,i  #aac? ,,congress  #a/ ,session  ,h4 
,r4 #bfhh  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,july #ae1 #bjac ,mr4 
,ross introduc$ ! foll[+ bill2 :i* 0    
ref]r$ to ! ,committee on ,ways &       
,means1 & 9 addition to ! ,committee on 
,en]gy & ,comm]ce1 = a p]iod to be      
subsequ5tly det]m9$ by ! ,speak]1 9 ea* 
case = consid]ation ( su* provisions z  
fall )9 ! jurisdiction ( ! committee    
conc]n$  ,a ,,bill  ,to improve         
heal?c>e-relat$1 tax-pref]r$ sav+s      
acc\nts & to provide = coop]ative gov]n+
 ( individual & gr\p heal? insurance    
cov]age across ,/ate l9es1 & = o!r      
purposes4  #a4 ,%ort title2 table (     
cont5ts  7a7 ,%ort title ,?is ,act may  
be cit$ z ! ,provid+ ,acc\ntability &   
,transp>5cy to ,inc5tivize ,economically
 ,necess>y ,transitions 9 ,heal? ,c>e   
,act ( #bjac or ! ,,pati5t's ,heal? ,c>e
 ,act ( #bjac4  7b7 ,table ( cont5ts ,! 
table ( cont5ts = ?is ,act is z foll[s3 
,sec4 #a4 ,%ort title2 table ( cont5ts4 
,title ,i--,heal?c>e-relat$ sav+s       

acc\nts ,sec4 #aja4 ,d$uction ( premiums
 = high d$uctible heal? plans4 ,sec4    
#ajb4 ,repeal ( high d$uctible heal?    
plan requirem5t4 ,sec4 #ajc4 ,increase 9
 d$uctible ,,hsa contribution           
limitations4 ,sec4 #ajd4 ,m$ic>e        
eligible individuals eligible to        
contribute to ,,hsa4 ,sec4 #aje4 ,,hsa  
rollov] to ,m$ic>e ,advantage ,,msa4    
,sec4 #ajf4 ,"o-"t transf] ( flexible   
sp5d+ arrangem5t balance to heal? sav+s 
acc\nt 9 case ( sep>ation f employm5t4  
,sec4 #ajg4 ,paym5t ( high d$uctible    
heal? plan premiums f ,,hsa4 ,sec4 #ajh4
 ,repeal ( disqualification ( exp5ses = 
ov]-!-c\nt] drugs "u c]ta9 acc\nts &    
arrangem5ts4 ,sec4 #aji4 ,paym5t (      
long-t]m c>e premiums f heal? flexible  
sp5d+ arrangem5t4 ,sec4 #aaj4 ,all[+    
,,msa & ,,hsa rollov] to adult *ild (   
acc\nt hold]4 ,sec4 #aaa4 ,disposition (
 unus$ heal? b5efits 9 cafet]ia plans & 
flexible sp5d+ arrangem5ts4 ,sec4 #aab4 
,p]mitt+ b5efici>y contributions to     
,m$ic>e ,advantage ,,msa4 ,sec4 #aac4   

,*ild heal? sav+s acc\nt4 ,title        
,,ii--,heal? insurance provisions ,sec4 
#bja4 ,coop]ative gov]n+ ( individual & 
gr\p heal? insurance cov]age4 ,sec4     
#bjb4 ,reau?orization ( ! ,preexi/+     
,condition ,insurance ,plan 7,,pcip7    
,program4  ,i ,heal?c>e-relat$ sav+s    
acc\nts  #aja4 ,d$uction ( premiums =   
high d$uctible heal? plans  7a7 ,9 g5]al
 ,"p ,,vii ( sub*apt] ,b ( *apt] #a ( ! 
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by r$esignat+ section #bbd z section    
#bbe & by ins]t+ aft] section #bbc !    
foll[+ new section3  #bbd4 ,premiums =  
high d$uctible heal? plans  7a7         
,d$uction all[$ ,9 ! case ( an          
individual1 !re %all be all[$ z a       
d$uction = ! taxable ye> ! aggregate    
am\nt paid by su* individual z premiums 
"u a high d$uctible heal? plan ) respect
 to mon?s dur+ su* ye> = :i* su*        
individual is an eligible individual )  
respect to su* heal? plan4  7b7         
,def9itions ,= purposes ( ?is section-- 
7#a7 ,eligible individual  7,a7 ,9 g5]al

 ,! t]m eligible individual means1 )    
respect to any mon?1 any individual if--
  7i7 su* individual is cov]$ "u a high 
d$uctible heal? plan z ( ! #a/ day ( su*
 mon?1 &  7ii7 su* individual is n1 :ile
 cov]$ "u a high d$uctible heal? plan1  
cov]$ "u any heal? plan--  7,i7 :i* is n
 a high d$uctible heal? plan1 &  7,,ii7 
:i* provides cov]age = any b5efit :i* is
 cov]$ "u ! high d$uctible heal? plan4  
7,b7 ,c]ta9 cov]age disreg>d$           
,subp>agraph 7,a77ii7 %all be appli$ )\t
 reg>d to--  7i7 cov]age = any b5efit   
provid$ by p]mitt$ insurance1  7ii7     
cov]age 7:e!r ?r\gh insurance or        
o!rwise7 = accid5ts1 disability1 d5tal  
c>e1 vision c>e1 or long-t]m c>e1 &     
7iii7 cov]age "u a heal? flexible sp5d+ 
arrangem5t dur+ any p]iod imm$iately    
foll[+ ! end ( a plan ye> ( su*         
arrangem5t dur+ :i* unus$ b5efits or    
contributions rema9+ at ! end ( su* plan
 ye> may be paid or reimburs$ to plan   
p>ticipants = qualifi$ b5efit exp5ses   
incurr$ dur+ su* p]iod if--  7,i7 !     

balance 9 su* arrangem5t at ! end ( su* 
plan ye> is z]o1 or  7,,ii7 ! individual
 is mak+ a qualifi$ ,,hsa di/ribution 7z
 def9$ 9 section #ajf7;e77 9 an am\nt   
equal to ! rema9+ balance 9 su*         
arrangem5t z ( ! end ( su* plan ye>1 9  
accordance ) rules prescrib$ by !       
,secret>y4  7#b7 ,high d$uctible heal?  
plan  7,a7 ,9 g5]al ,! t]m high         
d$uctible heal? plan means a heal?      
plan--  7i7 :i* has an annual d$uctible 
:i* is n less ?an--  7,i7 #a1jjj =      
self-only cov]age1 &  7,,ii7 twice !    
doll> am\nt 9 subclause 7,i7 = family   
cov]age1 &  7ii7 ! sum ( ! annual       
d$uctible & ! o!r annual out-(-pocket   
exp5ses requir$ to be paid "u ! plan    
7o!r ?an = premiums7 = cov]$ b5efits    
does n exce$--  7,i7 #e1jjj = self-only 
cov]age1 &  7,,ii7 twice ! doll> am\nt 9
 subclause 7,i7 = family cov]age4  7,b7 
,exclusion ( c]ta9 plans ,su* t]m does n
 include a heal? plan if sub/antially   
all ( its cov]age is describ$ 9 p>agraph
 7#a77;,b74  7,c7 ,safe h>bor = abs5ce (

 prev5tive c>e d$uctible ,a plan %all n 
fail to be treat$ z a high d$uctible    
heal? plan by reason ( fail+ to h a     
d$uctible = prev5tive c>e 7)9 ! mean+ ( 
section #ahga ( ! ,social ,security     
,act1 except z o!rwise provid$ by !     
,secret>y74  7,d7 ,special rule = annual
 out-(-pocket limitation = network plans
 ,9 ! case ( a plan us+ a network (     
provid]s1 su* plan %all n fail to be    
treat$ z a high d$uctible heal? plan by 
reason ( hav+ an out-(-pocket limitation
 = s]vices provid$ outside ( su* network
 :i* exce$s ! applicable limitation "u  
subp>agraph 7,a77ii74  7#c7 ,p]mitt$    
insurance ,! t]m p]mitt$ insurance      
means--  7,a7 insurance if sub/antially 
all ( ! cov]age provid$ "u su* insurance
 relates to--  7i7 liabilities incurr$  
"u work]s' comp5sation laws1  7ii7 tort 
liabilities1  7iii7 liabilities relat+  
to own]%ip or use ( prop]ty1 or  7iv7   
su* o!r simil> liabilities z ! ,secret>y
 may specify by regulations1  7,b7      
insurance = a specifi$ disease or       

illness1 &  7,c7 insurance pay+ a fix$  
am\nt p] day 7or o!r p]iod7 (           
hospitalization4  7#d7 ,family cov]age  
,! t]m family cov]age means any cov]age 
o!r ?an self-only cov]age4  7c7 ,special
 rules  7#a7 ,d$uction all[able = only  
#a plan ,= purposes ( ?is section1 9 !  
case ( an individual cov]$ by m ?an #a  
high d$uctible heal? plan = any mon?1 ! 
individual may only take into acc\nt    
am\nts paid = #a ( su* plans = su* mon?4
  7#b7 ,employ] provid$ cov]age  7,a7 ,9
 g5]al ,no d$uction %all be all[$ to an 
individual "u subsection 7a7 = any am\nt
 paid = cov]age "u a high d$uctible     
heal? plan = a mon? if t individual     
p>ticipates 9 any cov]age = su* mon? t  
is exclud$ 79 :ole or 9 "p7 f ! gross   
income ( ! individual or ! individual's 
sp\se "u section #ajf4  7,b7 ,cafet]ia  
plans1 etc ,employ] contributions to a  
cafet]ia plan or a flexible sp5d+ or    
simil> arrangem5t :i* are exclud$ f     
gross income "u section #ajf %all be    
treat$ = purposes ( ?is section z paid  

