain exceptions. Contacts in support of the Health Care Conscience Rights Act (HR 940, S. 1204), to prevent the imposition of regulatory mandates that violate the religious or moral convictions of those who purchase or provide health insurance, to prevent any level of government from discriminating against health care providers who decline to participate in abortions, and to empower victims to seek relief in court for violations of the federal conscience laws. Contacts in support of abortion-related limitation provisions in FY 2014 appropriations bills, including Hyde Amendment in HHS appropriations bill, and other carry-over abortion limitation provisions in FY 2014 appropriations bills, Commerce-Justice-Science (H.R. 2787/.S. 1329), Financial Services (H.R. 2786/S. 1371), Labor-HHS (House bill unnumbered, S. 1284), and State-Foreign Operations (H.R. 2855/ S. 1372). Contacts in support of curtailing U.S. funding of UNFPA. All carryover provisions were retained in omnibus appropriations bill (enacted as H.R. 3547) covering the remainder of FY 2014; no new abortion-related provisions were incorporated. Contacts in support of the Homeland Security Respect for Life Act (H.R. 493), to prevent federal funding of abortion under programs within the Department of Homeland Security, with certain exceptions, and comparable limitation language to FY 2014 Homeland Security appropriations bill (section 563 of H.R. 2217). Contacts in support of S. 154/HR 346, to prevent coverage of abortion, with certain exceptions, in "multi-state" (national) health plans, created by PL 111-148, to be administered by the Office of Personnel Management, and comparable language ("Nunnelee Amendment") in FY 2014 Financial Services appropriations bill (H.R. 2786). Contacts in support of the Title X Abortion Provider Prohibition Act (HR 217/S. 135). Consultations regarding other legislative concepts relating to Title X, including legislation dealing with adoption-counseling requirements with respect to Title X, including H.R. 3062, S. 1539, and other draft legislation not introduced; NRLC took no position on these measures. Consultations regarding abortion-related components of "American Health Care Reform Act" (H.R. 3121). See HCR page for additional information on contacts on this legislation. Consultations regarding proposed rule published by Office of Personnel Management in August 8, 2013 Federal Register, 78 Fed. Reg. 48337 (2013), concerning subsidies for health plans to be purchased by members of Congress and certain congressional staff on Obamacare exchanges. The OPM proposal would allow payments to flow through OPM to plans that cover elective abortion, in violation of the Smith Amendment, a limitation amendment to the Financial Services appropriations bill. Consultations on S. 959, related to drug compounding; NRLC took no position on this legislation. Contacts in opposition to "Women's Health Protection Act" (H.R. 3471, S. 1696), a proposed federal statute to invalidate virtually all state and federal regulations pertaining to abortion. Consultations regarding possible revisions to Empowering Patients First Act (H.R. 2300). (continued)

Client expense: $77,238 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 1254 - Auto Enroll Repeal Act Patient Protection and Affordable Care Act (P.L. 111-148) - Sections 1201, 1301, 1302, 1303, 1304, 1311, 1401, 1411, 1412, 1414, 1502, 1512, 1513, 1514, 4205 Section 4980H Budget Resolution - HConRes25; SConRes8 (SNAP provisions) S. 701 - Forty Hours Is Full Time Act of 2013 H.R. 2988 - Forty Hours Is Full Time Act of 2013 S. 1188 - Forty Hours Is Full Time Act of 2013 H.R. 2575 - Save American Workers Act of 2013 H.ConRes25 - Establishing the budget for the United States Government for fiscal year 2014 and setting forth appropriate budgetary levels for fiscal years 2015 through 2023 S.ConRes 8 - An original concurrent resolution setting forth the congressional budget for the United States Government for fiscal year 2014, revising the appropriate budgetary levels for fiscal year 2013, and setting forth the appropriate budgetary levels for fiscal years 2015 through 2023 Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2014 H.R. 2667 - Authority for Mandate Delay Act H.R. 3367, the Small Business and Family Relief Act H.R. 3522 - Employee Health Protection Act H.R. 3489 - To Amend Sec. 1341 of the Patient Protection and Affordable Care Act to repeal the funding mechanism for the transitional reinsurance program H.J.Res. 77 - Food Drug and Administration Continuing Appropriations Resolution, 2014 H.R. 3121 - American Health Care Reform Act H.R. 3419 - Small Business Fairness in Obamacare Act S. 1735 - Self-Insurance Protection Act S. 1724 - Union Tax Fairness Act of 2013

Client expense: $160,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Labor, Dept of (DOL), Office of Management & Budget (OMB), SENATE

