,,ii #aacth ,,congress #ast ,session ,s4 #aafd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,june #ac1 #bjac ,mr4 ,pryor 7for himself and ,mr4 ,coons7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend the ,patient ,protection and ,affordable ,care ,act to clarify provisions with respect to church plans4 #a4 ,short title ,this ,act may be cited as the ,church ,health ,plan ,act of #bjac4 #b4 ,church plans as qualified health plans 7a7 ,in general ,section #acja7;a7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjba7;a77 is amended-- 7#a7 by redesignating paragraphs 7#c7 and 7#d7 as paragraphs 7#d7 and 7#e71 respectively2 and 7#b7 by inserting after paragraph 7#b71 the following3 7#c7 ,inclusion of qualified church plans 7,a7 ,in general ,any reference in this title to a qualified health plan shall be deemed to include a qualified church plan1 unless specifically provided for otherwise4 7,b7 ,requirements of qualified church plans ,a qualified church plan is a church plan1 as defined in section #dad7;e7 of the ,internal ,revenue ,code of #aihf1 that-- 7i7 is a welfare plan1 as defined in section #b7;c7 of ,public ,law #ajf-bdd1 and provides health care coverage for the employees of ten or more eligible common law employers1 and if a majority of employees covered by the plan are employees of churches or qualified church-controlled organizations within the meaning of sections #caba7w77#c7 7,a7 and 7,b7 of the ,internal ,revenue ,code of #aihf1 respectively2 7ii7 provides an essential health benefits package1 as defined in section #acjb7;a72 7iii7 complies with the requirements under sections #bgjc1 #bgjf1 #bgjh1 #bgji1 #bgaa1 #bgab1 #bgac1 #bgad1 #bgae1 #bgai1 and #bgai;,a of the ,public ,health ,service ,act2 7iv7 prohibits exclusions based on preexisting conditions or other health status1 and prohibits discrimination against individual participants and beneficiaries based on health status for the purposes of enrollment1 within the meaning of sections #bgjd and #bgje of the ,public ,health ,service ,act1 except as provided under subparagraph 7,c77ii72 and 7v7 limits1 on average1 the ratio of incurred losses plus loss adjustment expenses to earned premiums1 within the meaning of section #bgah of the ,public ,health ,service ,act1 as calculated across the entire church plan1 except that1 for purposes of this paragraph1 earned premiums include payments by1 or on behalf of1 employees of a church1 as defined in #dad7;e77#c77;,b7 of the ,internal ,revenue ,code of #aihf4 7,c7 ,exclusion of qualified church plans from ,american health benefit exchanges 7i7 ,in general ,a qualified church plan may not participate in an ,american ,health ,benefit ,exchange established by a ,state under section #acaa7;b7 or by the ,secretary of ,health and ,human ,services 7referred to in this paragraph as the ,secretary7 under #acba7;c74 ,the ,secretary shall not assess a charge or make a payment to a qualified church plan to reflect actuarial risk pursuant to section #acdc1 and a qualified church plan shall be exempt from any other subsidies1 payments1 or requirements under this ,act that apply to qualified health plans offered on ,american ,health ,benefit ,exchanges1 except as provided by this paragraph4 7ii7 ,premiums ,a qualified church plan may differentiate premiums using methods and criteria consistent with those that the ,secretary uses to assess charges and payments to other qualified health plans based on the actuarial risks of enrollees of such plans pursuant to section #acdc and those described in section #dbb4cjh of title #db1 ,code of ,federal ,regulations4 ,a qualified church plan may develop additional methods and criteria to define and account for the actuarial risk associated with the prohibition against qualified church plans enrolling a larger number and more diverse pool of enrollees as long as such additional methods and criteria are not inconsistent with the risk adjusters described in section #acdc and those described in section #dbb4cjh of title #db1 ,code of ,federal ,regulations4 7,d7 ,deemed status of qualified church plans ,a qualified church plan shall be deemed to be-- 7i7 minimum essential coverage under an eligible employer-sponsored plan1 as defined under section #ejjj;,a7f77#b7 of the ,internal ,revenue ,code of #aihf2 and 7ii7 for the purposes of subparagraph 7,f71 equivalent to a health plan offered through an ,american ,health ,benefit ,exchange1 within the meaning of section #acaa7;b74 7,e7 ,employers participating in qualified church plans 7i7 ,eligible small employers ,an employer participating in a qualified church plan shall be deemed an eligible small employer under section #de,r7d7 of the ,internal ,revenue ,code of #aihf1 if-- 7,i7 the employer has not more than #be full-time equivalent employees1 as defined under section #de,r7d77#b7 of the ,internal ,revenue ,code of #aihf1 for the taxable year2 and 7,,ii7 the average annual wages of such full-time equivalent employees do exceed an amount equal to twice the dollar amount in effect under section #de,r7d77#c77;,b7 of the ,internal ,revenue ,code of #aihf for the taxable year1 and if no employee of the employer who is enrolled in the qualified church plan receives premium tax credits or reductions in cost-sharing under subparagraph 7,f74 7ii7 ,no exclusion from wages ,any employer participating in a qualified church plan shall not exclude from wages and other compensation1 for any individual receiving premium tax credits under section #adja1 any employer contribution for minimum essential coverage under a qualified church plan under section #ajf of the ,internal ,revenue ,code of #aihf4 7iii7 ,employers participating in qualified church plans ,any employer participating in a qualified church plan shall be deemed to be a religious employer as defined in section #adg4aca of title #de1 ,code of ,federal ,regulations4 7,f7 ,premium tax credits1 reductions in cost-sharing1 and qualified church plans ,an individual receiving minimum essential coverage under a qualified church plan-- 7i7 shall be deemed to satisfy the individual responsibility requirements under section #ejjj;,a of the ,internal ,revenue ,code of #aihf2 7ii7 shall be deemed to qualify as an applicable taxpayer eligible to receive premium tax credits under section #adja1 if the individual's household income for the taxable year equals or exceeds #ajj percent but does not exceed #djj percent of an amount equal to the poverty line for a family of the size involved2 and 7iii7 shall be deemed to qualify as an eligible insured eligible to receive reductions in cost-sharing under section #adjb7;b71 if the individual's household income exceeds #ajj percent but does not exceed #djj percent of the poverty line for a family of the size involved4 7,g7 ,regulations ,the ,secretary and the ,secretary of the ,treasury shall promulgate regulations-- 7i7 under subparagraph 7,e7 to ensure that an eligible small employer offering a qualified church plan receives the same tax credit as any other eligible small employer under section #de,r of the ,internal ,revenue ,code of #aihf2 7ii7 under subparagraph 7,f77ii7 to ensure that an applicable taxpayer receiving minimum essential coverage under a qualified church plan receives the same premium tax credit as any other applicable taxpayer under section #adja2 7iii7 under subparagraph 7,f77iii7 to ensure that an eligible insured receiving minimum essential coverage under a qualified church plan receives the same reduction in cost-sharing as any other eligible insured under section #adjb2 and 7iv7 providing church plans sufficient opportunity to make appropriate transitions in order to meet the definition of qualified church plan under subparagraph 7,b74 4 7b7 ,effective date ,the amendments made by this ,act shall take effect as if enacted as part of the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh74