2046
HR 3590 EAS/PP
appeals process, and to receive continued cov-
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erage pending the outcome of the appeals process.
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``(2) E
STABLISHED
PROCESSES
.--To comply
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with paragraph (1)--
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``(A) a group health plan and a health in-
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surance issuer offering group health coverage
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shall provide an internal claims and appeals
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process that initially incorporates the claims and
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appeals procedures (including urgent claims) set
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forth at section 2560.5031 of title 29, Code of
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Federal Regulations, as published on November
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21, 2000 (65 Fed. Reg. 70256), and shall update
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such process in accordance with any standards
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established by the Secretary of Labor for such
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plans and issuers; and
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``(B) a health insurance issuer offering indi-
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vidual health coverage, and any other issuer not
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subject to subparagraph (A), shall provide an in-
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ternal claims and appeals process that initially
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incorporates the claims and appeals procedures
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set forth under applicable law (as in existence on
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the date of enactment of this section), and shall
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update such process in accordance with any
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standards established by the Secretary of Health
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and Human Services for such issuers.
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