by ! employ]4  7#c7 ,contributions to   
heal? sav+s acc\nt requir$ ,a d$uction  
%all n be all[$ "u subsection 7a7 = a   
taxable ye> ) respect to su* individual 
if su* individual is n all[$ a d$uction 
"u section #bbc = su* taxable ye>4  7#d7
 ,m$ical & heal? sav+s acc\nts          
,subsection 7a7 %all n apply ) respect  
to any am\nt :i* is paid or di/ribut$   
out ( an ,ar*] ,,msa or a heal? sav+s   
acc\nt :i* is n includ$ 9 gross income  
"u section #bbj7;f7 or #bbc7;f71 z !    
case may be4  7#e7 ,coord9ation )       
d$uction = heal? insurance (            
self-employ$ individuals ,! am\nt tak5  
into acc\nt by ! taxpay] 9 comput+ !    
d$uction "u section #afb7l7 %all n be   
tak5 into acc\nt "u ?is section4  7#f7  
,coord9ation ) m$ical exp5se d$uction ,!
 am\nt tak5 into acc\nt by ! taxpay] 9  
comput+ ! d$uction "u ?is section %all n
 be tak5 into acc\nt "u section #bac4  4
  7b7 ,d$uction all[$ :e!r or n         
individual itemizes o!r d$uctions       
,subsection 7a7 ( section #fb ( su*     

,code is am5d$ by ins]t+ aft] p>agraph  
7#ba7 ! foll[+ new p>agraph3  7#bb7     
,premiums = high d$uctible heal? plans  
,! d$uction all[$ by section #bbd4  4   
7c7 ,cl]ical am5dm5t ,! table ( sections
 = "p ,,vii ( sub*apt] ,b ( *apt] #a (  
su* ,code is am5d$ by /rik+ ! la/ item &
 ins]t+ ! foll[+ new items3  ,sec4 #bbd4
 ,premiums = high d$uctible heal? plans4
 ,sec4 #bbe4 ,cross ref]5ce4  4  7d7    
,effective date ,! am5dm5ts made by ?is 
section %all apply to taxable ye>s      
beg9n+ aft] ,decemb] #ca1 #bjac4  #ajb4 
,repeal ( high d$uctible heal? plan     
requirem5t  7a7 ,9 g5]al ,subsection 7a7
 ( section #bbc ( su* ,code is am5d$ to 
read z foll[s3  7a7 ,d$uction all[$ ,9 !
 case ( an individual1 !re %all be all[$
 z a d$uction = a taxable ye> an am\nt  
equal to ! aggregate am\nt paid 9 ca%   
dur+ su* taxable ye> by or on behalf (  
su* individual to a heal? sav+s acc\nt (
 su* individual4  4  7b7 ,con=m+        
am5dm5ts  7#a7 ,section #bbc ( su* ,code
 is am5d$ by /rik+ subsection 7c7 &     

r$esignat+ subsections 7d7 ?r\gh 7h7 z  
subsections 7c7 ?r\gh 7g71 respectively4
  7#b7 ,section #bbc7;b7 ( su* ,code is 
am5d$ by /rik+ p>agraph 7#h74  7#c7     
,subp>agraph 7,a7 ( section #bbc7;c77#a7
 ( su* ,code 7z r$esignat$ by p>agraph  
7#a77 is am5d$--  7,a7 by /rik+         
subsection 7f77#e7 & ins]t+ subsection  
7e77#e71 &  7,b7 9 clause 7ii7--  7i7 by
 /rik+ ! sum (-- & all t foll[s & ins]t+
 ! doll> am\nt 9 effect "u subsection   
7b77#a744  7#d7 ,section #bbc7;f77#a7 ( 
su* ,code 7z r$esignat$ by p>agraph     
7#a77 is am5d$ by /rik+ ,ea* doll> am\nt
 9 subsections 7b77#b7 & 7c77#b77;,a7 & 
ins]t+ ,9 ! case ( a taxable ye> beg9n+ 
aft] ,decemb] #ca1 #bjaj1 ea* doll>     
am\nt 9 subsection 7b77#a74  7#e7       
,section #bf7;b77,u7 ( su* ,code is     
am5d$ by /rik+ section #bbc7;f77#d7 &   
ins]t+ section #bbc7;e77#d74  7#f7      
,sections #ce7;g77#c71                  
#bbj7;f77#e77;,a71 #hdh7;e77#a77v71     
#digc7;a77#e71 & #fjea7;a77#ab7 ( su*   
,code are ea* am5d$ by /rik+ section    

#bbc7;d7 ea* place x appe>s & ins]t+    
section #bbc7;c74  7#g7 ,section        
#ajf7;d77#a7 ( su* ,code is am5d$--     
7,a7 by /rik+ :o is an eligible         
individual 7z def9$ 9 section           
#bbc7;c77#a771 &  7,b7 by /rik+ section 
#bbc7;d7 & ins]t+ section #bbc7;c74     
7#h7 ,section #djh7;d77#i7 ( su* ,code  
is am5d$--  7,a7 9 subp>agraph 7,a7 by  
/rik+ :o is an eligible individual 7z   
def9$ 9 section #bbc7;c77 &1 &  7,b7 9  
subp>agraph 7,c7 by /rik+ comput$ on !  
basis ( ! type ( cov]age "u ! high      
d$uctible heal? plan cov]+ ! individual 
at ! "t ( ! qualifi$ ,,hsa fund+        
di/ribution4  7#i7 ,section             
#hgg;,a7g77#f7 ( su* ,code is am5d$ by  
/rik+ #bbc7;f77#d7 & ins]t+             
#bbc7;e77#d74  7#aj7 ,section #digc7;g7 
( su* ,code is am5d$--  7,a7 by /rik+   
section #bbc7;d7 & ins]t+ section       
#bbc7;c71  7,b7 9 p>agraph 7#b71 by     
/rik+ section #bbc7;f77#b7 & ins]t+     
section #bbc7;e77#b71 &  7,c7 by /rik+  
section #bbc7;f77#c7 & ins]t+ section   

#bbc7;e77#c74  7#aa7 ,section #dige (   
su* ,code is am5d$--  7,a7 9 subsection 
7c77#f7--  7i7 by /rik+ section #bbc7;d7
 & ins]t+ section #bbc7;c71 &  7ii7 by  
/rik+ section #bbc7;e77#b7 & ins]t+     
section #bbc7;d77#b71 &  7,b7 9         
subsection 7e77#a77;,e71 by /rik+       
section #bbc7;d7 & ins]t+ section       
#bbc7;c74  7#ab7 ,section               
#ffic7;a77#b77;,c7 ( su* ,code is am5d$ 
by /rik+ section #bbc7;h7 & ins]t+      
section #bbc7;g74  7c7 ,effective date  
,! am5dm5ts made by ?is section %all    
apply to taxable ye>s beg9n+ aft]       
,decemb] #ca1 #bjaa4  #ajc4 ,increase 9 
d$uctible ,,hsa contribution limitations
  7a7 ,9 g5]al ,p>agraph 7#a7 ( section 
#bbc7;b7 ( ! ,int]nal ,rev5ue ,code (   
#aihf is am5d$ by /rik+ ! sum ( ! mon?ly
 & all t foll[s ?r\gh eligible          
individual & ins]t+ #aj1jjj 7#bj1jjj 9 !
 case ( a jo9t return74  7b7 ,additional
 contributions ,p>agraph 7#c7 ( section 
#bbc7;b7 is am5d$ to read z foll[s3     
7#c7 ,additional contributions =        

individuals betwe5 #ee & #fe ,9 ! case (
 an individual :o has atta9$ ! age (    
#ee1 b has n atta9$ ! age ( #ff1 be=e ! 
close ( ! taxable ye>1 ! limitation "u  
p>agraph 7#a7 %all be increas$ by       
#aj1jjj4  4  7c7 ,con=m+ am5dm5ts  7#a7 
,section #bbc7;b7 ( su* ,code1 z am5d$  
by ?is ,act1 is am5d$ by /rik+ p>agraphs
 7#b7 & 7#e7 & by r$esignat+ p>agraphs  
7#c71 7#d71 7#f71 & 7#g7 z p>agraphs    
7#b71 7#c71 7#d71 & 7#e71 respectively4 
7#b7 ,section #bbc7;c77#a77;,a77ii7 (   
su* ,code 7z r$esignat$ by ?is ,act7 is 
am5d$ by /rik+ ! sum (-- & all t foll[s 
& ins]t+ ! doll> am\nt 9 effect "u      
subsection 7b77#a744  7#c7 ,section     
#bbc7;f77#a7 ( su* ,code 7z r$esignat$  
by ?is ,act7 is am5d$ by /rik+ ,ea*     
doll> am\nt 9 subsections 7b77#b7 &     
7c77#b77;,a7 & ins]t+ ,9 ! case ( a     
taxable ye> beg9n+ aft] ,decemb] #ca1   
#bjac1 ea* doll> am\nt 9 subsection     
7b77#a74  7#d7 ,p>agraph 7#c7 ( section 
#bbc7;b7 ( su* ,code 7z r$esignat$ by   
p>agraph 7#a77 is am5d$ by /rik+ ! la/  

s5t5ce4  7d7 ,effective date ,! am5dm5ts
 made by ?is section %all apply to      
taxable ye>s beg9n+ aft] ,decemb] #ca1  
#bjac4  #ajd4 ,m$ic>e eligible          
individuals eligible to contribute to   
,,hsa  7a7 ,subsection 7b7 ( section    
#bbc ( ! ,int]nal ,rev5ue ,code ( #aihf1
 z am5d$ by ?is ,act1 is am5d$ by /rik+ 
p>agraph 7#d74  7b7 ,effective date ,!  
am5dm5ts made by ?is section %all apply 
to taxable ye>s beg9n+ aft] ,decemb]    
#ca1 #bjac4  #aje4 ,,hsa rollov] to     
,m$ic>e ,advantage ,,msa  7a7 ,9 g5]al  
,p>agraph 7#b7 ( section #ach7;b7 ( !   
,int]nal ,rev5ue ,code ( #aihf is am5d$ 
by /rik+ or at ! end ( subp>agraph 7,a71
 by add+ or at ! end ( subp>agraph 7,c71
 & by add+ at ! end ! foll[+ new        
subp>agraph3  7,c7 a ,,hsa rollov]      
contribution describ$ 9 subsection      
7c77#e71  4  7b7 ,,hsa rollov]          
contribution ,subsection 7c7 ( section  
#ach ( su* ,code is am5d$ by add+ at !  
end ! foll[+ new p>agraph3  7#e7        
,rollov] contribution ,an am\nt is      

describ$ 9 ?is p>agraph z a rollov]     
contribution if x meets ! requirem5ts ( 
subp>agraphs 7,a7 & 7,b74  7,a7 ,9 g5]al
 ,! requirem5ts ( ?is subp>agraph are   
met 9 ! case ( an am\nt paid or         
di/ribut$ f a heal? sav+s acc\nt to !   
acc\nt b5efici>y to ! ext5t ! am\nt     
receiv$ is paid into a ,m$ic>e          
,advantage ,,msa ( su* b5efici>y n lat] 
?an ! #fj? day aft] ! day on :i* !      
b5efici>y receives ! paym5t or          
di/ribution4  7,b7 ,limitation ,?is     
p>agraph %all n apply to any am\nt      
describ$ 9 subp>agraph 7,a7 receiv$ by  
an individual f a heal? sav+s acc\nt if1
 at any "t dur+ ! #a-ye> p]iod end+ on !
 day ( su* receipt1 su* individual      
receiv$ any o!r am\nt describ$ 9        
subp>agraph 7,a7 f a heal? sav+s acc\nt 
:i* 0 n includible 9 ! individual's     
gross income because ( ! application (  
section #bbc7;e77#e77;,a74  4  7c7      
,con=m+ am5dm5t ,subp>agraph 7,a7 (     
section #bbc7;e77#e7 ( su* ,code1 z     
am5d$ by ?is ,act1 is am5d$ by ins]t+ or

 ,m$ic>e ,advantage ,,msa aft] into a   
heal? sav+s acc\nt4  7d7 ,effective date
 ,! am5dm5ts made by ?is section %all   
apply to taxable ye>s beg9n+ aft]       
,decemb] #ca1 #bjac4  #ajf4 ,"o-,"t     
transf] ( flexible sp5d+ arrangem5t     
balance to heal? sav+s acc\nt 9 case (  
sep>ation f employm5t  7a7 ,9 g5]al     
,section #abe ( ! ,int]nal ,rev5ue ,code
 ( #aihf is am5d$ by r$esignat+         
subsection 7j7 z subsection 7k7 & by    
ins]t+ aft] subsection 7i7 ! foll[+ new 
subsection3  7j7 ,"o-,"t transf] (      
rema9+ balance 9 heal? flexible sp5d+   
arrangem5t aft] sep>ation f employm5t   
7#a7 ,9 g5]al ,= purposes ( ?is title1 a
 plan %all n fail to be treat$ z a heal?
 flexible sp5d+ arrangem5t solely       
because a p>ticipant may1 9 connection )
 sep>ation f employm5t ) ! employ]1     
direct am\nts 9 ! p>ticipant's acc\nt "u
 su* arrangem5t to be contribut$ on     
behalf ( ! p>ticipant to a heal? sav+s  
acc\nt 7z def9$ 9 section #bbc7;c77     
ma9ta9$ = ! b5efit ( ! p>ticipant4  4   

7b7 ,con=m+ am5dm5t ,section            
#bbc7;c77#a77;,a7 ( su* ,code1 z am5d$  
by ?is ,act1 is am5d$ by /rik+ or       
section #bbj7;f77#e7 & ins]t+ 1 section 
#abe7;j71 or section #bbj7;f77#e74  7c7 
,effective date ,! am5dm5ts made by ?is 
section %all apply to taxable ye>s      
beg9n+ aft] ,decemb] #ca1 #bjac4  #ajg4 
,paym5t ( high d$uctible heal? plan     
premiums f ,,hsa  7a7 ,9 g5]al          
,subp>agraph 7,b7 ( section #bbc7;c77#b7
 ( su* ,code1 z am5d$ by ?is ,act1 is   
am5d$ by ins]t+ o!r ?an a high d$uctible
 plan 7z def9$ 9 section #bbd7;b77#b77  
be=e ! p]iod at ! end4  7b7 ,effective  
date ,! am5dm5t made by ?is section %all
 apply to taxable ye>s beg9n+ aft]      
,decemb] #ca1 #bjac4  #ajh4 ,repeal (   
disqualification ( exp5ses = ov]-!-c\nt]
 drugs "u c]ta9 acc\nts & arrangem5ts   
7a7 ,h,s,as ,subp>agraph 7,a7 ( section 
#bbc7;c77#b7 ( ! ,int]nal ,rev5ue ,code 
( #aihf1 z am5d$ by ?is ,act1 is am5d$  
by /rik+ ! la/ s5t5ce4  7b7 ,ar*]       
,m,s,as ,subp>agraph 7,a7 ( section     

#bbj7;d77#b7 ( su* ,code is am5d$ by    
/rik+ ! la/ s5t5ce4  7c7 ,heal? flexible
 sp5d+ arrangem5ts & heal? reimbursem5t 
arrangem5ts ,section #ajf ( su* ,code is
 am5d$ by /rik+ subsection 7f74  7d7    
,effective date ,! am5dm5ts made by ?is 
section %all apply to exp5ses incurr$   
aft] ,decemb] #ca1 #bjac4  #aji4 ,paym5t
 ( long-t]m c>e premiums f heal?        
flexible sp5d+ arrangem5t  7a7 ,9 g5]al 
,section #abe ( ! ,int]nal ,rev5ue ,code
 ( #aihf1 z am5d$ by ?is ,act1 is am5d$ 
by ins]t+ aft] subsection 7h7 ! foll[+  
new subsection3  7i7 ,paym5t ( long-,t]m
 c>e premiums f heal? flexible sp5d+    
arrangem5t  7#a7 ,9 g5]al ,no paym5t =  
insurance may be made f a heal? flexible
 sp5d+ arrangem5t4  7#b7 ,long-t]m c>e  
insurance ,p>agraph 7#a7 %all n apply to
 any exp5se = cov]age "u a qualifi$     
long-t]m c>e insurance contract 7z def9$
 9 section #ggjb;,b7b774  4  7b7        
,effective date ,! am5dm5ts made by ?is 
section %all apply to taxable ye>s      
beg9n+ aft] ,decemb] #ca1 #bjac4  #aaj4 

,all[+ ,,msa & ,,hsa rollov] to adult   
*ild ( acc\nt hold]  7a7 ,m,s,as  7#a7  
,9 g5]al ,subp>agraph 7,a7 ( section    
#bbj7;f77#h7 ( ! ,int]nal ,rev5ue ,code 
( #aihf 7relat+ to treatm5t aft] dea? ( 
acc\nt hold]7 is am5d$--  7,a7 by ins]t+
 or adult *ild aft] surviv+ sp\se1  7,b7
 by ins]t+ or adult *ild1 z ! case may  
be1 aft] ! sp\se1 &  7,c7 by ins]t+ or  
adult *ild aft] sp\se 9 ! head+ !re(4   
7#b7 ,adult *ild def9$ ,p>agraph 7#h7 ( 
section #bbj7;f7 ( su* ,code is am5d$ by
 add+ at ! end ! foll[+ new subp>agraph3
  7,c7 ,adult *ild ,= purposes ( ?is    
p>agraph1 ! t]m adult *ild means an     
individual--  7i7 :o is a *ild ( !      
deceas$ individual1 &  7ii7 ) respect to
 :om a d$uction "u section #aea w\ld n  
be all[able to ano!r taxpay] = a taxable
 ye> beg9n+ 9 ! cal5d> ye> 9 :i* su*    
individual's taxable ye> beg9s4  4  7b7 
,h,s,as  7#a7 ,9 g5]al ,subp>agraph 7,a7
 ( section #bbc7;e77#h7 ( su* ,code1 z  
am5d$ by ?is ,act1 is am5d$--  7,a7 by  
ins]t+ or adult *ild aft] surviv+ sp\se1

