id stringlengths 7 16 | section stringlengths 0 887 |
|---|---|
108hr5093ih | (3) Inflation adjustment
Paragraph (5) of section 179(b) of such Code (relating to inflations adjustments) is amended to read as follows: (5) Inflation adjustments
(A) Dollar limitation
In the case of any taxable year beginning in a calendar year after 2004, the $100,000 amount in paragraph (1) shall be increased by... |
108hr5093ih | multiplied by (ii) the cost-of-living adjustment under section 1(f)(3) for the calendar year in which the taxable year begins determined by substituting calendar year 2002 for calendar year 1992 in subparagraph (B) thereof. |
108hr5093ih | (B) Phaseout amount
In the case of any taxable year beginning in a calendar year after 2005, the $500,000 amount in paragraph (2) shall be increased by an amount equal to— (i) such dollar amount, multiplied by (ii) the cost-of-living adjustment under section 1(f)(3) for the calendar year in which the taxable year begi... |
108hr5093ih | (C) Rounding
(i) Dollar limitation
If the amount in paragraph (1) as increased under subparagraph (A) is not a multiple of $1,000, such amount shall be rounded to the nearest multiple of $1,000. (ii) Phaseout amount
If the amount in paragraph (2) as increased under subparagraph (B) is not a multiple of $10,000, such... |
108hr5093ih | (b) Work opportunity credit, welfare-to-work credit, and research credit allowed against alternative minimum tax
(1) In general
Subsection (c) of section 38 of the Internal Revenue Code of 1986 (relating to limitation based on amount of tax) is amended by redesignating paragraph (4) as paragraph (7) and by inserting ... |
108hr5093ih | and (ii) in applying paragraph (1) to such credit— (I) subparagraph (A) shall not apply, and (II) the limitation under paragraph (1) (as modified by subclause (I)) shall be reduced by the credit allowed under subsection (a) for the taxable year (other than the work opportunity credit, the welfare-to-work credit, or the... |
108hr5093ih | (5) Special rules for welfare-to-work credit
(A) In general
In the case of the welfare-to-work credit— (i) this section and section 39 shall be applied separately with respect to such credit, and (ii) in applying paragraph (1) to such credit— (I) subparagraph (A) shall not apply, and (II) the limitation under paragra... |
108hr5093ih | (B) Welfare-to-work credit
For purposes of this subsection, the term welfare-to-work credit means the credit allowable under subsection (a) by reason of section 51A(d)(2). |
108hr5093ih | (6) Special rules for research credit
(A) In general
In the case of the research credit— (i) this section and section 39 shall be applied separately with respect to such credit, and (ii) in applying paragraph (1) to such credit— (I) subparagraph (A) shall not apply, and (II) the limitation under paragraph (1) (as mod... |
108hr5093ih | (B) Research credit
For purposes of this subsection, the term research credit means the credit allowable under subsection (a) by reason of section 41.. (2) Conforming amendments
(A) Subclause (II) of section 38(c)(2)(A)(ii) of such Code is amended— (i) by striking or after employment credit and inserting a comma, and... |
108hr5093ih | (B) Subclause (II) of section 38(c)(3)(A)(ii) of such Code is amended by inserting , the work opportunity credit, the welfare-to-work, or the research credit after employee credit. (3) Effective date
The amendments made by this subsection shall apply to taxable years beginning after December 31, 2004. 2. |
108hr5093ih | Standard home office deduction
(a) In general
Subsection (c) of section 280A of the Internal Revenue Code of 1986 (relating to disallowance of certain expenses in connection with business use of home, rental of vacation homes, etc.) is amended by adding at the end the following new paragraph: (7) Standard home office... |
108hr5093ih | the deductions allowed under this chapter for the taxable year by reason of being attributed to such use shall not be less than $2,500. (b) Standard home office deduction not subject to limitation
Paragraph (5) of section 280A(c) of such Code (relating to limitation on deductions) is amended by striking In the case of... |
108hr5093ih | Minimum wage provisions
(a) Increase in tip income
Section 3(m)(1) of the Fair Labor Standards Act of 1938 ( 29 U.S.C. 203(m)(1) ) is amended by adding before the semicolon the following: , except that, for purposes of this paragraph, the cash wage paid such employee shall be not less than $3.25 an hour beginning Oct... |
108hr5093ih | 206 ) is amended— (A) in subsection (a), by inserting after Every employer the following: who employs ten or more employees ; and (B) in subsection (b), by inserting after Every employer the following: who employs ten or more employees. (2) Phased increase
