Exchange Information Disclosure Act

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM. FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851, 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19, 2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ration of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-Party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. S. 1486 Introduced August 1, 2013 by Sen. Carper,Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S.Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD-9) with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, or any period after December 31, 2014, from being requirement to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool. HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 5214 Introduced July 28, 2014 by Pete Olsen (R-TX) To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should have access to the individual's medical history. HR 4633 Introduced May 9, 2014 by H. Griffith (R-VA) Insurance Rate Transparency Act - Amends the Public Health Service Act to require that specific health insurance premium increase information submitted to the Secretary of Health and Human Services (HHS) be disclosed to Congress no later than 30 days after receipt of the information. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), SENATE

HR 81, HR 105, HR.RES.17, HR 344, HR 544, HR 582, HR 607, HR 675, HR 762, HR 763, HR 903, HR 1076, HR 1200, HR 1205, HR 1239, HR 1248, HR 1254, HR 1342, HR 1549, HR 1558, HR 2328, HR 2527, HR 2575, HR 2577, HR 2667, HR 2995, HR 2988, HR 3362, HR 3367, HR 4244, HR 4128, HR 4144, HR 2453, HR 4160, HR 4302, HR 1179, HR 5183, HR 5557, S.CON. RES.8, S24, S351, S399, S.AMDT.409, S482, S603, S650, S701, S764, S1188, S1729, S2069, S2173, S2174, S2175, S2546,S2783, H.R.5860, H.R. 3512

Client expense: $45,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

H.R. 544 Liberty Act (All provisions) S. 650 Access to Independent Health Insurance Advisors Act (All provisions) P.L. 111-148 Patient Protection and Affordable Care Act (Implementation) H.R. 2328 Access to Professional Health Insurance Advisors Act (All provisions) H.R. 2980 (No short title) (All provisions) H.R. 2951 (No short title) (All provisions) H.R. 3362 Exchange Information Disclosure Act of 2013 (All provisions) S. 1590 Exchange Information Disclosure Act of 2013 (All provisions) H.R. 3429 Consumer Protection Act (All provisions) S. 1666 Healthcare Privacy and Anti-Fraud Act (All provisions) H.R. 3811 Health Exchange Security and Transparency (All provisions) S. 2175 Enhancing Access for Agents and Brokers (All provisions) S. 2173 The CHOICE Act (All provisions) H.R. 2575 Save American Workers Act of 2014 (All provisions) S. 1188 Forty Hours is Full Time Act of 2014 (All provisions) H.R. 4 Jobs for America Act (Insurance provisions)

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

Government targets: Agriculture, Dept of (USDA), Federal Emergency Management Agency (FEMA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center,including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing,administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Support the proposed extension of the Terrorism Risk Insurance Act, specifically HR 4871 and S2244. Issues related to supporting the National Assoc. of Registered Agents and Brokers Reform Act, as included in S2244 and H.R.4871. Monitor issues re implementation of health ins reform, specifically retaining a private sector role for ins brokers in health care reform & employee benefits and efforts to delay ACA mandates and require income certifications for subsidies - HR2775,
HR3362 and HR3811. Support for HR3462 -- Self-Insurance Protection Act. Monitor H.R. 3522 the Employee Health Care Protection Act. Monitor efforts to make changes in the Dodd-Frank Act, as they may relate to insurance. Issues related to implementing the law modernizing the regulation of surplus lines insurance.. Monitor the activities of the Federal Insurance Office and the development of insurance modernization proposals. Monitor and/or provide information regarding cyber security issues, particularly HR3696 the National Cybersecurity and Critical Infrastructure Protection Act. Monitor issues related to possible tax proposals, particularly those affecting insurance. Oppose efforts by IRS to include property insurance under the terms of Foreign Account Tax Compliance Act. Monitor legislation regarding expatriate health care coverage, particularly HR4414. Oppose amendments to the National Defense Authorization Act that would provide for a government takeover of the private sector role under the Defense Base Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851, 4406 HR 3541 introduced by Tim Griffin November 19, 2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating nto the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding high risk insurance pools, implementation of state based health exchanges, eligibility for health insurance premium subsidies 2. H.R. 3362, Exchange Information Disclosure Act, entire bill

Client expense: $60,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Social Security Administration (SSA)

See attached addendum for General Lobbying Issue Area: HCR - HealthcareState-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. See following page on Health Care Reform issuesHR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 5214 Introduced July 28, 2014 by Pete Olsen (R-TX) To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. HR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 4633 Introduced May 9, 2014 by H. Griffith (R-VA) Insurance Rate Transparency Act - Amends the Public Health Service Act to require that specific health insurance premium increase information submitted to the Secretary of Health and Human Services (HHS) be disclosed to Congress no later than 30 days after receipt of the information. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule; Expatriate Legislation. See following page on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts. HR 3522 Introduced November 18, 2013 by Bill Cassidy (R-LA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes. HR 5214 Introduced July 28, 2014 by Pete Olsen (R-TX) To require the Secretary of Health and Human Services to provide for recommendations for the development and use of clinical data registries for the improvement of patient care. See following page on Health Care Reform issuesHR 3750 Introduced December 12, 2013 by Donna Matsui (D-CA) Telehealth Modernization Act of 2013 - Calls for states to authorize health care professionals to deliver health care to individuals through telehealth and to consider adopting conditions under which such a professional should: have access to the individual's medical history. HR 4633 Introduced May 9, 2014 by H. Griffith (R-VA) Insurance Rate Transparency Act - Amends the Public Health Service Act to require that specific health insurance premium increase information submitted to the Secretary of Health and Human Services (HHS) be disclosed to Congress no later than 30 days after receipt of the information. HR 5453 Introduced September 11, 2014 by Bruce Braley (D-IA) To authorize health insurance issuers to continue to offer for sale current group health insurance coverage in satisfaction of the minimum essential health insurance coverage requirement, and for other purposes.