  7,b7 by ins]t+ or adult *ild1 z ! case
 may be1 aft] ! sp\se1 &  7,c7 by ins]t+
 or adult *ild aft] sp\se 9 ! head+     
!re(4  7#b7 ,adult *ild def9$ ,p>agraph 
7#h7 ( section #bbc7;e7 ( su* ,code1 z  
am5d$ by ?is ,act1 is am5d$ by add+ at !
 end ! foll[+ new subp>agraph3  7,c7    
,adult *ild ,= purposes ( ?is p>agraph1 
! t]m adult *ild has ! mean+ giv5 su*   
t]m by section #bbj7;f77#h77;,c74  4    
7c7 ,effective date ,! am5dm5ts made by 
?is section %all apply to taxable ye>s  
beg9n+ aft] ,decemb] #ca1 #bjac4  #aaa4 
,disposition ( unus$ heal? b5efits 9    
cafet]ia plans & flexible sp5d+         
arrangem5ts  7a7 ,9 g5]al ,section #abe 
( ! ,int]nal ,rev5ue ,code ( #aihf is   
am5d$ by r$esignat+ subsections 7k7 &   
7l7 z subsections 7l7 & 7m71            
respectively1 & by ins]t+ aft]          
subsection 7j7 ! foll[+3  7k7 ,c>ry=w>ds
 or paym5ts ( c]ta9 unus$ heal? b5efits 
7#a7 ,9 g5]al ,= purposes ( ?is title1 a
 plan or o!r arrangem5t %all n fail to  
be treat$ z a cafet]ia plan solely      

because qualifi$ b5efits "u su* plan    
include a heal? flexible sp5d+          
arrangem5t "u :i* n m ?an #ejj ( unus$  
heal? b5efits may be--  7,a7 c>ri$ =w>d 
to ! succe$+ plan ye> ( su* heal?       
flexible sp5d+ arrangem5t1 or  7,b7 paid
 to or on behalf ( an employee z        
comp5sation z ( ! end ( su* plan ye> or 
^u ! t]m9ation (1 or failure to         
re-enroll 91 su* plan or arrangem5t4    
7#b7 ,di/ribution ( unus$ heal? b5efits 
on behalf ( employee ,= purposes (      
p>agraph 7#a77;,b71 unus$ heal? b5efits 
paid z comp5sation on behalf ( an       
employee by ! employ] %all be--  7,a7   
includible 9 gross income & wages ( !   
employee1 :e!r or n a d$uction = su*    
paym5t is all[able "u ?is title to !    
employee1 &  7,b7 excludable f--  7i7   
gross income to ! ext5t provid$ "u      
section #djb7;e71 #deg7;a7 7) respect to
 contributions to an eligible def]r$    
comp5sation plan 7z def9$ 9 section     
#deg7;b77 ( an eligible employ] describ$
 9 section #deg7;e77#a77;,a771 or #bbj1 

&  7ii7 wages to ! ext5t o!rwise provid$
 = am\nts s excludable4  7#c7 ,unus$    
heal? b5efits ,= purposes ( ?is         
subsection1 ! t]m unus$ heal? b5efits   
means ! excess (--  7,a7 ! maximum am\nt
 ( reimbursem5t all[able dur+ a plan ye>
 "u a heal? flexible sp5d+ arrangem5t1  
ov]  7,b7 ! actual am\nt ( reimbursem5t 
dur+ su* ye> "u su* arrangem5t4  4  7b7 
,effective date ,! am5dm5t made by      
subsection 7a7 %all apply to taxable    
ye>s beg9n+ aft] ,decemb] #ca1 #bjac4   
#aab4 ,p]mitt+ b5efici>y contributions  
to ,m$ic>e ,advantage ,,msa  7a7 ,9     
g5]al ,subsection 7b7 ( section #ach (  
su* ,code is am5d$ by /rik+ p>agraph    
7#b7 & by r$esignat+ p>agraphs 7#c7 &   
7#d7 z p>agraphs 7#b7 & 7#c71           
respectively4  7b7 ,effective date ,!   
am5dm5ts made by ?is section %all apply 
to taxable ye>s beg9n+ aft] ,decemb]    
#ca1 #bjac4  #aac4 ,*ild heal? sav+s    
acc\nt  7a7 ,9 g5]al ,section #bbc ( !  
,int]nal ,rev5ue ,code ( #aihf1 z am5d$ 
by ?is ,act1 is am5d$ by add+ at ! end !

 foll[+ new subsection3  7h7 ,*ild heal?
 sav+s acc\nts  7#a7 ,9 g5]al ,9 ! case 
( an individual1 9 addition to any      
d$uction all[$ "u subsection 7a7 = any  
taxable ye>1 !re %all be all[$ z a      
d$uction "u ?is section an am\nt equal  
to ! aggregate am\nt paid 9 ca% by !    
taxpay] dur+ ! taxable ye> to a *ild    
heal? sav+s acc\nt ( a *ild ( ! taxpay]4
  7#b7 ,limitation ,! am\nt tak5 into   
acc\nt "u p>agraph 7#a7 ) respect to ea*
 *ild ( ! taxpay] = ! taxable ye> %all n
 exce$ an am\nt equal to #c1jjj4  7#c7  
,*ild heal? sav+s acc\nt ,= purposes (  
?is subsection1 ! t]m *ild heal? sav+s  
acc\nt means a heal? sav+s acc\nt       
designat$ z a *ild heal? sav+s acc\nt & 
e/abli%$ = ! b5efit ( a *ild ( a        
taxpay]1 b only if--  7,a7 su* acc\nt 0 
e/abli%$ = ! b5efit ( ! *ild be=e ! *ild
 atta9s ! age ( #e1 &  7,b7 "u ! writt5 
gov]n+ in/rum5t creat+ ! tru/1 no       
contribution w be accept$ to ! ext5t su*
 contribution1 :5 add$ to previ\s       
contributions to ! tru/ = ! cal5d> ye>1 

exce$s ! doll> am\nt 9 effect "u        
p>agraph 7#b74  7#d7 ,treatm5t ( acc\nt 
be=e age #ah ,= purposes ( ?is section1 
except z o!rwise provid$ 9 ?is          
subsection1 a *ild heal? sav+s acc\nt   
e/abli%$ = ! b5efit ( ! *ild ( a taxpay]
 %all be treat$ z a heal? sav+s acc\nt (
 ! taxpay] until ! *ild atta9s ! age (  
#ah1 aft] :i* su* acc\nt %all be treat$ 
z a heal? sav+s acc\nt ( ! *ild4  7#e7  
,di/ributions  7,a7 ,9 g5]al ,9 ! case (
 a *ild heal? sav+s acc\nt e/abli%$ "u  
?is section = ! b5efit ( a *ild ( a     
taxpay]--  7i7 ,be=e age #ah ,any am\nt 
paid or di/ribut$ out ( su* acc\nt be=e 
! *ild has atta9$ ! age ( #ah1 %all be  
includ$ 9 ! gross income ( ! taxpay]1 & 
subp>agraph 7,a7 ( subsection 7f7 %all  
apply 7relat+ to additional tax on      
di/ributions n us$ = qualifi$ m$ical    
exp5ses74  7ii7 ,age #ah & old] ,any    
am\nt paid or di/ribut$ out ( su* acc\nt
 aft] ! *ild has atta9$ ! age ( #ah may 
only be treat$ z us$ to pay qualifi$    
m$ical exp5ses to ! ext5t su* *ild is n 

cov]$ z a dep5d5t "u insurance 7o!r ?an 
p]mitt$ insurance7 ( a p>5t4  7,b7      
,exceptions = disability or dea? ( *ild 
,if ! *ild becomes disabl$ )9 ! mean+ ( 
section #gb7m77#g7 or dies--  7i7       
subp>agraph 7,a7 %all n apply to any    
subsequ5t paym5t or di/ribution1 &  7ii7
 ! taxpay] may rollov] ! am\nt 9 su*    
acc\nt to an individual retirem5t plan (
 ! taxpay]1 to any heal? sav+s acc\nt ( 
! taxpay]1 or to any *ild heal? sav+s   
acc\nt ( any o!r *ild ( ! taxpay]4  7,c7
 ,heal? insurance may be pur*as$ f      
acc\nt ,subp>agraph 7,b7 ( subsection   
7d77#b7 %all n apply to any heal? sav+s 
acc\nt orig9ally e/abli%$ z a *ild heal?
 sav+s acc\nt4  7#f7 ,regulations ,!    
,secret>y %all prescribe su* regulations
 z may be necess>y to c>ry out !        
purposes ( ?is subsection1 includ+ rules
 = det]m9+ application ( ?is subsection 
9 ! case ( legal gu>dians & 9 ! case (  
p>5ts ( a *ild :o file sep>ately1 are   
sep>at$1 or are n m>ri$4  4  7b7        
,effective date ,! am5dm5ts made by ?is 

section %all apply to taxable ye>s      
beg9n+ aft] ,decemb] #ca1 #bjac4  ,,ii  
,heal? insurance provisions  #bja4      
,coop]ative gov]n+ ( individual & gr\p  
heal? insurance cov]age  7a7 ,9 g5]al   
,title ,,xxvii ( ! ,public ,heal?       
,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg et  
seq47 is am5d$ by add+ at ! end ! foll[+
 new "p3  ,d ,coop]ative ,gov]n+ (      
,individual & ,gr\p ,heal? ,insurance   
,cov]age  #bgie4 ,def9itions ,9 ?is "p3 
7#a7 ,prim>y /ate ,! t]m prim>y ,/ate   
means1 ) respect to individual or gr\p  
heal? insurance cov]age (f]$ by a heal? 
insurance issu]1 ! ,/ate designat$ by ! 
issu] z ! ,/ate ^: cov]$ laws %all gov]n
 ! heal? insurance issu] 9 ! sale ( su* 
cov]age "u ?is "p4 ,an issu]1 ) respect 
to a p>ticul> policy1 may only designate
 "o su* ,/ate z its prim>y ,/ate )      
respect to all su* cov]age x (f]s4 ,su* 
an issu] may n *ange ! designat$ prim>y 
,/ate ) respect to individual or gr\p   
heal? insurance cov]age once ! policy is
 issu$1 except t su* a *ange may be made

 ^u r5ewal ( ! policy4 ,) respect to su*
 designat$ ,/ate1 ! issu] is deem$ to be
 do+ bus9ess 9 t ,/ate4  7#b7 ,second>y 
/ate ,! t]m second>y ,/ate means1 )     
respect to individual or gr\p heal?     
insurance cov]age (f]$ by a heal?       
insurance issu]1 any ,/ate t is n !     
prim>y ,/ate4 ,9 ! case ( a heal?       
insurance issu] t is sell+ a policy 91  
or to a resid5t (1 a second>y ,/ate1 !  
issu] is deem$ to be do+ bus9ess 9 t    
second>y ,/ate4  7#c7 ,heal? insurance  
issu] ,! t]m heal? insurance issu] has !
 mean+ giv5 su* t]m 9 section           
#bgia7;b77#b71 except t su* an issu] mu/
 be lic5s$ 9 ! prim>y ,/ate & be        
qualifi$ to sell individual heal?       
insurance cov]age 9 t ,/ate4  7#d7      
,individual heal? insurance cov]age ,!  
t]m individual heal? insurance cov]age  
means heal? insurance cov]age (f]$ 9 !  
individual m>ket1 z def9$ 9 section     
#bgia7;e77#a74  7#e7 ,gr\p heal?        
insurance cov]age ,! t]m gr\p heal?     
insurance cov]age has ! mean+ giv5 su*  

t]m 9 #bgia7;b77#d74  7#f7 ,applicable  
/ate au?ority ,! t]m applicable ,/ate   
au?ority means1 ) respect to a heal?    
insurance issu] 9 a ,/ate1 ! ,/ate      
insurance commission] or (ficial or     
(ficials designat$ by ! ,/ate to en=ce !
 requirem5ts ( ?is title = ! ,/ate )    
respect to ! issu]4  7#g7 ,haz>d\s      
f9ancial condition ,! t]m haz>d\s       
f9ancial condition means t1 bas$ on its 
pres5t or reasonably anticipat$ f9ancial
 condition1 a heal? insurance issu] is  
unlikely to be able--  7,a7 to meet     
obligations to policyhold]s ) respect to
 kn[n claims & reasonably anticipat$    
claims2 or  7,b7 to pay o!r obligations 
9 ! normal c\rse ( bus9ess4  7#h7 ,cov]$
 laws  7,a7 ,9 g5]al ,! t]m cov]$ laws  
means ! laws1 rules1 regulations1       
agreem5ts1 & ord]s gov]n+ ! insurance   
bus9ess p]ta9+ to--  7i7 individual or  
gr\p heal? insurance cov]age issu$ by a 
heal? insurance issu]2  7ii7 ! (f]1     
sale1 rat+ 7includ+ m$ical und]writ+71  
r5ewal1 & issuance ( individual or gr\p 

heal? insurance cov]age to an           
individual2  7iii7 ! provision to an    
individual 9 relation to individual or  
gr\p heal? insurance cov]age ( heal? c>e
 & insurance relat$ s]vices2  7iv7 !    
provision to an individual 9 relation to
 individual or gr\p heal? insurance     
cov]age ( managem5t1 op]ations1 &       
inve/m5t activities ( a heal? insurance 
issu]2 &  7v7 ! provision to an         
individual 9 relation to individual or  
gr\p heal? insurance cov]age ( loss     
control & claims adm9i/ration = a heal? 
insurance issu] ) respect to liability =
 :i* ! issu] provides insurance4  7,b7  
,exception ,su* t]m does n include any  
law1 rule1 regulation1 agreem5t1 or ord]
 gov]n+ ! use ( c>e or co/ managem5t    
te*niques1 includ+ any requirem5t relat$
 to provid] contract+1 network access or
 adequacy1 heal? c>e data collection1 or
 quality assurance4  7#i7 ,/ate ,! t]m  
,/ate means ! #ej ,/ates & includes !   
,di/rict ( ,columbia1 ,pu]to ,rico1 !   
,virg9 ,isl&s1 ,guam1 ,am]ican ,samoa1 &

 ! ,nor!rn ,m>iana ,isl&s4  7#aj7       
,unfair claims settlem5t practices ,!   
t]m unfair claims settlem5t practices   
means only ! foll[+ practices3  7,a7    
,kn[+ly misrepres5t+ to claimants &     
insur$ individuals relevant facts or    
policy provisions relat+ to cov]age at  
issue4  7,b7 ,fail+ to ackn[l$ge )      
reasonable promptness p]t95t            
communications ) respect to claims aris+
 "u policies4  7,c7 ,fail+ to adopt &   
implem5t reasonable /&>ds = ! prompt    
inve/igation & settlem5t ( claims aris+ 
"u policies4  7,d7 ,fail+ to effectuate 
prompt1 fair1 & equitable settlem5t (   
claims submitt$ 9 :i* liability has     
become reasonably cle>4  7,e7 ,refus+ to
 pay claims )\t conduct+ a reasonable   
inve/igation4  7,f7 ,fail+ to affirm or 
d5y cov]age ( claims )9 a reasonable    
p]iod ( "t aft] hav+ complet$ an        
inve/igation relat$ to ^? claims4  7,g7 
,a patt]n or practice ( compell+ insur$ 
individuals or _! b5efici>ies to        
in/itute suits to recov] am\nts due "u  

its policies by (f]+ sub/antially less  
?an ! am\nts ultimately recov]$ 9 suits 
br\ght by !m4  7,h7 ,a patt]n or        
practice ( attempt+ to settle or settl+ 
claims = less ?an ! am\nt t a reasonable
 p]son w\ld believe ! insur$ individual 
or 8 or h] b5efici>y 0 entitl$ by       
ref]5ce to writt5 or pr9t$ adv]tis+     
mat]ial accompany+ or made "p ( an      
application4  7,i7 ,attempt+ to settle  
or settl+ claims on ! basis ( an        
application t 0 mat]ially alt]$ )\t     
notice to1 or k or cons5t (1 ! insur$4  
7,j7 ,fail+ to provide =ms necess>y to  
pres5t claims )9 #ae cal5d> days ( a    
reque/ ) reasonable explanations reg>d+ 
_! use4  7,k7 ,attempt+ to cancel a     
policy 9 less "t ?an t prescrib$ 9 !    
policy or by ! law ( ! prim>y ,/ate4    
7#aa7 ,fraud & abuse ,! t]m fraud &     
abuse means an act or omission committ$ 
by a p]son :o1 kn[+ly & ) int5t to      
defraud1 commits1 or conceals any       
mat]ial in=mation conc]n+1 "o or m ( !  
foll[+3  7,a7 ,pres5t+1 caus+ to be     

pres5t$ or prep>+ ) k or belief t x w be
 pres5t$ to or by an insur]1 a re9sur]1 
brok] or its ag5t1 false in=mation z "p 
(1 9 support ( or conc]n+ a fact mat]ial
 to "o or m ( ! foll[+3  7i7 ,an        
application = ! issuance or r5ewal ( an 
insurance policy or re9surance contract4
  7ii7 ,! rat+ ( an insurance policy or 
re9surance contract4  7iii7 ,a claim =  
paym5t or b5efit pursuant to an         
insurance policy or re9surance contract4
  7iv7 ,premiums paid on an insurance   
policy or re9surance contract4  7v7     
,paym5ts made 9 accordance ) ! t]ms ( an
 insurance policy or re9surance         
contract4  7vi7 ,a docum5t fil$ ) !     
commission] or ! *ief insurance         
regulatory (ficial ( ano!r jurisdiction4
  7vii7 ,! f9ancial condition ( an      
insur] or re9sur]4  7viii7 ,! =mation1  
acquisition1 m]g]1 reconsolidation1     
dissolution or )drawal f "o or m l9es ( 
insurance or re9surance 9 all or "p ( a 
,/ate by an insur] or re9sur]4  7ix7 ,! 
issuance ( writt5 evid5ce ( insurance4  

7x7 ,! re9/atem5t ( an insurance policy4
  7,b7 ,solicitation or acceptance ( new
 or r5ewal insurance risks on behalf (  
an insur] re9sur] or o!r p]son engag$ 9 
! bus9ess ( insurance by a p]son :o kn[s
 or %\ld "k t ! insur] or o!r p]son     
responsible = ! risk is insolv5t at ! "t
 ( ! transaction4  7,c7 ,transaction ( !
 bus9ess ( insurance 9 violation ( laws 
requir+ a lic5se1 c]tificate ( au?ority 
or o!r legal au?ority = ! transaction ( 
! bus9ess ( insurance4  7,d7 ,attempt to
 commit1 aid+ or abett+ 9 ! commission  
(1 or conspiracy to commit ! acts or    
omissions specifi$ 9 ?is p>agraph4      
#bgif4 ,application ( law  7a7 ,9 g5]al 
,! cov]$ laws ( ! prim>y ,/ate %all     
apply to individual & gr\p heal?        
insurance cov]age (f]$ by a heal?       
insurance issu] 9 ! prim>y ,/ate & 9 any
 second>y ,/ate1 b only if ! cov]age &  
issu] comply ) ! conditions ( ?is       
section ) respect to ! (f]+ ( cov]age 9 
any second>y ,/ate & only if ! cov]$    
laws ( ! prim>y ,/ate--  7#a7 d n apply 