H.R. 45, To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010 H.R. 523, Protect Medical Innovation Act of 2013 H.R. 581, First Responder Medical Device Tax Relief Act H.R. 582, Healthcare Tax Relief and Mandate Repeal Act H.R. 763, To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act H.R. 781, Medicare Identity Theft Prevention Act of 2013 H.R. 903 / S. 399, American Job Protection Act H.R. 1248 / S. 610, Family Health Care Flexibility Act H.R. 1254, Auto Enroll Repeal Act H.R. 1295, Medical Device Tax Elimination Act H.R. 1558 / S. 24, Small Business Health Relief Act of 2013 H.R. 1735, In It All Together Act H.R. 1780, To provide that the only health plans that the Federal Government may make available to the President, Vice President, Members of Congress, and Federal employees are those created under the Patient Protection and Affordable Care Act or offered through a health insurance exchange H.R. 2575, Save American Workers Act H.R. 2667, Authority for Mandate Delay Act H.R. 2668, Fairness for American Families Act H.R. 2674, Job Creation Act of 2013 H.R. 2835 / S. 1647, Restoring Access to Medication Act of 2013 H.R. 2925, Strengthening Medicare Anti-Fraud Measures Act of 2013 H.R. 2988 / S. 701 / S. 1188, Forty Hours Is Full Time Act of 2013 H.R. 3121, American Health Care Reform Act of 2013 H.R. 3124, Investing in Permanency for Youth in Foster Care Act H.R. 3204, Drug Quality and Security Act H.R. 3367, To amend section 9010 of the Patient Protection and Affordable Care Act to delay the application of the health insurance provider annual fee until 2016 and to provide a process to return to consumers any amounts attributable to the expected application of the annual fee to 2014 or 2015 H.R. 3419, Small Business Fairness in Obamacare Act H.R. 3462 / S. 1735, Self-Insurance Protection Act S. 232, Medical Device Access and Innovation Protection Act S. 603, Jobs and Premium Protection Act S. 612, Social Security Number Protection Act of 2011 S. 1031, Family and Retirement Health Investment Act of 2013 S. 1488, A bill to delay the application of the individual health insurance mandate, to delay the application of the employer health insurance mandate, and for other purposes Proposed Regulation on the Patient Protection and Affordable Care Act; standards related to Essential Health Benefits, Actuarial Value, and Accreditation, (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 CFR pts 147, 155, and 156) Proposed Regulation on the Health Insurance Market Rules; Rate Review (77 Fed. Reg. 70,584-70,617, November 26, 2012) (to be codified at 45 CFR pts 144, 147, and 150) Proposed Regulation on the HHS Notice of Benefit and Payment Parameters for 2014 (77 Fed. Reg. 73,118-73,218, December 7, 2012) (to be codified at 45 CFR pts 153, 155, 156, 157 and 158) Proposed Regulation on the Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation, (77 Fed. Reg. 70,644-70,676, November 26, 2012) (to be codified at 45 CFR pts 147, 155, and 156) Proposed Regulation on Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing ( 78 Fed. Reg. 4,594-4,724, January 22, 2013) (to be codified at 42 CFR Parts 430, 431, 433, 435, 440, 447, and 457) Proposed Rule on Incentives for Nondiscriminatory Wellness Programs in Group Health Plans, (77 Fed. Reg. 70,620-370,642, November 26, 2012) (to be codified at 26 C.F.R. pt 54) Proposed Regulation on Shared Responsibility for Employers Regarding Health Coverage, (78 Fed. Reg. 218-253, January 2, 2013) (to be codified at 26 C.F.R. pts 1, 54 and 301) Proposed Rule on Information Reporting of Minimum Essential Coverage, (78 Fed. Reg. 54,986-54,996, September 9, 2013) (to be codified at 26 C.F.R. pts. 1 and 301) Proposed Rule on Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans, (78 Fed. Reg. 54,996-55,013, September 9, 2013) (to be codified at 26 C.F.R. pt. 301) Proposed Rule regarding the Establishment of Exchanges and Qualified Health Plans; Small Business Health Options Program, (78 Fed. Reg. 15,553-15,558, March 11, 2013) (to be codified at 45 CFR pts 155 and 156) Interim Final Rule on Procedures for the Handling of Retaliation Complaints under Section 1558 of the Affordable Care Act, (78 Fed. Reg. 13,222-13,236, February 27, 2013) (to be codified at 29 CFR pts 1984) Response to the Department of Labors document FAQs about Affordable Care Act Implementation Part XI issued on January 24, 2013, regarding the Patient Protection and Affordable Care Act, on the Legality of Employer Subsidies for Individual Health Insurance Comments for the Record on the Equal Employment Opportunity Commissions public meeting on Wellness Programs under Federal Equal Employment Opportunity Laws, held on May 8, 2013 Proposed Rule on the Health Insurance Providers Fee, (78 Fed. Reg. 14,034-14,046, March 4, 2013) (to be codified at 26 C.F.R. pt 57) Proposed Rule on The $500,000 Deduction Limitation for Remuneration Provided by Certain Health Insurance Providers, (78 Fed. Reg. 19,950-19,977, April 2, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Rule on Minimum Value of Eligible Employer-Sponsored Plans and Other Rules Regarding the Health Insurance Premium Tax Credit, (78 Fed. Reg. 25,909-25,916, May 3, 2013) (to be codified at 26 C.F.R. pt. 1) Proposed Rule on Federal Employees Health Benefits Program: Members of Congress and Congressional Staff, (78 Fed. Reg. 48,337-48,339, August 8, 2013) (to be codified at 5 C.F.R. pt. 890) Various issues relating to proposed and final regulations (HHS and IRS) implementing provisions of the Patient Protection and Affordable Care Act (P.L. 111-148), including implementation of regulatory process, legislative corrections, coverage, financing, delivery reform, 1099 reporting, grandfathering, HSA and FSA changes, CMS claims database, IPAB, CLASS program, employer mandate, medical loss ratio, medical malpractice reform, compensation deductibility, exchanges, flexible spending accounts and health savings accounts, incompleteness or inaccuracy of cost impact analyses, lack of quantified benefit analysis, need for empirical data sources on which to base costs and benefits; Medicare Part D rebates; non-interference with Medicare Part D prescription drug prices; entitlement reform; the regulatory process and legislative corrections to Health Care and Education Affordability Reconciliation Act of 2010 (P.L. 111-152), including ERISA preemption and the impact on small business; Small Business Health Options Program (SHOP), small business impact on the delay of the SHOP exchanges

