H.R. 3758

119 HR 3758 IH: Workers’ Disability Benefits Parity Act of 2025
 U.S. House of Representatives
 2025-06-05
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 I  119th CONGRESS  1st Session  H. R. 3758  IN THE HOUSE OF REPRESENTATIVES   June 5, 2025   Mr. DeSaulnier  (for himself and  Mr. Scott of Virginia ) introduced the following bill; which was referred to the  Committee on Education and Workforce    A BILL
To amend the Employee Retirement Income Security Act of 1974 to establish parity in the treatment of behavioral health and physical health conditions under disability benefit plans.
1.
Short title
This Act may be cited as the   Workers’ Disability Benefits Parity Act of 2025  .
2.
Findings; Sense of Congress
(a)
Findings
The Congress finds the following:
(1)
The Advisory Council on Employee Welfare and Pension Benefit Plans ( ERISA Advisory Council ) was established pursuant to section 512 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1142 ) to provide advice and recommendations to the Secretary of Labor.
(2)
In 2023, the ERISA Advisory Council published a report to the Secretary entitled  Long-Term Disability Benefits and Mental Health Disparity .
(3)
This report found that discriminatory benefit limitations—including duration limits found in nearly all long-term disability benefit plans—impede access to disability benefits for workers whose disability is caused by a behavioral health condition.
(4)
The report called for the Secretary to work with Congress to ensure that there is parity in disability benefits provided to workers.
(b)
Sense of congress
It is the sense of Congress that—
(1)
benefit limitations for workers whose disability is caused by a behavioral health condition are discriminatory; and
(2)
disability benefits should be provided without regard to the cause of a worker’s disability.
I
ERISA Amendments
101.
Parity in disability plan requirements
(a)
In general
Subtitle B of title I of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1021 et seq. ) is amended by adding at the end the following new part:
9
Disability benefit plan requirements
901.
Definitions
For purposes of this part:
(1)
Disability benefit
The term  disability benefit  means payment provided to a participant or beneficiary as a result of the loss of earning capacity resulting from injury or sickness.
(2)
Disability benefit plan
The term  disability benefit plan  means an employee welfare benefit plan that provides a disability benefit to participants or beneficiaries directly or through insurance or otherwise.
(3)
Mental health condition
The term  mental health condition  means any condition (other than a substance use disorder) that falls under any of the diagnostic categories listed in the mental, behavioral, and neurodevelopmental disorders chapter (or equivalent chapter) of the current version of the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems (or a successor publication), or that is listed in the current version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (or a successor publication).
(4)
Substance use disorder
The term ‘substance use disorder’ means any disorder that falls under any of the diagnostic categories listed as a mental or behavioral disorder due to psychoactive substance use (or equivalent category) in the mental, behavioral, and neurodevelopmental disorders chapter of the current version of the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems (or a successor publication) or that is listed as a Substance-Related and Addictive Disorder (or equivalent category) in the current version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (or a successor publication).
902.
Parity requirement for disability benefits
A disability benefit plan—
(1)
may not place a limitation, exclusion, or other restriction on benefits relating to a disability arising from a mental health condition or substance use disorder that is more restrictive than those applicable to benefits relating to a disability arising from a physical health condition; and
(2)
shall consider any physical health condition suffered by an individual that is caused by a disability arising from a mental health condition or a substance use disorder to be part of such disability.
  .
(b)
Civil monetary penalties
Section 502(c) of such Act is amended by adding at the end the following:
(13)
Civil penalties for violations of Part 9
(A)
In general
The Secretary may assess a civil penalty against any sponsor, administrator, service provider, or any other person or entity (except for a plan) who violates, or knowingly causes or conceals a violation of, part 9 of this title.
(B)
Amount
The amount of the penalty imposed by subparagraph (A) shall be equal to the amount of the penalty described in paragraph (10)(B) for each day in the noncompliance period described in subparagraph (C) with respect to each participant or beneficiary to whom such violation relates.
(C)
Noncompliance period
In this paragraph, the term  noncompliance period  means, with respect to a violation described in subparagraph (A), the period—
(i)
beginning on the date the violation occurs; and
(ii)
ending on the date the violation is corrected.
 .
102.
Authority to collect civil monetary penalties
Section 502(a)(6) of the Employee Retirement Income Security Act of 1974 is amended to read as follows:
(6)
by the Secretary to collect any civil penalty under this title;
 .
II
Additional disability parity requirements
201.
Definitions
In this title:
(1)
Administrator
The term  administrator  has the meaning given the term in section 3(16)(A) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1002(16)(A) ).
(2)
Employer
The term  employer  has the meaning given the term in section 3(5) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1002(5) ).
(3)
Governmental employee benefit plan
The term  governmental employee benefit plan  has the meaning given  governmental plan  in section 3(32) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1002(32) ), except that such term shall not include a plan established or maintained for its employees by the Government of the United States, or any agency or instrumentality thereof.
(4)
Issuer
The term  issuer  means an insurance company, insurance service, or insurance organization, which is licensed to engage in the business of insurance in a State and which is subject to State law which regulates insurance (within the meaning of section 514(b)(2) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1144(b)(2) )). Such term does not include an employee benefit plan (as defined under section 3(3) of such Act ( 29 U.S.C. 1002(3) )).
(5)
Secretary
The term  Secretary  means the Secretary of Labor.