Section 6(a) of such Act ( 29 U.S.C. 206(a) ) is amended by st... |
108hr5093ih | not less than $5.50 an hour during the year beginning October 1, 2005, not less than $6.00 an hour during the year beginning October 1, 2006, and not less than $6.50 an hour during the year beginning October 1, 2007. (c) Effective date
The amendment made by subsection (b)(1) shall apply beginning October 1, 2005. 4. |
108hr5093ih | Increased exemption for annual gross volume of sales made or business done by an enterprise
Section 3(s)(1)(A)(ii) of the Fair Labor Standards Act of 1938 ( 29 U.S.C. 203(s)(1)(A)(ii) ) is amended to read as follows: (ii) is an enterprise whose annual gross volume of sales made or business done, exclusive of excise ta... |
108hr5093ih | 2005, not less than $800,000 during the year beginning October 1, 2006, and not less than $1,000,000 during the year beginning October 1, 2007. 5. Earned income exclusion under the SSI program
(a) In general
Section 1612(b) of the Social Security Act ( 42 U.S.C. 1382a(b) ) is amended— (1) by striking and at the end o... |
108hr5093ih | and (3) by adding at the end the following: (24) (A) if such individual does not have an eligible spouse, the amount (if any) by which the minimum wage rate in effect for the month under section 6 of the Fair Labor Standards Act of 1938 multiplied by the number of hours for which such individual is gainfully employed d... |
108hr5093ih | the amount (if any) by which the minimum wage rate in effect for the month under section 6 of the Fair Labor Standards Act of 1938 multiplied by the total number of hours for which such individual and such spouse are gainfully employed during the month exceeds the total amount of earned income of such individual and su... |
108hr5094ih | 1. Temporary expansion of penalty-free withdrawals from individual retirement plans for individuals within certain disaster areas
(a) In general
Paragraph (2) of section 72(t) of the Internal Revenue Code of 1986 (relating to 10-percent additional tax on early distributions from qualified retirement plans) is amended... |
108hr5094ih | an area determined by the President to warrant assistance from the Federal Government under the Robert T. Stafford Disaster Relief and Emergency Assistance Act by reason of hurricane, flood, or other natural disaster at least part of which occurred in calendar year 2004 if such distribution is made within 6 months afte... |
108hr5094ih | Distributions shall not be taken into account under the preceding sentence if such distributions are described in subparagraph (A), (D), (E), or (F) or to the extent paragraph (1) does not apply to such distributions by reason of subparagraph (B).. (b) Effective date
The amendment made by this section shall apply to d... |
108hr4964ih | 1. Short title; findings; table of contents
(a) Short title
This Act may be cited as the American Health Benefits Program Act of 2004. (b) Findings
Congress finds the following: (1) Uninsured americans and lack of access to choices
(A) In 2002, 43.6 million Americans were uninsured, 80 percent of whom were employed... |
108hr4964ih | (C) Only 8 percent of employers providing health benefits are able to offer their employees a choice between two or more health plans. (2) Double-digit growth in employer costs
In 2003 the average per capita cost for employers to provide health benefits coverage increased by almost 14 percent. This was the third conse... |
108hr4964ih | (B) The Federal Employee Health Benefits Program (FEHBP) currently manages negotiations with health insurers over premiums and benefits on behalf of 8.6 million Federal employees and retirees and their dependents. (C) Overhead costs for employers providing health benefits coverage can be over 30 percent for employers w... |
108hr4964ih | (4) Expansion of FEHBP model to cover uninsured and other americans
Requiring participation in an FEHBP-style program would expand consumer choice, ensure portability and continuity of coverage, improve incentives for cost containment, and stabilize the burden on businesses (5) Personal responsibility
A recent survey... |
108hr4964ih | Establishment of American Health Benefits Program Title XXII—American Health Benefits Program Sec. 2201. Establishment of program Sec. 2202. Eligibility; requirement of coverage Sec. 2203. Qualified health plans; benefits; premiums Sec. 2204. Government contribution; American Health Benefits Program Trust Fund Sec. 220... |
108hr4964ih | Amendments to the medicaid and SCHIP program Sec. 5. Studies 2. Establishment of American Health Benefits Program
(a) In general
The Social Security Act is amended by adding at the end the following new title: XXII American Health Benefits Program
2201. Establishment of program
There is established under this title... |