Client expense: $1,540,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

H.R. 544 Liberty Act (All Provisions) S. 650 Access to Independent Health Insurance Advisors Act (All Provisions) P.L. 111-148 Patient Protection and Affordable Care Act (Implementation) H.R. 2328 Access to Professional Health Insurance Advisors Act (All Provisions) H.R. 2980 (No Short Title) (All Provisions) H.R. 2951 (No Short Title) (All Provisions) H.R. 3362 Exchange Information Disclosure Act of 2013 (All Provisions) S. 1590 Exchange Information Disclosure Act of 2013 (All Provisions) H.R. 3429 Consumer Protection Act (All Provisions) S. 1666 Healthcare Privacy and Anti-Fraud Act (All Provisions) H.R. 3811 Health Exchange Security and Transparency (All Provisions) S. 2175 Enhancing Access for Agents and Brokers (All Provisions) S. 2173 The CHOICE Act (All Provisions) H.R. 2575 Save American Workers Act of 2014 (All Provisions) S. 1188 Forty Hours is Full Time Act of 2014 (All Provisions) H.R. 4 Jobs for America Act (Insurance Provisions)

Client expense: $270,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Federal Emergency Management Agency (FEMA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of

HR 81, HR 105, HR.RES.17, HR 344, HR 544, HR 582, HR 607, HR 675, HR 762, HR 763, HR 903, HR 1076, HR 1200, HR 1205, HR 1239, HR 1248, HR 1254, HR 1342, HR 1549, HR 1558, HR 2328, HR 2527, HR 2575, HR 2577, HR 2667, HR 2995, HR 2988, HR 3362, HR 3367, HR 4244, HR 4128, HR 4144, HR 2453, HR 4160, HR 4302, HR 1179, HR 5183, HR 5557, S.CON. RES.8, S24, S351, S399, S.AMDT.409, S482, S603, S650, S701, S764, S1188, S1729, S2069, S2173, S2174, S2175, S2546,S2783

Client expense: $45,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

Support the proposed extension of the Terrorism Risk Insurance Act, specifically HR 4871 and S2244. Issues related to supporting the National Assoc. of Registered Agents and Brokers Reform Act, as included in S2244 and H.R.4871. Monitor issues re implementation of health ins reform, specifically retaining a private sector role for ins brokers in health care reform & employee benefits and efforts to delay ACA mandates and require income certifications for subsidies - HR2775,
HR3362 and HR3811. Support for HR3462 -- Self-Insurance Protection Act. Monitor H.R. 3522 the Employee Health Care Protection Act. Monitor efforts to make changes in the Dodd-Frank Act, as they may relate to insurance. Issues related to implementing the law modernizing the regulation of surplus lines insurance.. Monitor the activities of the Federal Insurance Office and the development of insurance modernization proposals. Monitor and/or provide information regarding cyber security issues, particularly HR3696 the National Cybersecurity and Critical Infrastructure Protection Act. Monitor issues related to possible tax proposals, particularly those affecting insurance. Oppose efforts by IRS to include property insurance under the terms of Foreign Account Tax Compliance Act. Monitor legislation regarding expatriate health care coverage, particularly HR4414. Oppose amendments to the National Defense Authorization Act S.2410 that would provide for a government takeover of the private sector role under the Defense Base Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

HR 81, HR 105, HR.RES.17, HR 344, HR 544, HR 582, HR 607, HR 675, HR 762, HR 763, HR 903, HR 1076, HR 1200, HR 1205, HR 1239, HR 1248, HR 1254, HR 1342, HR 1549, HR 1558, HR 2328, HR 2527, HR 2575, HR 2577, HR 2667, HR 2995, HR 2988, HR 3362, HR 3367, HR 4244, HR 4128, HR 4144, HR 2453, HR 4160, HR 4302, HR 1179, S.CON. RES.8, S24, S351, S399, S.AMDT.409, S482, S603, S650, S701, S764, S1188, S1729, S2069, S2173, S2174, S2175, S2546

Client expense: $45,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Deliver System Reforms. State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database. Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees. Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health BEnefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851, 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19, 2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue and governance. Section 104 Substitute Amendment. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health an Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified b health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (T-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD-9) with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the elecronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient PRotection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate th health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool.