any age limitations ) respect to :o may 
pur*ase su* cov]age t is a high         
d$uctible heal? plan2 &  7#b7 d n       
require su* cov]age t is a high         
d$uctible heal? plan to provide = any   
specific type ( cov]age4  7b7           
,exemptions f cov]$ laws 9 a second>y   
/ate ,except z provid$ 9 ?is section1 a 
heal? insurance issu] ) respect to its  
(f]1 sale1 rat+ 7includ+ m$ical         
und]writ+71 r5ewal1 & issuance (        
individual or gr\p heal? insurance      
cov]age 9 any second>y ,/ate is exempt f
 any cov]$ laws ( ! second>y ,/ate 7&   
any rules1 regulations1 agreem5ts1 or   
ord]s s\ght or issu$ by su* ,/ate "u or 
relat$ to su* cov]$ laws7 to ! ext5t t  
su* laws w\ld--  7#a7 make unlawful1 or 
regulate1 directly or indirectly1 !     
op]ation ( ! heal? insurance issu]      
op]at+ 9 ! second>y ,/ate1 except t any 
second>y ,/ate may require su* an       
issu]--  7,a7 to pay1 on a              
nondiscrim9atory basis1 applicable      
premium & o!r taxes 7includ+ high risk  

pool assessm5ts7 :i* are levi$ on       
insur]s & surplus l9es insur]s1 brok]s1 
or policyhold]s "u ! laws ( ! ,/ate2    
7,b7 to regi/] ) & designate ! ,/ate    
insurance commission] z its ag5t solely 
= ! purpose ( receiv+ s]vice ( legal    
docum5ts or process2  7,c7 to submit to 
an exam9ation ( its f9ancial condition  
by ! ,/ate insurance commission] 9 any  
,/ate 9 :i* ! issu] is do+ bus9ess to   
det]m9e ! issu]'s f9ancial condition1   
if--  7i7 ! ,/ate insurance commission] 
( ! prim>y ,/ate has n done an          
exam9ation )9 ! p]iod recomm5d$ by !    
,national ,association ( ,insurance     
,commission]s2 &  7ii7 any su*          
exam9ation is conduct$ 9 accordance ) ! 
exam9]s' h&book ( ! ,national           
,association ( ,insurance ,commission]s 
& is coord9at$ to avoid unju/ifi$       
duplication & unju/ifi$ repetition2     
7,d7 to comply ) a lawful ord] issu$--  
7i7 9 a del9qu5cy proce$+ comm5c$ by !  
,/ate insurance commission] if !re has  
be5 a f9d+ ( f9ancial impairm5t "u      

subp>agraph 7,c72 or  7ii7 9 a volunt>y 
dissolution proce$+2  7,e7 to comply )  
an injunction issu$ by a c\rt ( compet5t
 jurisdiction1 ^u a petition by ! ,/ate 
insurance commission] alleg+ t ! issu]  
is 9 haz>d\s f9ancial condition2  7,f7  
to p>ticipate1 on a nondiscrim9atory    
basis1 9 any insurance insolv5cy gu>anty
 association or simil> association to   
:i* a heal? insurance issu] 9 ! ,/ate is
 requir$ to belong2  7,g7 to comply )   
any ,/ate law reg>d+ fraud & abuse 7z   
def9$ 9 section #bgie7aj771 except t if 
! ,/ate seeks an injunction reg>d+ !    
conduct describ$ 9 ?is subp>agraph1 su* 
injunction mu/ be obta9$ f a c\rt (     
compet5t jurisdiction2  7,h7 to comply )
 any ,/ate law reg>d+ unfair claims     
settlem5t practices 7z def9$ 9 section  
#bgie7i772 or  7,i7 to comply ) !       
applicable requirem5ts = indep5d5t      
review "u section #bgih ) respect to    
cov]age (f]$ 9 ! ,/ate2  7#b7 require   
any individual or gr\p heal? insurance  
cov]age issu$ by ! issu] to be          

c\nt]sign$ by an insurance ag5t or brok]
 resid+ 9 t second>y ,/ate2  7#c7 apply 
any age limitations ) respect to :o may 
pur*ase su* cov]age t is a high         
d$uctible heal? plan2  7#d7 require su* 
cov]age t is a high d$uctible heal? plan
 to provide = any specific type (       
cov]age2 or  7#e7 o!rwise discrim9ate   
aga9/ ! issu] issu+ insurance 9 bo? !   
prim>y ,/ate & 9 any second>y ,/ate4    
7c7 ,cle> & conspicu\s disclosure ,a    
heal? insurance issu] %all provide !    
foll[+ notice1 9 #ab-po9t bold type1 9  
any insurance cov]age (f]$ 9 a second>y 
,/ate "u ?is "p by su* a heal? insurance
 issu] & at r5ewal ( ! policy1 ) ! #e   
blank spaces !re9 be+ appropriately     
fill$ ) ! "n ( ! heal? insurance issu]1 
! "n ( prim>y ,/ate1 ! "n ( ! second>y  
,/ate1 ! "n ( ! second>y ,/ate1 & ! "n (
 ! second>y ,/ate1 respectively1 = !    
cov]age conc]n$3 ,notice3 ,?is policy is
 issu$ by  & is gov]n$ by ! laws &      
regulations ( ! ,/ate ( 1 & x has met   
all ! laws ( t ,/ate z det]m9$ by t     

,/ate's ,dep>tm5t ( ,insurance4 ,?is    
policy may be less exp5sive ?an o!rs    
because x is n subject to all ( !       
insurance laws & regulations ( ! ,/ate (
 1 includ+ cov]age ( "s s]vices or      
b5efits m&at$ by ! law ( ! ,/ate ( 4    
,additionally1 ?is policy is n subject  
to all ( ! consum] protection laws or   
re/rictions on rate *anges ( ! ,/ate ( 4
 ,z ) all insurance products1 be=e      
pur*as+ ?is policy1 y %\ld c>efully     
review ! policy & det]m9e :at heal? c>e 
s]vices ! policy cov]s & :at b5efits x  
provides1 includ+ any exclusions1       
limitations1 or conditions = su* s]vices
 or b5efits44  7d7 ,prohibition on c]ta9
 reclassifications & premium increases  
7#a7 ,9 g5]al ,= purposes ( ?is section1
 a heal? insurance issu] t provides     
individual or gr\p heal? insurance      
cov]age to an individual "u ?is "p 9 a  
prim>y or second>y ,/ate may n ^u       
r5ewal--  7,a7 move or reclassify !     
individual insur$ "u ! heal? insurance  
cov]age f ! class su* individual is 9 at

 ! "t ( issue ( ! contract bas$ on !    
heal? /atus-relat$ factors ( !          
individual2 or  7,b7 increase ! premiums
 assess$ ! individual = su* cov]age bas$
 on a heal? /atus-relat$ factor or *ange
 ( a heal? /atus-relat$ factor or ! pa/ 
or prospective claim exp]i5ce ( ! insur$
 individual4  7#b7 ,con/ruction ,no?+ 9 
p>agraph 7#a7 %all be con/ru$ to        
prohibit a heal? insurance issu]--  7,a7
 f t]m9at+ or discont9u+ cov]age or a   
class ( cov]age 9 accordance )          
subsections 7b7 & 7c7 ( section #bgdb2  
7,b7 f rais+ premium rates = all        
policyhold]s )9 a class bas$ on claims  
exp]i5ce2  7,c7 f *ang+ premiums or (f]+
 disc\nt$ premiums to individuals :o    
engage 9 wellness activities at int]vals
 prescrib$ by ! issu]1 if su* premium   
*anges or inc5tives--  7i7 are disclos$ 
to ! consum] 9 ! insurance contract2    
7ii7 are bas$ on specific wellness      
activities t are n applicable to all    
individuals2 &  7iii7 are n obta9able by
 all individuals to :om cov]age is (f]$2

  7,d7 f re9/at+ laps$ cov]age2 or  7,e7
 f retroactively adju/+ ! rates *>g$ an 
insur$ individual if ! initial rates 7  
set bas$ on mat]ial misrepres5tation by 
! individual at ! "t ( issue4  7e7      
,prior (f]+ ( policy 9 prim>y /ate ,a   
heal? insurance issu] may n (f] = sale  
individual or gr\p heal? insurance      
cov]age 9 a second>y ,/ate unless t     
cov]age is curr5tly (f]$ = sale 9 !     
prim>y ,/ate4  7f7 ,lic5s+ ( ag5ts or   
brok]s = heal? insurance issu]s ,any    
,/ate may require t a p]son act+1 or    
(f]+ to act1 z an ag5t or brok] = a     
heal? insurance issu] ) respect to !    
(f]+ ( individual or gr\p heal?         
insurance cov]age obta9 a lic5se f t    
,/ate1 ) commissions or o!r comp5sation 
subject to ! provisions ( ! laws ( t    
,/ate1 except t a ,/ate may n impose any
 qualification or requirem5t :i*        
discrim9ates aga9/ a nonresid5t ag5t or 
brok]4  7g7 ,docum5ts = submission to   
/ate insurance commission] ,ea* heal?   
insurance issu] issu+ individual or gr\p

 heal? insurance cov]age 9 bo? prim>y & 
second>y ,/ates %all submit--  7#a7 to !
 insurance commission] ( ea* ,/ate 9 :i*
 x int5ds to (f] su* cov]age1 be=e x may
 (f] individual or gr\p heal? insurance 
cov]age 9 su* ,/ate--  7,a7 a copy ( !  
plan ( op]ation or feasibility /udy or  
any simil> /atem5t ( ! policy be+ (f]$ &
 its cov]age 7:i* %all include ! "n (   
its prim>y ,/ate & its pr9cipal place ( 
bus9ess72  7,b7 writt5 notice ( any     
*ange 9 its designation ( its prim>y    
,/ate2 &  7,c7 writt5 notice f ! issu] (
 ! issu]'s compliance ) all ! laws ( !  
prim>y ,/ate2 &  7#b7 to ! insurance    
commission] ( ea* second>y ,/ate 9 :i* x
 (f]s individual or gr\p heal? insurance
 cov]age1 a copy ( ! issu]'s qu>t]ly    
f9ancial /atem5t submitt$ to ! prim>y   
,/ate1 :i* /atem5t %all be c]tifi$ by an
 indep5d5t public acc\ntant & conta9 a  
/atem5t ( op9ion on loss & loss adju/m5t
 exp5se res]ves made by--  7,a7 a memb] 
( ! ,am]ican ,academy ( ,actu>ies2 or   
7,b7 a qualifi$ loss res]ve speciali/4  

7h7 ,p[] ( c\rts ,to enjo9 conduct ,no?+
 9 ?is section %all be con/ru$ to affect
 ! au?ority ( any ,f$]al or ,/ate c\rt  
to enjo9--  7#a7 ! solicitation or sale 
( individual or gr\p heal? insurance    
cov]age by a heal? insurance issu] to   
any p]son or gr\p :o is n eligible = su*
 insurance2 or  7#b7 ! solicitation or  
sale ( individual or gr\p heal?         
insurance cov]age t violates !          
requirem5ts ( ! law ( a second>y ,/ate  
:i* are describ$ 9 subp>agraphs 7,a7    
?r\gh 7,h7 ( section #bgif7;b77#a74  7i7
 ,p[] ( ,second>y ,/ates ,to ,take      
,adm9i/rative ,action ,no?+ 9 ?is       
section %all be con/ru$ to affect !     
au?ority ( any ,/ate to enjo9 conduct 9 
violation ( t ,/ate's laws describ$ 9   
section #bgif7;b77#a74  7j7 ,/ate p[]s  
,to en=ce /ate laws  7#a7 ,9 g5]al      
,subject to ! provisions ( subsection   
7b77#a77;,g7 7relat+ to injunctions7 &  
p>agraph 7#b71 no?+ 9 ?is section %all  
be con/ru$ to affect ! au?ority ( any   
,/ate to make use ( any ( its p[]s to   

en=ce ! laws ( su* ,/ate ) respect to   
:i* a heal? insurance issu] is n exempt 
"u subsection 7b74  7#b7 ,c\rts (       
compet5t jurisdiction ,if a ,/ate seeks 
an injunction reg>d+ ! conduct describ$ 
9 p>agraphs 7#a7 & 7#b7 ( subsection    
7h71 su* injunction mu/ be obta9$ f a   
,f$]al or ,/ate c\rt ( compet5t         
jurisdiction4  7k7 ,/ates' au?ority ,to 
sue ,no?+ 9 ?is section %all affect !   
au?ority ( any ,/ate to br+ action 9 any
 ,f$]al or ,/ate c\rt4  7l7 ,g5]ally    
applicable laws ,no?+ 9 ?is section %all
 be con/ru$ to affect ! applicability ( 
,/ate laws g5]ally applicable to p]sons 
or corporations4  7m7 ,gu>ante$         
,availability ( ,cov]age to ,,hipaa     
,eligible ,individuals ,to ! ext5t t a  
heal? insurance issu] is (f]+ cov]age 9 
a prim>y ,/ate t does n accommodate     
resid5ts ( second>y ,/ates or does n    
provide a work+ me*anism = resid5ts ( a 
second>y ,/ate1 & ! issu] is (f]+       
cov]age "u ?is "p 9 su* second>y ,/ate  
:i* has n adopt$ a qualifi$ high risk   

pool z its acceptable alt]native        
me*anism 7z def9$ 9 section             
#bgdd7;c77#b771 ! issu] %all1 ) respect 
to any individual or gr\p heal?         
insurance cov]age (f]$ 9 a second>y     
,/ate "u ?is "p1 comply ) ! gu>ante$    
availability requirem5ts = eligible     
individuals 9 section #bgda4  7n7 ,no   
m&at$ b5efit cov]age requirem5ts        
,not)/&+ any o!r provision ( law1 a     
heal? insurance issu] (f]+ individual or
 gr\p heal? insurance cov]age 9 a prim>y
 ,/ate & 9 any second>y ,/ate 9         
accordance ) ?is "p 7& any cov]age s    
(f]$7 %all n be subject to any ,f$]al   
law t w\ld o!rwise--  7#a7 apply any age
 limitations ) respect to :o may pur*ase
 su* cov]age t is a high d$uctible heal?
 plan2 or  7#b7 require su* cov]age t is
 a high d$uctible heal? plan to provide 
= any specific type ( cov]age4  #bgig4  
,prim>y ,/ate mu/ meet ,f$]al floor be=e
 issu] may sell into second>y ,/ates ,a 
heal? insurance issu] may n (f]1 sell1  
or issue individual or gr\p heal?       

insurance cov]age 9 a second>y ,/ate if 
! ,/ate insurance commission] does n use
 a risk-bas$ capital =mula = !          
det]m9ation ( capital & surplus         
requirem5ts = all heal? insurance       
issu]s4  #bgih4 ,indep5d5t ext]nal      
appeals proc$ures  7a7 ,"r to ,ext]nal  
,appeal ,a heal? insurance issu] may n  
(f]1 sell1 or issue individual or gr\p  
heal? insurance cov]age 9 a second>y    
,/ate "u ! provisions ( ?is title       
unless--  7#a7 bo? ! second>y ,/ate & ! 
prim>y ,/ate h legislation or           
regulations 9 place e/abli%+ an         
indep5d5t review process = individuals  
:o are cov]$ by individual heal?        
insurance cov]age or gr\p heal?         
insurance (f]$ by a heal? insurance     
issu]1 respectively1 or  7#b7 9 any case
 9 :i* ! requirem5ts ( subp>agraph 7,a7 
are n met ) respect to ! ei!r ( su*     
,/ates1 ! issu] provides an indep5d5t   
review me*anism sub/antially id5tical 7z
 det]m9$ by ! applicable ,/ate au?ority 
( su* ,/ate7 to t prescrib$ 9 ! ,heal?  

,c>ri] ,ext]nal ,review ,model ,act ( ! 
,national ,association ( ,insurance     
,commission]s = all individuals :o      
pur*ase insurance cov]age "u ! t]ms (   
?is "p1 except t1 "u su* me*anism1 !    
review is conduct$ by an indep5d5t      
m$ical review]1 or a panel ( su*        
review]s1 ) respect to :om ! requirem5ts
 ( subsection 7b7 are met4  7b7         
,qualifications ( ,indep5d5t ,m$ical    
,review]s ,9 ! case ( any indep5d5t     
review me*anism ref]r$ to 9 subsection  
7a77#b73  7#a7 ,9 g5]al ,9 ref]r+ a     
d5ial ( a claim to an indep5d5t m$ical  
review]1 or to any panel ( su* review]s1
 to conduct indep5d5t m$ical review1 !  
issu] %all ensure t--  7,a7 ea*         
indep5d5t m$ical review] meets !        
qualifications describ$ 9 p>agraphs 7#b7
 & 7#c72  7,b7 ) respect to ea* review1 
ea* review] meets ! requirem5ts (       
p>agraph 7#d7 & ! review]1 or at lea/ #a
 review] on ! panel1 meets ! requirem5ts
 describ$ 9 p>agraph 7#e72 &  7,c7      
comp5sation provid$ by ! issu] to ea*   

review] is consi/5t ) p>agraph 7#f74    
7#b7 ,lic5sure & exp]tise ,ea* indep5d5t
 m$ical review] %all be a physician     
7allopa?ic or o/eopa?ic7 or heal? c>e   
pr(essional :o--  7,a7 is appropriately 
cr$5tial$ or lic5s$ 9 #a or m ,/ates to 
deliv] heal? c>e s]vices2 &  7,b7       
typically treats ! condition1 makes !   
diagnosis1 or provides ! type ( treatm5t
 "u review4  7#c7 ,indep5d5ce  7,a7 ,9  
g5]al ,subject to subp>agraph 7,b71 ea* 
indep5d5t m$ical review] 9 a case %all--
  7i7 n be a relat$ p>ty 7z def9$ 9     
p>agraph 7#g772  7ii7 n h a mat]ial     
familial1 f9ancial1 or pr(essional      
relation%ip ) su* a p>ty2 &  7iii7 n    
o!rwise h a conflict ( int]e/ ) su* a   
p>ty 7z det]m9$ "u regulations74  7,b7  
,exception ,no?+ 9 subp>agraph 7,a7 %all
 be con/ru$ to--  7i7 prohibit an       
individual1 solely on ! basis (         
affiliation ) ! issu]1 f s]v+ z an      
indep5d5t m$ical review] if--  7,i7 a   
non-affiliat$ individual is n reasonably
 available2  7,,ii7 ! affiliat$         

individual is n involv$ 9 ! provision ( 
items or s]vices 9 ! case "u review2    
7,,iii7 ! fact ( su* an affiliation is  
disclos$ to ! issu] & ! enrollee 7or    
au?oriz$ repres5tative7 & nei!r p>ty    
objects2 &  7,,iv7 ! affiliat$          
individual is n an employee ( ! issu] & 
does n provide s]vices exclusively or   
prim>ily to or on behalf ( ! issu]2     
7ii7 prohibit an individual :o has /aff 
privileges at ! in/itution :]e !        
treatm5t involv$ takes place f s]v+ z an
 indep5d5t m$ical review] m]ely on !    
basis ( su* affiliation if ! affiliation
 is disclos$ to ! issu] & ! enrollee 7or
 au?oriz$ repres5tative71 & nei!r p>ty  
objects2 or  7iii7 prohibit receipt (   
comp5sation by an indep5d5t m$ical      
review] f an entity if ! comp5sation is 
provid$ consi/5t ) p>agraph 7#f74  7#d7 
,practic+ heal? c>e pr(essional 9 same  
field  7,a7 ,9 g5]al ,9 a case involv+  
treatm5t1 or ! provision ( items or     
s]vices--  7i7 by a physician1 a review]
 %all be a practic+ physician 7allopa?ic

 or o/eopa?ic7 ( ! same or simil>       
specialty1 z a physician :o1 act+ )9 !  
appropriate scope ( practice )9 ! ,/ate 
9 :i* ! s]vice is provid$ or r5d]$1     
typically treats ! condition1 makes !   
diagnosis1 or provides ! type ( treatm5t
 "u review2 or  7ii7 by a non-physician 
heal? c>e pr(essional1 ! review]1 or at 
lea/ #a memb] ( ! review panel1 %all be 
a practic+ non-physician heal? c>e      
pr(essional ( ! same or simil> specialty
 z ! non-physician heal? c>e pr(essional
 :o1 act+ )9 ! appropriate scope (      
practice )9 ! ,/ate 9 :i* ! s]vice is   
provid$ or r5d]$1 typically treats !    
condition1 makes ! diagnosis1 or        
provides ! type ( treatm5t "u review4   
7,b7 ,practic+ def9$ ,= purposes ( ?is  
p>agraph1 ! t]m practic+ means1 )       
respect to an individual :o is a        
physician or o!r heal? c>e pr(essional1 
t ! individual provides heal? c>e       
s]vices to individual pati5ts on av]age 
at lea/ #b days p] week4  7#e7 ,p$iatric
 exp]tise ,9 ! case ( an ext]nal review 

relat+ to a *ild1 a review] %all h      
exp]tise "u p>agraph 7#b7 9 p$iatrics4  
7#f7 ,limitations on review] comp5sation
 ,comp5sation provid$ by ! issu] to an  
indep5d5t m$ical review] 9 connection ) 
a review "u ?is section %all--  7,a7 n  
exce$ a reasonable level2 &  7,b7 n be  
cont+5t on ! decision r5d]$ by !        
review]4  7#g7 ,relat$ p>ty def9$ ,=    
purposes ( ?is section1 ! t]m relat$    
p>ty means1 ) respect to a d5ial ( a    
claim "u a cov]age relat+ to an         
enrollee1 any ( ! foll[+3  7,a7 ,! issu]
 involv$1 or any fiduci>y1 (fic]1       
director1 or employee ( ! issu]4  7,b7  
,! enrollee 7or au?oriz$ repres5tative74
  7,c7 ,! heal? c>e pr(essional t       
provides ! items or s]vices involv$ 9 ! 
d5ial4  7,d7 ,! in/itution at :i* !     
items or s]vices 7or treatm5t7 involv$ 9
 ! d5ial are provid$4  7,e7 ,!          
manufactur] ( any drug or o!r item t is 
includ$ 9 ! items or s]vices involv$ 9 !
 d5ial4  7,f7 ,any o!r p>ty det]m9$ "u  
any regulations to h a sub/antial int]e/

 9 ! d5ial involv$4  7#h7 ,def9itions ,=
 purposes ( ?is subsection3  7,a7       
,enrollee ,! t]m enrollee means1 )      
respect to heal? insurance cov]age (f]$ 
by a heal? insurance issu]1 an          
individual enroll$ ) ! issu] to receive 
su* cov]age4  7,b7 ,heal? c>e           
pr(essional ,! t]m heal? c>e pr(essional
 means an individual :o is lic5s$1      
accr$it$1 or c]tifi$ "u ,/ate law to    
provide specifi$ heal? c>e s]vices & :o 
is op]at+ )9 ! scope ( su* lic5sure1    
accr$itation1 or c]tification4  #bgii4  
,en=cem5t  7a7 ,9 g5]al ,subject to     
subsection 7b71 ) respect to specific   
individual or gr\p heal? insurance      
cov]age ! prim>y ,/ate = su* cov]age has
 sole jurisdiction to en=ce ! prim>y    
,/ate's cov]$ laws 9 ! prim>y ,/ate &   
any second>y ,/ate4  7b7 ,second>y      
/ate's au?ority ,no?+ 9 subsection 7a7  
%all be con/ru$ to affect ! au?ority ( a
 second>y ,/ate to en=ce its laws z set 
=? 9 ! exception specifi$ 9 section     
#bgif7;b77#a74  7c7 ,c\rt int]pretation 

,9 review+ action initiat$ by !         
applicable second>y ,/ate au?ority1 !   
c\rt ( compet5t jurisdiction %all apply 
! cov]$ laws ( ! prim>y ,/ate4  7d7     
,notice ( compliance failure ,9 ! case (
 individual heal? insurance cov]age (f]$
 9 a second>y ,/ate1 or gr\p heal?      
insurance cov]age (f]$ by a heal?       
insurance issu] 9 a second>y ,/ate1 t   
fails to comply ) ! cov]$ laws ( !      
prim>y ,/ate1 ! applicable ,/ate        
au?ority ( ! second>y ,/ate may notify !
 applicable ,/ate au?ority ( ! prim>y   
,/ate4  4  7b7 ,effective date ,!       
am5dm5t made by subsection 7a7 %all     
apply to heal? insurance cov]age (f]$1  
issu$1 or sold aft] ! date t is "o ye>  
aft] ! date ( ! enactm5t ( ?is ,act4    
7c7 ,,gao ongo+ /udy & reports  7#a7    
,/udy ,! ,comptroll] ,g5]al ( ! ,unit$  
,/ates %all conduct an ongo+ /udy       
conc]n+ ! effect ( ! am5dm5t made by    
subsection 7a7 on--  7,a7 ! numb] (     
un9sur$ & "u-insur$2  7,b7 !            
availability & co/ ( heal? insurance    

policies = individuals ) pre-exi/+      
m$ical conditions2  7,c7 ! availability 
& co/ ( heal? insurance policies        
g5]ally2  7,d7 ! elim9ation or r$uction 
( diff]5t types ( b5efits "u heal?      
insurance policies (f]$ 9 diff]5t       
,/ates2 &  7,e7 cases ( fraud or abuse  
relat+ to heal? insurance cov]age (f]$  
"u su* am5dm5t & ! resolution ( su*     
cases4  7#b7 ,annual reports ,!         
,comptroll] ,g5]al %all submit to       
,congress an annual report1 aft] ! end (
 ea* ( ! #e ye>s foll[+ ! effective date
 ( ! am5dm5t made by subsection 7a71 on 
! ongo+ /udy conduct$ "u p>agraph 7#a74 
#bjb4 ,reau?orization ( ! ,preexi/+     
,condition ,insurance ,plan 7,,pcip7    
,program  7a7 ,9 g5]al ,! ,,pcip program
 is h]eby reau?oriz$ ?r\gh ,decemb] #ca1
 #bjaf1 & %all cont9ue 9 effect subject 
to ! provisions ( ?is section4  7b7     
,elim9ation ( requirem5t = noncov]age = 
#f mon?s ,to be eligible individual ,!  
condition "u p>agraph 7#b7 ( section    
#aaja7;d7 ( ! ,pati5t ,protection &     

,af=dable ,c>e ,act 7#db ,u4,s4,c4      
#ahjja7;d77 %all n apply to ! reau?oriz$
 ,,pcip program4  7c7 ,fund+  7#a7      
,initial fund+ ,initial fund+ = !       
reau?oriz$ ,,pcip program %all be d]iv$ 
f ! foll[+3  7,a7 ,fund+ t 0 available 9
 ! ,pati5t-,c5t]$ ,outcomes ,rese>*     
,in/itute ,tru/ ,fund "u section #ieaa (
 ! ,int]nal ,rev5ue ,code ( #aihf on !  
day be=e ! date ( ! enactm5t ( ?is ,act4
  7,b7 ,any unobligat$ funds 9 !        
,prev5tion & ,public ,heal? ,fund 7"u   
section #djjb ( ,public ,law #aaa-adh1  
#db ,u4,s4,c4 #cjju-#aa7 attributable to
 fiscal ye> #bjac z ( ! day be=e ! date 
( ! enactm5t ( ?is ,act4  7#b7          
,subsequ5t fund+ ,subsequ5t fund+ = !   
reau?oriz$ ,,pcip program %all be d]iv$ 
f any funds t w\ld o!rwise be made      
available to su* ,prev5tion & ,public   
,heal? ,fund = fiscal ye>s #bjad ?r\gh  
#bjaf4  7#c7 ,transf] ,fund+ "u !       
previ\s p>agraphs %all be transf]r$ to  
an acc\nt )9 ! ,dep>tm5t ( ,heal? &     
,human ,s]vices t provid$ fund+1 z ( !  

day be=e ! date ( ! enactm5t ( ?is ,act1
 to c>ry out ! ,,pcip program4  7d7     
,def9itions ,9 ?is section3  7#a7 ,! t]m
 ,,pcip program means ! ,preexi/+       
,condition ,insurance ,plan 7,,pcip7    
,program e/abli%$ z ( ! day be=e ! date 
( ! enactm5t ( ?is ,act "u section #aaja
 ( ,public ,law #aaa-adh 7#db ,u4,s4,c4 
#ahjja74  7#b7 ,! t]m reau?oriz$ ,,pcip 
program means ! ,,pcip program z        
reau?oriz$ "u ?is section4