108hr4964ih | The coverage is provided in a manner similar to the manner in which coverage has been provided to Members of Congress and Federal government employees and retirees and their dependents under the Federal Employees Health Benefits Program (FEHBP). 2202. Eligibility; requirement of coverage
(a) Eligibility
(1) In genera... |
108hr4964ih | the term AHBP-eligible individual means an individual residing in the United States who is— (i) a citizen or national of the United States; (ii) an alien lawfully admitted to the United States for permanent residence; (iii) an alien admitted into the United States under section 207 of the Immigration and Nationality Ac... |
108hr4964ih | and (v) an alien with the status of a nonimmigrant who is within a class of long-term nonimmigrants under section 101(a)(15) of the Immigration and Nationality Act that the Commissioner determines, in consultation with the Secretary of Homeland Security, to be appropriate. (B) Exception
Such term does not include an i... |
108hr4964ih | (2) Exception for individuals demonstrating public health insurance coverage
The requirement of paragraph (1) shall not apply to an individual who demonstrates coverage under any of the following: (A) Medicare
Coverage under parts A and B (or under part C) of title XVIII. (B) Medicaid
Coverage under a State plan und... |
108hr4964ih | (D) Indian health services
Coverage under a medical care program of the Indian Health Service or of a tribal organization. (E) Veterans health
Coverage under the veterans health care program under chapter 17 of title 38, United States Code, if the coverage for the individual involved is determined to be not less than... |
108hr4964ih | (3) Exception for nonimmigrants
The requirement of paragraph (1) shall not apply to an individual described in subsection (a)(2)(A)(v). (c) Enrollment; default enrollment
(1) In general
The Commissioner shall establish a process for AHBP-eligible individuals to enroll in qualified health plans. Such process shall be... |
108hr4964ih | (2) Default enrollment
(A) In general
The Commissioner shall establish a procedure under which an AHBP-eligible individual who is required under subsection (b) to enroll, but is not enrolled, in a qualified health plan will be assigned to, and enrolled in, such a plan. (B) Rules
In carrying out subparagraph (A), the... |
108hr4964ih | (3) Changes in enrollment
The Commissioner shall establish enrollment procedures that include an annual open season and permitting changes in enrollment with qualified health plans at other times (such as by reason of changes in marital or dependent status). Such procedures shall be based on the enrollment procedures ... |
108hr4964ih | To the extent consistent with eligibility under subsection (a), the Commissioner shall provide rules similar to the rules under FEHBP for the enrollment of family members who are AHBP-eligible individuals in the same plan, except that such rules shall permit a family consisting only of a married couple to elect to enro... |
108hr4964ih | The Commissioner shall provide for termination of such enrollment for an individual at the time the individual is no longer an AHBP-eligible individual. (f) Enrollment guides
The Commissioner shall provide for the broad dissemination of information on qualified health plans offered under this title. Such information s... |
108hr4964ih | Qualified health plans; benefits; premiums
(a) Offering of plans
(1) Contracts
The Commissioner shall enter into contracts with entities for the offering of qualified health plans in accordance with this title. Such contracts shall be entered into in a manner similar to the process by which the Director of the Offic... |
108hr4964ih | (2) Requirements for entities offering plans
No such contract shall be entered into with an entity for the offering of a qualified health plan in a region unless the entity— (A) is licensed as a health maintenance organization in that State or is licensed or to sell group health insurance in that State; (B) meets such... |
108hr4964ih | (3) Contracting with limited number of plans in a region within types of plans
(A) In general
The Commissioner shall contract with only a limited number of qualified health plans of each type (as specified under subparagraph (B)) in each AHBP region. (B) Types of plans
For purposes of subparagraph (A), the Commissio... |
108hr4964ih | (b) FEHBP scope of benefits
(1) Comprehensive benefits
Qualified health plans shall provide for the same scope and type of comprehensive benefits that have been provided under FEHBP, including the types of benefits described in section 8904 of title 5, United States Code and including benefits previously required by ... |
108hr4964ih | (2) No exclusion for pre-existing conditions
Qualified health plans shall not impose pre-existing condition exclusions or otherwise discriminate against any enrollee based on the health status of such enrollee (including genetic information relating to such enrollee). (3) Other consumer protections
Qualified health p... |
108hr4964ih | (c) Community-rated premiums
(1) In general
The premiums established for a qualified health plan under this title for individual or family coverage shall be community-rated and shall not vary based on age, gender, health status (including genetic information), or other factors. (2) Collection process
The Commissione... |
108hr4964ih | Such process shall include methods for payment through payroll withholding, as well as payment through automatic debiting of accounts with financial institutions, and shall be coordinated with the application of section 59B of the Internal Revenue Code of 1986. Such premiums shall be deposited into the American Health ... |
108hr4964ih | (d) High-risk reinsurance pool
The Commissioner shall establish an arrangement among the entities offering qualified health plans under which such entitles contribute in an equitable manner (as determined by the Commissioner) into a fund that provides payment to plans for a percentage (specified by the Commissioner an... |
108hr4964ih | (e) Marketing practices and costs
The Commissioner shall monitor marketing practices with respect to qualified health plans in order to assure— (1) the accuracy of the information disseminated regarding such plans; and (2) that costs of marketing are reasonable and do not exceed a percentage of total costs that is spe... |
108hr4964ih | Government contribution; American Health Benefits Program Trust Fund
(a) Government contribution
(1) In general
The Commissioner shall provide each year for a contribution under this subsection towards the coverage provided under this title for those AHBP-eligible individuals who are required to be enrolled in a qua... |
108hr4964ih | (2) Use of regional weighted average
Instead of computing the Government contribution using methodology under section 8906(b)(1) of title 5, United States Code, based on 72 percent of the weighted average premium for qualified health plans nationally, the Commissioner shall compute such contribution based on 72 percen... |
108hr4964ih | (2) Risk adjusted payment
The payment to a qualified health plan under this subsection shall be adjusted in a budget-neutral manner specified the Commissioner to reflect the actuarial risk of the enrollees in the plan compared to an average actuarial risk. (3) Reduction for administrative expenses and contingency rese... |
108hr4964ih | Such percentage shall consist of the following: (A) Contingency reserve
A percentage (not to exceed 3 percent) to provide for a contingency reserve described in section 2206(h)(1). (B) Federal administrative costs
A percentage (not to exceed 5 percent) to cover Federal administrative costs in implementing this title.... |
108hr4964ih | (2) Deposits
The Trust Fund shall consist of such gifts and bequests as may be provided in section 201(i)(1) and such amounts as may be deposited in, or appropriated to, such fund as provided in this title. There are hereby appropriated to the Fund, out of any moneys in the Treasury not otherwise appropriated, amounts... |
108hr4964ih | as determined by the Secretary of the Treasury by applying the applicable rates of tax under such sections to such wages, which wages shall be certified by the Commissioner of Social Security on the basis of records of wages established and maintained by such Commissioner in accordance with such reports; (B) the taxes ... |
108hr4964ih | which self-employment income shall be certified by the Commissioner of Social Security on the basis of records of self-employment established and maintained by such Commissioner in accordance with such returns; and (C) the excess of the amounts imposed under section 59B of the Internal Revenue Code of 1986 over the amo... |
108hr4964ih | The amounts appropriated by the preceding sentence shall be transferred from time to time from the general fund in the Treasury to the Trust Fund, such amounts to be determined on the basis of estimates by the Secretary of the Treasury of the taxes, specified in the preceding sentence, paid to or deposited into the Tre... |
108hr4964ih | (3) Application of trust fund provisions
The provisions of subsections (b) through (f) of section 1817 shall apply to the Trust Fund in the same manner as they apply to the Federal Hospital Insurance Trust Fund, except that, for purposes of this paragraph, any reference in such subsections to a provision of the Intern... |
108hr4964ih | Premium and cost-sharing subsidies for lower income individuals
(a) Premium subsidies
The Commissioner, in consultation with the Secretary of the Treasury, shall assist individuals in estimating the amount of the premium subsidy which will be allowed to such individual under section 36 of the Internal Revenue Code of... |
108hr4964ih | (b) Cost-sharing subsidies
(1) No cost-sharing for individuals with family income below lowest income threshold
In the case of a cost-sharing subsidy-eligible individual whose family income is less than the lowest income threshold, there shall be a cost-sharing subsidy so the cost-sharing is reduced to zero. (2) No c... |
108hr4964ih | (3) Sliding scale for other individuals
In the case of cost-sharing subsidy-eligible individuals not described in paragraph (1) or (2), the Commissioner of Health Benefits, in consultation with the Secretary of the Treasury, shall establish a schedule of cost-sharing subsidies consistent with this paragraph. |
108hr4964ih | Under such schedule the amount of cost-sharing subsidy for such individuals shall— (A) be such that the cost-sharing is nominal (as defined for purposes of section 1916(a)(3)) for individuals whose family income is at the lowest income threshold; and (B) be such that, as the family income increases from such lowest inc... |
108hr4964ih | (4) Application of a previous year’s family income
In applying this subsection for cost-sharing subsidies for expenses incurred for services furnished in a year, family income shall be determined based on the modified AGI for taxable years ending in or with the previous year (or, if information on such modified AGI fo... |
108hr4964ih | (5) Application for subsidies
A cost-sharing subsidy shall not be available to a cost-sharing subsidy-eligible individual under this subsection unless the there has been an application, in a form and manner and containing such information and in such frequency as the Commissioner shall specify, has been made for such ... |
108hr4964ih | Such payments may be in such form as the Commissioner specifies and may include— (A) a capitation payment, in an amount that reflects the per capita actuarial value of such subsidies; (B) reimbursement for the reductions in cost-sharing made to carry out this subsection; or (C) a combination of the methodologies under ... |
108hr4964ih | and required under section 2202(b) to be enrolled, in a qualified health plan under this title; (ii) whose family income does not exceed twice the lowest income threshold (as defined in subparagraph (B)); and (iii) who does not have in effect (and any of whose family members does not have in effect), in a form and mann... |
108hr4964ih | (B) Lowest income threshold
The term lowest income threshold means, with respect to coverage consisting of— (i) only an individual, 125 percent of the poverty line (as defined in section 673(2) of the Community Services Block Grant Act ( 42 U.S.C. 9902(2) ), including any revision required by such section) for a singl... |
108hr4964ih | (C) Family income
The term family income means, with respect to an AHBP-eligible individual who is enrolled in a qualified health plan— (i) for individual-only coverage, the modified AGI of the individual; or (ii) for coverage that includes other family members, the sum of the modified AGI of the individual and of eac... |
108hr4964ih | The Commissioner, in consultation with the Secretary of the Treasury, may provide for exclusion from family income under subparagraph (B) of family members (such as children) who have de minimis income (as specified by such Commissioner). |
108hr4964ih | (D) Modified AGI defined
The term modified AGI means adjusted gross income (as defined in section 62 of the Internal Revenue Code of 1986)— (i) determined without regard to sections 135, 911, 931, and 933 of such Code; and (ii) increased by the amount of interest received or accrued during the taxable year which is ex... |
108hr4964ih | Administration
(a) Application of FEHBP rules
(1) In general
Except as otherwise provided in this title, the program under this title shall be administered in the same manner as FEHBP. (2) Specific provisions
In carrying out this title, the Commissioner pursuant to paragraph (1) shall provide for the following: (A)... |
108hr4964ih | (b) Establishment of Health Benefits Administration
There is hereby established, as an independent agency in the executive branch of Government, a Health Benefits Administration (in this title referred to as the Administration ). (c) Duties
(1) In general
It shall be the duty of the Administration to administer the ... |
108hr4964ih | (2) Establishment of AHBP regions
For purposes of carrying out this title, the Commissioner shall divide the United States into, and establish, AHBP regions. (d) Officers
(1) Commissioner of Health Benefits
(A) In general
There shall be in the Administration a Commissioner of Health Benefits who shall be appointed ... |
108hr4964ih | (C) Term
The provisions of section 702(b)(2) shall apply to the Commissioner in the same manner as they apply to the Commissioner of Social Security, except that any reference to January 19, 2001, shall be treated as a reference to the date that is January 19 of the fifth year that begins after the date of the enactme... |
108hr4964ih | (B) Application of SSA provisions
The provisions of paragraphs (2) through (4) of section 701(c) shall apply to the Deputy Commissioner in the same manner as they apply to the Deputy Commissioner of Social Security, except that any reference to January 19, 2001, shall be treated as a reference to the date specified un... |
108hr4964ih | The provisions of subsections (c) through (e) of section 701 shall apply with respect to such officers in the same manner as they apply with respect to comparable officers in the Social Security Administration. (4) Personnel; budgetary matters; seal of office
The provisions of subsections (a)(1), (a)(2), (b), and (d) ... |
108hr4964ih | (e) Authority and rulemaking
The provisions of paragraphs (4) through (7) of section 701(b) and section 704 shall apply to the Administration and Commissioner in the same manner as they apply to the Social Security Administration and the Commissioner of Social Security. (f) Use of regional and field offices
The Commi... |
108hr4964ih | (g) Coverage of administration costs
The Commissioner shall provide for the collection of administrative costs of offering coverage under this title from entities offering qualified health plans in the same manner as FEHBP provides for coverage of its administrative costs. (h) Contingency reserves
(1) AHBP contingenc... |
108hr4964ih | (2) Plan reserves
A qualified health plan may establish contingency reserves, that are in addition to the reserve described in paragraph (1), in a manner similar to that permitted under FEHBP. 2207. Definitions
For purposes of this title: (1) The term Administration means the Health Benefits Administration establishe... |
108hr4964ih | (4) The term Commissioner means the Commissioner of Health Benefits appointed under section 2206(c). (5) The term FEHBP means the program under chapter 89 of title 5, United States Code, as in effect before the date of the enactment of this title. (6) The term qualified health plan means such a plan offered under this ... |
108hr4964ih | (2) Effect on collective bargaining agreements
Nothing in this Act shall be construed as preventing a collectively bargained agreement from providing coverage that is additional to, or supplementary of, benefits provided under the American Health Benefits Program. 2201. Establishment of program
There is established u... |
108hr4964ih | The coverage is provided in a manner similar to the manner in which coverage has been provided to Members of Congress and Federal government employees and retirees and their dependents under the Federal Employees Health Benefits Program (FEHBP). 2202. Eligibility; requirement of coverage
(a) Eligibility
(1) In genera... |
108hr4964ih | the term AHBP-eligible individual means an individual residing in the United States who is— (i) a citizen or national of the United States; (ii) an alien lawfully admitted to the United States for permanent residence; (iii) an alien admitted into the United States under section 207 of the Immigration and Nationality Ac... |
108hr4964ih | and (v) an alien with the status of a nonimmigrant who is within a class of long-term nonimmigrants under section 101(a)(15) of the Immigration and Nationality Act that the Commissioner determines, in consultation with the Secretary of Homeland Security, to be appropriate. (B) Exception
Such term does not include an i... |
108hr4964ih | (2) Exception for individuals demonstrating public health insurance coverage
The requirement of paragraph (1) shall not apply to an individual who demonstrates coverage under any of the following: (A) Medicare
Coverage under parts A and B (or under part C) of title XVIII. (B) Medicaid
Coverage under a State plan und... |
108hr4964ih | (D) Indian health services
Coverage under a medical care program of the Indian Health Service or of a tribal organization. (E) Veterans health
Coverage under the veterans health care program under chapter 17 of title 38, United States Code, if the coverage for the individual involved is determined to be not less than... |
108hr4964ih | (3) Exception for nonimmigrants
The requirement of paragraph (1) shall not apply to an individual described in subsection (a)(2)(A)(v). (c) Enrollment; default enrollment
(1) In general
The Commissioner shall establish a process for AHBP-eligible individuals to enroll in qualified health plans. Such process shall be... |