Client expense: $5,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), SENATE, Treasury, Dept of

Support the proposed extension of the Terrorism Risk Insurance Act, specifically HR 4871 and S2244. Issues related to supporting the National Assoc of Registered Agents and Brokers Reform Act, as included in S2244 and H.R.4871. Monitor issues re implementation of health ins reform, specifically retaining a private sector role for ins brokers in health care reform &employee benefits and efforts to delay ACA mandates and require income certifications for subsidies - HR2775,HR3362 and HR3811. Support for excluding broker commissions from the medical loss ratio calculation related to health care reform implementation and support for HR3462 -- Self-Insurance Protection Act. Monitor efforts to make changes in the Dodd-Frank Act, as they may relate to insurance. Issues related to implementing the law modernizing the regulation of surplus lines insurance. Issues related to supporting an Optional Federal Charter for Insurers. Monitor the activities of the Federal Insurance Office and the development of insurance modernization proposals. Monitor and/or provide information regarding cyber security issues, particularly HR3696 the National Cybersecurity and Critical Infrastructure Protection Act. Monitor issues related to possible tax proposals, particularly those affecting insurance. Oppose efforts by IRS to include property insurance under the terms of Foreign Account Tax Compliance Act. Monitor legislation regarding expatriate health care coverage, particularly HR4414.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule See following page on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts.

Client expense: $1,820,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding high risk insurance pools, implementation of state based health exchanges, eligibility for health insurance premium subsidies 2. H.R. 3362, Exchange Information Disclosure Act, entire bill

Client expense: $60,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Social Security Administration (SSA)

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851. 4406 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: ACA Implementation and back-end issues; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation; Third-party payment of premiums; Electronic Health Records (EHRs); Health IT Roadmap; Contraception Rule S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. HR 3985 Introduced February 3, 2014 by Lynn Westmoreland (R-GA) Prohibits health insurance issuers and third-party administrators, for any period after December 31, 2014, from being required to make payments under the Patient Protection and Affordable Care Act (PPACA) for a transitional reinsurance program for the individual health insurance market in each state. Allows payments to issuers, as limited by this Act, only to the extent of available funds. Limits to 2014 the applicability of the program of risk corridors, under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums . HR 4496 Introduced April 28, 2014 by Cory Gardner (R-CO) Covering People With Pre-Existing Conditions Act of 2014 - Requires each state to mitigate the health costs of high risk individuals in the state through a state reinsurance program or a state high risk pool HR 4777 Introduced May 30, 2014 by Michael Burgess (R-TX) To amend the Internal Revenue Code of 1986 to modify rules relating to health savings accounts.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 544 Liberty Act (All Provisions) S. 650 Access to Independent Health Insurance Advisors Act (All Provisions) P.L. 111-148 Patient Protection and Affordable Care Act (Implementation) P.L. 111-150 Healthcare and Education Reconciliation Act (Implementation)H.R. 2328 Access to Professional Health Insurance Advisors Act (All Provisions) H.R. 2980 (No Short Title) (All Provisions) H.R. 2951 (No Short Title) (All Provisions) H.R. 3362 Exchange Information Disclosure Act of 2013 (All Provisions) S. 1590 Exchange Information Disclosure Act of 2013 (All Provisions) H.R. 3429 Consumer Protection Act (All Provisions) S. 1666 Healthcare Privacy and Anti-Fraud Act (All Provisions) H.R. 3811 Health Exchange Security and Transparency (All Provisions) S. 2175 Enhancing Access for Agents and Brokers (All Provisions) S. 2173 The CHOICE Act (All Provisions) H.R. 2575 Save American Workers Act of 2014 (All Provisions) S. 1188 Forty Hours is Full Time Act of 2013 (All Provisions)

Client expense: $600,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Federal Emergency Management Agency (FEMA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of

Support the proposed extension of the Terrorism Risk Insurance Act, specifically HR 4871 and S2244. Issues related to supporting the National Assoc of Registered Agents and Brokers Reform Act, as included in S2244 and H.R.4871.
Monitor issues re implementation of health ins reform, specifically retaining a private sector role for ins brokers in health care reform & employee benefits and efforts to delay ACA mandates and require income certifications for subsidies - HR2775, HR3362 and HR3811. Support for excluding broker commissions from the medical loss ratio calculation related to health care reform implementation and support for HR3462 -- Self-Insurance Protection Act. Monitor efforts to make changes in the Dodd-Frank Act, as they may relate to insurance. Issues related to implementing the law modernizing the regulation of surplus lines insurance. Monitor the activities of the Federal Insurance Office and the development of insurance modernization proposals. Monitor and/or provide information regarding cyber security issues, particularly HR3696 the National Cybersecurity and Critical Infrastructure Protection Act. Monitor issues related to possible tax proposals, particularly those affecting insurance. Oppose efforts by IRS to include property insurance under the terms of Foreign Account Tax Compliance Act.

Client expense: Not reported · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. CON.RES.8, S24, S351, S399, SADMT.409, S482, S603, S650, S701, S764, S1188, S1729, S2069, S2173, S2174, S2175, HR81, HR105, H.RES175, HR344, HR544, HR582, HR607, HR675, HR762, HR763, HR779, HR903, HR1076, HR1140, HR1200, HR1205, HR1239, HR1248, HR1254, HR1342, HR1549, HR1558, HR2328, HR2527, HR2575, HR2577, HR2667, HR2995, HR2988, HR3362, HR3367, HR4244, HR4128, HR4144, HR2453, HR4160, HR4302

Client expense: $330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), SENATE, Treasury, Dept of, White House Office

1. Patient Protection and Affordable Health Care Act, implementation of provisions regarding high risk insurance pools, implementation of state based health exchanges, eligibility for health insurance premium subsidies 2. H.R. 3362, Exchange Information Disclosure Act, entire bill 3. H.R. 4118, SIMPLE Fairness Act, entire bill

Client expense: $60,000 · Firm income: Not reported

Government targets: Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE, Social Security Administration (SSA)

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: Delay of Individual Mandate; ACA Implementation; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation See following pages on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: Delay of Individual Mandate; ACA Implementation; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation See following pages on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information.

Client expense: $360,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

H.R. 3795 OH NO Act of 2013; H.R. 7 No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2014; H.R. 3362 Exchange Information Disclosure Act; H.R. 3541 Obamacare Taxpayer Bailout Prevention Act; S. 1726 Obamacare Taxpayer Bailout Prevention Act

Client expense: $190,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Internal Revenue Service (IRS), SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: Delay of Individual Mandate; ACA Implementation; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation See following pages on Health Care Reform issuesS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information.

Client expense: $1,760,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

Monitor efforts to alter the requirement for actuarial rates in the Natl Fld Ins Prog, S1926, Homeowner Fld Ins Affrd Act 2014. Monitor legislation on national atastrophe tax incentives as in HR549. Issues related to supporting the National Assoc of Registered Agents and Brokers Reform Act of 2013, as included in S1926.Monitor issues re to implementation of health ins reform, specifically retaining a private sector role for ins brokers in health care reform & employee benefits and efforts to delay ACA mandates and require income certifications for subsidies - HR2775, HR3362 and HR3811. Support for excluding broker commisions from the medical loss ratio calculation related to health care reform implementation and support for HR3462 -- Self-Insurance Protection Act. Monitor efforts to make changes in the Dodd-Frank Act, as they may relate to insurance. Issues related to implementing the law modernizing the regulation of surplus lines insurance. Issues related to supporting an Optional Federal Charter for Insurers. Monitor the activities of the Federal Insurance Office and the development of insurance modernization proposals. Monitor and/or provide information regarding cyber security issues, particularly HR3696 the National Cybersecurity and Critical Infrastructure Protection Act of 2013. Monitor issues related to possible tax proposals, particularly those affecting insurance. Support the proposed extension of the Terrorism Risk Insurance Act, specifically HR508 HR2146 and HR1945. Oppose amendments to the Defense Base Act to eliminate the private sector role, particularly focused on the National Defense Authorization Act. Oppose efforts by IRS to include property insurance under the terms of Foreign Account Tax Compliance Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

Please see attached addendum for general issue area code: HCRS. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information.

Client expense: $20,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareAffordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees HealthCare Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ration of a health insurance plan. HR 3541 introduced by Tim Griffin November 19, 2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: Delay of Individual Mandate; ACA Implementation; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. Section 104 Substitute Amendment.HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX) Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information.

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE

Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM FEHBP Modernization Act circulation draft President's budget, regional PPOs, government contributions HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act Bailouts for Insurance Companies, S. 1726, H.R. 3541, 3812, 3851 HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. HR 3541 introduced by Tim Griffin November 19,2013 Obamacare Taxpayer Bailout Prevention Act - Repeals the provision of the Patient Protection and Affordable Care Act that directs the Secretary of Health and Human Services (HHS) to establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market is required to participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan's aggregate premiums. Other general Affordable Care Act topics related to multiple parts of legislation: Delay of Individual Mandate; ACA Implementation; Multi-State Plan Program Implementation; Risk Corridors and Risk Mitigation; Reinsurance; Small Business Health Options Program (SHOP) implementation S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance.. Section 104 Substitute Amendment. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN)Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. HR 1701 Introduced April 24, 2013 by Ted Poe (R-TX)Cutting Costly Codes Act of 2013 - Prohibits the Secretary of Health and Human Services (HHS) from implementing, administering, or enforcing specified regulations insofar as they would replace International Classification of Diseases (ICD)-9 with ICD-10 as a standard for code sets for appropriate data elements for financial and administrative transactions involving the electronic exchange of health information. Medicare Reforms: Medicare A & B; Delivery System Reforms, Benefit Restructuring ; Medigap first-dollar coverage; Quality Initiatives/SGR Reform, HIPAA Code Adoption Process, Medicare Advantage Risk Delay Part D Cuts, HR 2810 Introduced by Burgess (R-TX) on July 31, 2013 Multi-State Plan Programs, Medicare Patient Access and Quality Improvement Act of 2013, Medicare Prescription Drug Integrity.

Client expense: $43,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 544 Liberty Act (All Provisions) S. 650 Access to Independent Health Insurance Advisors Act (All Provisions) P.L. 111-148 Patient Protection and Affordable Care Act (Implementation) P.L. 111-150 Healthcare and Education Reconciliation Act (Implementation)H.R. 2328 Access to Professional Health Insurance Advisors Act (All Provisions) H.R. 2980 (No Short Title) (All Provisions) H.R. 2951 (No Short Title) (All Provisions) H.R. 3362 Exchange Information Disclosure Act of 2013 (All Provisions) S. 1590 Exchange Information Disclosure Act of 2013 (All Provisions) H.R. 3429 Consumer Protection Act (All Provisions) S. 1666 Healthcare Privacy and Anti-Fraud Act (All Provisions) H.R. 3811 Health Exchange Security and Transparency (All Provisions) S. 2175 Enhancing Access for Agents and Brokers (All Provisions) S. 2173 The CHOICE Act (All Provisions) H.R. 2575 Save American Workers Act of 2014 (All Provisions) S. 1188 Forty Hours is Full Time Act of 2013 (All Provisions)