(6)
State
The term  State  includes—
(A)
the 50 States;
(B)
the District of Columbia;
(C)
the Commonwealth of Puerto Rico;
(D)
the Virgin Islands;
(E)
Guam;
(F)
American Samoa; and
(G)
the Commonwealth of the Northern Mariana Islands.
(7)
Additional ERISA terms
The terms  disability benefit ,  disability benefit plan ,  mental health condition , and  substance use disorder  have the meanings given the terms in section 901 of the Employee Retirement Income Security Act.
(8)
Other ERISA terms
The terms  administrator ,  employer , and  State  have the meanings given the terms in section 3 of such Act.
202.
Requirement for parity in workers’ disability benefits
In the case of any governmental employee benefit plan or issuer that provides disability benefits to an individual, such a plan or issuer—
(1)
may not place a limitation, exclusion, or other restriction on benefits relating to a disability arising from a mental health condition or substance use disorder that is more restrictive than those applicable to benefits relating to a disability arising from a physical health condition; and
(2)
shall consider any physical health condition suffered by an individual that is caused by a disability arising from a mental health condition or a substance use disorder to be part of such disability.
203.
Enforcement
(a)
State enforcement
(1)
State authority
With respect to disability benefits provided by an issuer, each State may require that issuers that issue, sell, renew, or offer disability benefits in the State meet the requirements of this title with respect to such issuers.
(2)
Failure to implement provisions
In the case of a determination by the Secretary that a State has failed to substantially enforce the requirements of this title with respect to insurance issuers in the State, the Secretary shall enforce such requirements.
(b)
Secretarial enforcement authority
(1)
In general
If a governmental employee benefit plan or an issuer in a State described in subsection (a)(2) is found by the Secretary to fail to meet the requirements of this title, the Secretary may assess a civil monetary penalty against the responsible entity described in paragraph (3) with respect to such violation.
(2)
Civil penalty
(A)
In general
The Secretary may assess a civil penalty described in paragraph (1) against any sponsor, administrator, service provider, or any other person or entity (except for a plan) who violates, or knowingly causes or conceals a violation of, this title.
(B)
Amount
The amount of the penalty imposed by subparagraph (A) shall be equal the penalty amount described in section 502(c)(10)(B) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1132(c)(10)(B) ) for each day in the noncompliance period described in subparagraph (C) with respect to each participant or beneficiary to whom such violation relates.
(C)
Noncompliance period
In this paragraph, the term  noncompliance period  means, with respect to a violation described in subparagraph (A), the period—
(i)
beginning on the date the violation occurs; and
(ii)
ending on the date the violation is corrected.
(3)
Responsible entity
The responsible entity described in this paragraph is, in the case of a failure to meet the requirements of this title by—
(A)
an issuer, such issuer; or
(B)
a governmental employee benefit plan that is—
(i)
sponsored by 2 or more employers, the plan administrator; or
(ii)
not so sponsored, the employer.
(4)
Additional authority
All powers, remedies, and authority described in part 5 of the Employee Retirement Income Security Act shall be available to the Secretary with respect to any violation of this title by a governmental employee benefit plan or an issuer described in subsection (a)(2).
(c)
Right of action
Any individual who is aggrieved by the failure of a governmental employee benefit plan or issuer, with respect to disability benefits, to comply with the requirements of this title may bring an action in State or Federal court for appropriate equitable relief.
204.
Continued applicability of State law
This title shall not be construed to supersede any provision of State law that establishes, implements, or continues in effect any requirement or prohibition with respect to disability benefits except to the extent that such requirement or prohibition prevents the application of this title.
III
Implementation by Secretary of Labor
301.
Implementation of ERISA advisory council recommendations
(a)
Study
Not later than 18 months after the date of enactment of the Worker’s Disability Benefits Parity Act of 2025, the Secretary shall carry out a study on the cost to plan sponsors of providing disability benefits to participants and beneficiaries whose disability is caused by a behavioral health condition, including an actuarial analysis of such cost.
(b)
Education
Not later than 18 months after the date of enactment of the Worker’s Disability Benefits Parity Act of 2025, the Secretary shall conduct outreach and provide information to plan sponsors on the effect of duration limits on access to benefits by participants and beneficiaries with mental health and substance use disorder conditions.
302.
Implementation authority
The Secretary of Labor may issue such regulations as may be necessary or appropriate to carry out the provisions of this Act. The Secretary may issue sub-regulatory guidance and promulgate any interim final rules as the Secretary determines are appropriate to carry out this Act.
303.
Authorization of appropriations
There is authorized to be appropriated $10,000,000 for each fiscal year that begins in the 5-year period beginning on the date of enactment of this Act.
304.
Effective date
(a)
In general
The amendments made by this Act shall apply to plan years that begin after the date that is 18 months after the date of enactment of this Act.
(b)
Special rule for collective bargaining agreements
In the case of a plan maintained pursuant to one or more collective bargaining agreements between employee representatives and one or more employers ratified before the date of the enactment of this Act, the amendments made by this section shall not apply to plan years beginning before the later of—
(1)
the date on which the last of the collective bargaining agreements relating to the plan terminates (determined without regard to any extension thereof agreed to after the date of the enactment of this Act), or
(2)
18 months after the date of enactment of this Act.
 For purposes of paragraph (1), any plan amendment made pursuant to a collective bargaining agreement relating to the plan that amends the plan solely to conform to any requirement added by this section shall not be treated as a termination of such collective bargaining agreement.