108hr4964ih | (2) Default enrollment
(A) In general
The Commissioner shall establish a procedure under which an AHBP-eligible individual who is required under subsection (b) to enroll, but is not enrolled, in a qualified health plan will be assigned to, and enrolled in, such a plan. (B) Rules
In carrying out subparagraph (A), the... |
108hr4964ih | (3) Changes in enrollment
The Commissioner shall establish enrollment procedures that include an annual open season and permitting changes in enrollment with qualified health plans at other times (such as by reason of changes in marital or dependent status). Such procedures shall be based on the enrollment procedures ... |
108hr4964ih | To the extent consistent with eligibility under subsection (a), the Commissioner shall provide rules similar to the rules under FEHBP for the enrollment of family members who are AHBP-eligible individuals in the same plan, except that such rules shall permit a family consisting only of a married couple to elect to enro... |
108hr4964ih | The Commissioner shall provide for termination of such enrollment for an individual at the time the individual is no longer an AHBP-eligible individual. (f) Enrollment guides
The Commissioner shall provide for the broad dissemination of information on qualified health plans offered under this title. Such information s... |
108hr4964ih | Qualified health plans; benefits; premiums
(a) Offering of plans
(1) Contracts
The Commissioner shall enter into contracts with entities for the offering of qualified health plans in accordance with this title. Such contracts shall be entered into in a manner similar to the process by which the Director of the Offic... |
108hr4964ih | (2) Requirements for entities offering plans
No such contract shall be entered into with an entity for the offering of a qualified health plan in a region unless the entity— (A) is licensed as a health maintenance organization in that State or is licensed or to sell group health insurance in that State; (B) meets such... |
108hr4964ih | (3) Contracting with limited number of plans in a region within types of plans
(A) In general
The Commissioner shall contract with only a limited number of qualified health plans of each type (as specified under subparagraph (B)) in each AHBP region. (B) Types of plans
For purposes of subparagraph (A), the Commissio... |
108hr4964ih | (b) FEHBP scope of benefits
(1) Comprehensive benefits
Qualified health plans shall provide for the same scope and type of comprehensive benefits that have been provided under FEHBP, including the types of benefits described in section 8904 of title 5, United States Code and including benefits previously required by ... |
108hr4964ih | (2) No exclusion for pre-existing conditions
Qualified health plans shall not impose pre-existing condition exclusions or otherwise discriminate against any enrollee based on the health status of such enrollee (including genetic information relating to such enrollee). (3) Other consumer protections
Qualified health p... |
108hr4964ih | (c) Community-rated premiums
(1) In general
The premiums established for a qualified health plan under this title for individual or family coverage shall be community-rated and shall not vary based on age, gender, health status (including genetic information), or other factors. (2) Collection process
The Commissione... |
108hr4964ih | Such process shall include methods for payment through payroll withholding, as well as payment through automatic debiting of accounts with financial institutions, and shall be coordinated with the application of section 59B of the Internal Revenue Code of 1986. Such premiums shall be deposited into the American Health ... |
108hr4964ih | (d) High-risk reinsurance pool
The Commissioner shall establish an arrangement among the entities offering qualified health plans under which such entitles contribute in an equitable manner (as determined by the Commissioner) into a fund that provides payment to plans for a percentage (specified by the Commissioner an... |
108hr4964ih | (e) Marketing practices and costs
The Commissioner shall monitor marketing practices with respect to qualified health plans in order to assure— (1) the accuracy of the information disseminated regarding such plans; and (2) that costs of marketing are reasonable and do not exceed a percentage of total costs that is spe... |
108hr4964ih | Government contribution; American Health Benefits Program Trust Fund
(a) Government contribution
(1) In general
The Commissioner shall provide each year for a contribution under this subsection towards the coverage provided under this title for those AHBP-eligible individuals who are required to be enrolled in a qua... |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.