Client expense: $400,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Federal Emergency Management Agency (FEMA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of

S. 2157, the Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 H.R. 2019 Gabriella Miller Kids First Research Act H.R. 1037 Occupational Therapy in Mental Health Act H.R. 1178 Creating Access to Residency Education Act of 2013H.R. 1180 Resident Physician Shortage Reduction Act of 2013 H.R. 1201 Training Tomorrow's Doctors Act H.R. 1252 Physical Therapist Workforce and Patient Access Act of 2013 H.R. 1274 Access to Quality Diabetes Education Act of 2013 H.R. 1326 Health Care Price Transparency Promotion Act of 2013 H.R. 1339 Palliative Care and Hospice Education and Training Act H.R. 1427 Truth in Healthcare Marketing Act of 2013 H.R. 1790 Health IT Modernization for Underserved Communities Act of 2013 H.R. 1814 Equitable Access to Care and Health (EACH) Act H.R. 1821 Registered Nurse Safe Staffing Act of 2013 H.R. 1827 Pediatric Subspecialty and Mental Health Workforce Reauthorization Act of 2013 H.R. 1838 Enhanced Access to Medicaid Services Act of 2013 H.R. 1874 Pro-Growth Budgeting Act H.R. 1907 Nurse Staffing Standards for Patient Safety and Quality Care Act of 2013 H.R. 1976 Access to Certified Professional Midwives Act of 2013 H.R. 2131 Supplying Knowledge-based Immigrants and Lifting Levels of STEM (SKILLS) Visas Act of 2013 H.R. 235 Veteran Emergency Medical Technician Support Act of 2013 H.R. 2415 Treat and Reduce Obesity Act H.R. 244 Physician Availability Act of 2013 H.R. 2453 Medicare Beneficiary Preservation of Choice Act of 2013 H.R. 2484 Conrad State 30 and Physician Access Act H.R. 2619 Medicare Repiratory Therapist Access Act of 2013 H.R. 2651 Critical Care Assessment and Improvement Act of 2013 H.R. 2663 Preventive Health Savings Act H.R. 2801 Protecting Access to Rural Therapy Services (PARTS) Act H.R. 2810 Medicare Patient Access and Quality Improvement Act of 2013 H.R. 2843/S. 1180 Medicare Data Access for Transparency and Accountability Act H.R. 2867 Medicare Hospice Care Access Act of 2013 H.R. 2969 Medicare Patient Access to Hospice Act of 2013 H.R. 297 Children's Hospital GME Support Reauthorization Act of 2013 H.R. 2986 Protecting Access to Primary Care Act H.R. 3077 TELEmedicine for MEDicare Act of 2013 or TELE-MED Act of 2013 H.R. 3120 Comprehensive Dental Reform Act of 2013 H.R. 3303 Sensible Oversight for Technology which Advances Regulatory Efficiency (SOFTWARE) Act H.R. 3306 Telehealth Enhancement Act of 2013 H.R. 3362, Exchange Information Disclosure Act H.R. 3392 Medicare Part D Patient Safety and Drug Abuse Prevention Act of 2013 H.R. 3474 Hire More Heroes Act of 2013 H.R. 3507 21st Century Care for Military and Veterans Act H.R. 3717, the Helping Families in Mental Health Crisis Act of 2013 H.R. 3811, Health Exchange Security and Transparency Act H.R. 3979 Protecting Volunteer Firefighters and Emergency Responders Act of 2014 H.R. 4106, Barr-Bera Saving Lives, Saving Costs Act H.R. 4118, The SIMPLE Fairness Act H.R. 4160 - the "Keep the Promise to Seniors Act of 2014." H.R. 4177: a bill to amend the Internal Revenue Code of 1986 to Allow Medicare beneficiaries participating in a Medicare Advantage MSA to contribute their own money to their MSA. H.R. 4180: a bill to amend the Internal Revenue Code of 1986 to permit rollovers from health savings accounts to Medicare Advantage MSAs H.R. 4196: Seniors' Fairness Act of 2014H.R. 4201: Seniors' Rights to Know Act H.R. 487 Primary Care Workforce Access Improvement Act of 2013 H.R. 574 Medicare Physician Payment Innovation Act of 2013 H.R. 7, No Taxpayer Funding for Abortion Act H.R. 794 To amend title XVIII of the Social Security Act to provide for treatment of clinical psychologists as physicians for purposes of furnishing clinical psychologist services under the Medicare Program. H.R. 962 Medicare Diabetes Prevention Act H.R. 2575, the "Save American Workers Act of 2014," H.R. 4064, FAIR ACT of 2014 H.R. 4302, the Protecting Access to Medicare Act of 2014 H.RES.356 A resolution recognizing that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States. H.R.1024 The Medication Therapy Management Empowerment Act IMPACT Act of 2014 (Improving Medicare Post-Acute Care Transformation Act of 2014) S. 1060 Veterans to Paramedics Transition Act S. 1061 Veterans Access to Care Act S. 1064 Medicare Mental Health Access Act S. 1143 Protecting Access to Rural Therapy Services (PARTS) Act S. 1152 Building a Health Care Workforce for the Future Act S. 1184 Treat and Reduce Obesity Act S. 1193 Data Security and Breach Notification Act of 2013 S. 1228 Medicare Better Health Rewards Program Act S. 1422 Preventive Health Savings Act S. 1439 Care Planning Act of 2013 S. 1444 Medicare Access to Rural Anesthesiology Act of 2013 S. 1445 National Health Service Corps Improvement Act of 2013 S. 1475 National Nurse Act of 2013 S. 1517 Behavioral Health Information Technology Act of 2013 S. 1522 Comprehensive Dental Reform Act of 2013 S. 1557 Children's Hospital GME Support Reauthorization Act of 2013 S. 1685 Behavioral Health Information Technology Coordination Act of 2013 S. 1729 - Expanded Consumer Choice Act S. 1758 Quality Data, Quality Healthcare Act of 2013 S. 1871, SGR Repeal and Medicare Beneficiary Improvement Act of 2013 S. 2000/H.R. 4015 SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2007, Preventing Regulatory Overreach To Enhance Care Technology Act of 2014 (PROTECT Act) S. 2110, SGR Repeal and Medicare Provider Payment Modernization Act of 2014 S. 2166 Treating Families Fairly Act S. 2168 amends the definition from 50 100 employees for the purposes of the employer mandate S. 2173 the CHOICE Act S. 2175 Enhancing Access to Agents and Brokers Act S. 2240 The Medicare Choices Empowerment and Protection Act S. 236 Medicare Patient Empowerment Act S. 328 Strengthening Rural Access to Emergency Services Act S. 382 A bill to amend title XVIII of the Social Security Act to allow physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs.S. 452 Medicare Diabetes Prevention Act S. 557 The Medication Therapy Management Empowerment Act S. 577 The Resident Physician Shortage Reduction Act of 2013 S. 602 Physical Therapist Workforce and Patient Access Act of 2013 S. 616 Conrad State 30 and Physician Access Act S. 641 Palliative Care and Hospice Education and Training Act S. 739 National Nursing Shortage Reform and Patient Advocacy Act S. 744 Border Security, Economic Opportunity, and Immigration Modernization Act S. 755 Enhanced Access to Medicaid Services Act of 2013 S. 945 Access to Quality Diabetes Education Act of 2013 S.1067 Innovation Inspiration School Grant Program Act S.1897 Personal Data Privacy and Security Act of 2014 S.1927 The Data Security Act of 2014 S.1932/H.R. 3890 The Better Care, Lower Cost Act S.1976 Data Security and Breach Notification Act of 2014 S.1995 Personal Data Protection and Breach Accountability Act S.2106, FAIR Act of 2014 S.236 / H.R. 1310 - Medicare Patient Empowerment Act of 2013 S.577 Resident Physician Shortage Reduction Act of 2013 S.RES.26 A resolution recognizing that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States.

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

Government targets: Centers For Medicare and Medicaid Services (CMS), Congressional Budget Office (CBO), Executive Office of the President (EOP), Food & Drug Administration (FDA), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), SENATE

Monitor efforts to alter the requirement for actuarial rates in the National Flood Insurance Program, S1926, Homeowner Flood Insurance Affordability Act 2014. Monitor legislation on national catastrophe tax incentives as in HR549. Issues related to supporting the National Assoc. of Registered Agents and Brokers Reform Act of 2013, as included in S 1926 Monitor issues re to implementation of health ins. reform, specifically retaining a private sector role for ins. brokers in health care reform & employee benefits and efforts to delay ACA mandates and require income certifications for subsidies - HR2775, H.R.3362 and H.R.3811. Support for excluding broker commissions from the medical loss ratio calculation related to health care reform implementation and support for HR3462 -- Self-Insurance Protection Act. Monitor efforts to make changes in the Dodd-Frank Act, as they may relate to insurance. Issues related to implementing the law modernizing the regulation of surplus lines insurance. Monitor the activities of the Federal Insurance Office and the development of insurance modernization proposals. Monitor and/or provide information regarding cyber security issues, particularly H.R.3696 the National Cybersecurity and Critical Infrastructure Protection Act of 2013. Monitor issues related to possible tax proposals, particularly those affecting insurance. Support the proposed extension of the Terrorism Risk Insurance Act, specifically HR508, HR2146 and HR1945. Oppose amendments to the Defense Base Act to eliminate the private sector role. Oppose efforts by IRS to include property insurance under the terms of Foreign Account Tax Compliance Act.

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE, Treasury, Dept of

H.R. 3362, the Exchange Information Disclosure Act, all sections

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareSuccessful Insurance Industry Implementation of Health Reforms: Reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers Health Care Quality; Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/ Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act S. 1488 Introduced in Senate September 9, 2013 Fairness for American Families Act - Amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act (PPACA), to delay until 2015 the requirement that individuals maintain minimal essential health care coverage. Authority for Mandate Delay Act - Amends PPACA to delay until 2015 enforcement of requirements that large employers offer their full-time employees the opportunity to enroll in minimum essential coverage. Delays the effective date of related reporting requirements for such employers and for providers of minimum essential coverage. HR 3350 Passed House without amendment November 15, 2013 Keep Your Health Plan Act of 2013 - Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. HR 3362 Introduced October 29, 2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange.HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. H.J. Res. 59 making continuing appropriations for fiscal year 2014, and for other purposes; providing for consideration of motions to suspend the rules; providing for proceedings during the period from December 14, 2013, through January 6, 2014. HR 460 Introduced in House February 4, 2013 Rep. McKinley, David B. (R-WV) Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, application to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier. Grandfathering and Delay of Individual Mandate ACA Implementation Multi-state Plan Program Implementation Risk Corridors

Client expense: Not reported · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Personnel Management (OPM), SENATE

S.CON.RES.8;S24,S351,S399,S.AMDT.409, S482,S 603, S 650, S 701, S 764, S 1188, S 1729, HR 81, HR 105, H.RES.175, HR.344, HR 544, HR 582, HR 607, HR675, HR 762, HR 763, HR 779,HR 903, HR 1076, HR 1200, HR 1205, HR 1239, HR 1248, HR 1254, HR 1342, HR 1549, HR 1558, HR 2328, HR 2575, HR 2577, HR 2667, HR 2995, HR 2988, HR 3362

Client expense: $330,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), Executive Office of the President (EOP), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Internal Revenue Service (IRS), Labor, Dept of (DOL), President of the U.S., SENATE, Treasury, Dept of

See attached addendum for General Lobbying Issue Area: HCR - HealthcareSuccessful Insurance Industry Implementation of Health Reforms: Reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act S. 1488 Introduced in Senate September 9, 2013 Fairness for American Families Act - Amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act (PPACA), to delay until 2015 the requirement that individuals maintain minimal essential health care coverage. Authority for Mandate Delay Act - Amends PPACA to delay until 2015 enforcement of requirements that large employers offer their full-time employees the opportunity to enroll in minimum essential coverage. Delays the effective date of related reporting requirements for such employers and for providers of minimum essential coverage. HR 3350 Passed House without amendment November 15, 2013 Keep Your Health Plan Act of 2013 - Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan.S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. H.J. Res. 59 making continuing appropriations for fiscal year 2014, and for other purposes; providing for consideration of motions to suspend the rules; providing for proceedings during the period from December 14, 2013, through January 6, 2014. HR 460 Introduced in House February 4, 2013 Rep. McKinley, David B. (R-WV) Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier. Grandfathering and Delay of Individual Mandate ACA Implementation Multi-state Plan Program Implementation Risk Corridors

Client expense: $1,960,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

See attached addendum for General Lobbying Issue Area: HCR - HealthcareSuccessful Insurance Industry Implementation of Health Reforms: Reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act S. 1488 Introduced in Senate September 9, 2013 Fairness for American Families Act - Amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act (PPACA), to delay until 2015 the requirement that individuals maintain minimal essential health care coverage. Authority for Mandate Delay Act - Amends PPACA to delay until 2015 enforcement of requirements that large employers offer their full-time employees the opportunity to enroll in minimum essential coverage. Delays the effective date of related reporting requirements for such employers and for providers of minimum essential coverage. HR 3350 Passed House without amendment November 15, 2013 Keep Your Health Plan Act of 2013 - Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan.S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. H.J. Res. 59 making continuing appropriations for fiscal year 2014, and for other purposes; providing for consideration of motions to suspend the rules; providing for proceedings during the period from December 14, 2013, through January 6, 2014. HR 460 Introduced in House February 4, 2013 Rep. McKinley, David B. (R-WV) Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier. Grandfathering and Delay of Individual Mandate ACA Implementation Multi-state Plan Program Implementation Risk Corridors

Client expense: $520,000 · Firm income: Not reported

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Office of Management & Budget (OMB), Office of Personnel Management (OPM), SENATE, Treasury, Dept of, White House Office

Successful Insurance Industry Implementation of Health Reforms: Reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating onpremiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Medical Loss Ratios: Level Playing Field for MLRs; Consistent reporting requirements for all insurers; MLR Broker Fees: Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM Medicare Reforms: Medicare A & B; Delivery System Reforms, Benefit Restructuring; Medigap first dollar coverage; cost contract extension HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act S. 1488 Introduced in Senate September 9, 2013 Fairness for American Families Act - Amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act (PPACA), to delay until 2015 the requirement that individuals maintain minimal essential health care coverage. Authority for Mandate Delay Act - Amends PPACA to delay until 2015 enforcement of requirements that large employers offer their full-time employees the opportunity to enroll in minimum essential coverage. Delays the effective date of related reporting requirements for such employers and for providers of minimum essential coverage. HR 3350 Passed House without amendment November 15, 2013 Keep Your Health Plan Act of 2013 - Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan. S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. H.J. Res. 59 making continuing appropriations for fiscal year 2014, and for other purposes; providing for consideration of motions to suspend the rules; providing for proceedings during the period from December 14, 2013, through January 6, 2014. HR 460 Introduced in House February 4, 2013 Rep. McKinley, David B. (R-WV) Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier. Grandfathering and Delay of Individual Mandate ACA Implementation Multi-state Plan Program Implementation Risk Corridors

Client expense: $38,000 · Firm income: Not reported

Government targets: HOUSE OF REPRESENTATIVES, SENATE

See attached addendum for General Lobbying Issue Area: HCR - HealthcareSuccessful Insurance Industry Implementation of Health Reforms: Reasonable regulatory implementation timeline for compliance with PL 111-148 Affordable Private Health Care: Effect of the Health Insurance Tax, defined Essential Health Benefits, and Age Rating on premiums; Healthcare Delivery System Reforms State-based regulation: State Oversight of Rates; Properly designed state based health insurance exchanges to improve competition and maximize choice; federal exchanges; Multi-State Health Plans; Centralized All-Payer Database Health Care Quality: Delivery System Incentives to Promote Better Care; Payment Reforms; Patient-centered Primary Care/Medical Home; Evidence Based Care; Wellness; Chronic Care Management Insurance Market Reform; Individual Market Reform; Small Group Market Reform; Guaranteed Issue; Community Rating; Age Rating; Health Savings Accounts Federal Employee Health Benefit Program (FEHBP) regarding proposals to allow additional types of carriers including regional PPOs to be included in the coverage options offered by OPM HR 2667 Introduced by Griffin (R-AR) on July 11, 2013 Authority for Mandate Delay Act HR 2668 Introduced by Young (R-IN) on July 17, 2013 Fairness for Families Act S. 1488 Introduced in Senate September 9, 2013 Fairness for American Families Act - Amends the Internal Revenue Code, as amended by the Patient Protection and Affordable Care Act (PPACA), to delay until 2015 the requirement that individuals maintain minimal essential health care coverage. Authority for Mandate Delay Act - Amends PPACA to delay until 2015 enforcement of requirements that large employers offer their full-time employees the opportunity to enroll in minimum essential coverage. Delays the effective date of related reporting requirements for such employers and for providers of minimum essential coverage. HR 3350 Passed House without amendment November 15, 2013 Keep Your Health Plan Act of 2013 - Permits a health insurance issuer that has in effect health insurance coverage in the individual market as of January 1, 2013, to continue offering such coverage for sale during 2014 outside of a health care exchange established under the Patient Protection and Affordable Care Act. Treats such coverage as a grandfathered health plan for purposes of an individual meeting the requirement to maintain minimum essential health coverage. HR 2328 Introduced in House June 12, 2013 Rep. Rogers, Mike J. (R-MI) Access to Professional Health Insurance Advisors Act of 2013 - Amends the Public Health Service Act to exclude remuneration paid for licensed independent insurance producers from administrative cost calculations for purposes of calculating the medical-loss ratio of a health insurance plan.S. 1486 Introduced August 1, 2013 by Sen. Carper, Thomas R. (D-DE) Postal Reform Act of 2013 - Amends provisions of federal law relating to the funding of the U.S. Postal Service (USPS) retirement and health care systems, operations, revenue, and governance. HR 3362 Introduced October 29,2013 by Rep. Terry, Lee (R-NE) Exchange Information Disclosure Act - Amends the Patient Protection and Affordable Care Act to expand reporting requirements related to health care exchanges. Requires the Secretary of Health and Human Services (HHS) to publish reports weekly through March 31, 2015, on: (1) consumer interactions with healthcare.gov or subsequent sites and any efforts undertaken to remedy problems that impact taxpayers and consumers, (2) calls to the federal customer service call center, including the number of calls received by the call center, problems identified by users, and referrals of those calls; (3) all navigators and certified application counselors that have been trained and certified by health care exchanges; and (4) all agents and brokers who have been trained and certified by the federal health care exchange. HR 762 Introduced in House February 15, 2013 by Rep. Blackburn, Marsha (R-TN) Health Care Choice Act of 2013 - Repeals the health insurance and health coverage expansion requirements of the Patient Protection and Affordable Care Act and related requirements of the Health Care and Education Reconciliation Act of 2010. Restores provisions of law amended or repealed by such provisions. H.J. Res. 59 making continuing appropriations for fiscal year 2014, and for other purposes; providing for consideration of motions to suspend the rules; providing for proceedings during the period from December 14, 2013, through January 6, 2014. HR 460 Introduced in House February 4, 2013 Rep. McKinley, David B. (R-WV) Patients' Access to Treatments Act of 2013 - Amends the Public Health Service Act to establish cost-sharing limits for health plans that cover prescription drugs and use a formulary or other tiered cost-sharing structure. Prohibits such a health plan from imposing cost-sharing requirements, including co-payment and co-insurance, applicable to prescription drugs in a specialty drug tier that exceed the dollar amount of cost-sharing requirements applicable to prescription drugs in a non-preferred brand drug tier. Applies the non-preferred brand drug tier for which beneficiary cost-sharing is lowest, if a formulary used by the health plan contains more than one non-preferred brand drug tier. Grandfathering and Delay of Individual Mandate ACA Implementation Multi-state Plan Program Implementation Risk Corridors

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

Government targets: HOUSE OF REPRESENTATIVES, SENATE

H.R. 544 Liberty Act (All Provisions) S. 650 Access to Independent Health Insurance Advisors Act (All Provisions) P.L. 111-148 Patient Protection and Affordable Care Act (Implementation) P.L. 111-150 Healthcare and Education Reconciliation Act (Implementation)H.R. 2328 Access to Professional Health Insurance Advisors Act (All Provisions) H.R. 2980 (No Short Title) (All Provisions) H.R. 2951 (No Short Title) (All Provisions) H.R. 3362 Exchange Information Disclosure Act of 2013 (All Provisions) S. 1590 Exchange Information Disclosure Act of 2013 (All Provisions) H.R. 3429 Consumer Protection Act (All Provisions) S. 1666 Healthcare Privacy and Anti-Fraud Act (All Provisions)

Client expense: $270,000 · Firm income: Not reported

Government targets: Agriculture, Dept of (USDA), Federal Emergency Management Agency (FEMA), Government Accountability Office (GAO), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Housing & Urban Development, Dept of (HUD), SENATE, Treasury, Dept of