Client expense: $16,490,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Army, Dept of (Corps of Engineers), Commerce, Dept of (DOC), Commodity Futures Trading Commission (CFTC), Council on Environmental Quality (CEQ), Defense, Dept of (DOD), Education, Dept of, Energy, Dept of, Environmental Protection Agency (EPA), Equal Employment Opportunity Commission (EEOC), Executive Office of the President (EOP), Federal Accounting Standards Advisory Board (FASAB), Federal Aviation Administration (FAA), Federal Communications Commission (FCC), Federal Deposit Insurance Corporation (FDIC), Federal Reserve System, General Services Administration (GSA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Homeland Security, Dept of (DHS), Interior, Dept of (DOI), Internal Revenue Service (IRS), Justice, Dept of (DOJ), Labor, Dept of (DOL), Natl Economic Council (NEC), Natl Institute of Standards & Technology (NIST), Natl Labor Relations Board (NLRB), Natl Security Council (NSC), Office of Management & Budget (OMB), Office of the Comptroller of the Currency (OCC), Patent & Trademark Office (PTO), Pension Benefit Guaranty Corporation (PBGC), SENATE, Securities & Exchange Commission (SEC), Small Business Administration (SBA), State, Dept of (DOS), Transportation Security Administration (TSA), Transportation, Dept of (DOT), Treasury, Dept of, U.S. Copyright Office, U.S. Customs & Border Protection, U.S. Trade Representative (USTR), White House Office

See Attachment.INS Fourth Quarter Report - 2013 H.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019 (under current law the Program expires on December 31, 2014). Issue: Terrorism Insurance H.R. 911, Competitive Health Insurance Reform Act of 201. Issue: McCarran-Ferguson Act Issues H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues. Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions. S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards S. ____, Draft bill pertaining to insurance capital standards under Basel III rules. Issue: Capital Standards, Basel III Tracking: H.R. 1155, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing S. 534, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing

Client expense: $910,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

monitor issues regarding healthcare reform; HR 3121 American Health Care Reform Act of 2013; HR 3165 Common Sense Health Reform Act

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Public Law 111-203, H.R. 4173- Dodd-Frank Wall Street Reform and Consumer Protection Act. Issue: Implementation and Regulatory reform. Captive Reinsurance Transactions. H.R. 911, Competitive Health Insurance Reform Act of 201. Issue: McCarran-Ferguson Act IssuesH.R. 508, Terrorism Risk Insurance Act of 2002 Reauthorization Act of 2013. Amends the Terrorism Risk Insurance Act of 2002 to extend the Terrorism Insurance Program until December 31, 2019 (under current law the Program expires on December 31, 2014). Issue: Terrorism Insurance H.R. 2140, Insurance Capital and Accounting Standards Act of 2013. Amends the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank) and the Home Owners' Loan Act to make minimum leverage and risk-based capital requirements governing insurance companies under the state law also apply to insurance companies that are either depository holding companies or subsidiaries of depository holding companies. Issue: Capital Standards, Basel III H.R. 2374, the Retail Investor Protection Act. To amend the Securities Exchange Act of 1934 to provide protections for retail customers, and for other purposes. Issue: Fiduciary Duties S. 798, TBTF Act. Requires federal banking agencies to establish capital requirements for the ratio of equity capital to total consolidated assets for all financial institutions. Issue: Capital Standards S. ____, Draft bill pertaining to insurance capital standards under Basel III rules. Issue: Capital Standards, Basel III H.R. 3121, American Health Care Reform Act of 2013. Issue: McCarran-Ferguson Act issues. H.R. 1155, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing S. 534, National Association of Registered Agents and Brokers Reform Act of 2013. Amends the Gramm-Leach-Bliley Act to repeal the contingent conditions under which the National Association of Registered Agents and Brokers (NARAB) shall not be established. Reestablishes the NARAB without contingent conditions as a nonprofit corporation to prescribe, on a multi-state basis, licensing and insurance producer qualification requirements and conditions. Issue: Agent Licensing

Client expense: $550,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE