,i #aae? ,,congress #a/ ,session ,h4 ,r4 #aaja ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,febru>y #af1 #bjag,mr4 ,sam ,johnson ( ,texas 7= himself & ,mr4 ,walb]g7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,education & ! ,work=ce ,a ,,bill ,to am5d title ,i ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd to improve access & *oice = entrepr5eurs ) small bus9esses ) respect to m$ical c>e = _! employees4 #a4 ,%ort title2 table ( cont5ts 7a7 ,%ort title ,?is ,act may be cit$ z ! ,small ,bus9ess ,heal? ,fairness ,act ( #bjag4 7b7 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 table ( cont5ts4 ,sec4 #b4 ,rules gov]n+ association heal? plans4 ,sec4 #c4 ,cl>ification ( treatm5t ( s+le employ] arrangem5ts4 ,sec4 #d4 ,en=cem5t provisions relat+ to association heal? plans4 ,sec4 #e4 ,coop]ation betwe5 ,f$]al & ,/ate au?orities4 ,sec4 #f4 ,effective date & transitional & o!r rules4 #b4 ,rules gov]n+ association heal? plans 7a7 ,9 ,g5]al ,subtitle ,b ( title ,i ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd is am5d$ by add+ aft] "p #g ! foll[+ new "p3 #h ,,rules ,,gov]n+ ,,association ,,heal? ,,plans #hja4 ,association heal? plans 7a7 ,9 ,g5]al ,= purposes ( ?is "p1 ! t]m association heal? plan means a gr\p heal? plan ^: sponsor is 7or is deem$ "u ?is "p to be7 describ$ 9 subsection 7b74 7b7 ,sponsor%ip ,! sponsor ( a gr\p heal? plan is describ$ 9 ?is subsection if su* sponsor-- 7#a7 is organiz$ & ma9ta9$ 9 good fai?1 ) a con/itution & bylaws specifically /at+ its purpose & provid+ = p]iodic meet+s on at lea/ an annual basis1 z a bona fide trade association1 a bona fide indu/ry association 7includ+ a rural electric coop]ative association or a rural telephone coop]ative association71 a bona fide pr(essional association1 or a bona fide *amb] ( comm]ce 7or simil> bona fide bus9ess association1 includ+ a corporation or simil> organization t op]ates on a coop]ative basis 7)9 ! mean+ ( section #acha ( ! ,int]nal ,rev5ue ,code ( #aihf771 = sub/antial purposes o!r ?an t ( obta9+ or provid+ m$ical c>e2 7#b7 is e/abli%$ z a p]man5t entity :i* receives ! active support ( its memb]s & requires = memb]%ip paym5t on a p]iodic basis ( dues or paym5ts necess>y to ma9ta9 eligibility = memb]%ip 9 ! sponsor2 & 7#c7 does n condition memb]%ip1 su* dues or paym5ts1 or cov]age "u ! plan on ! basis ( heal? /atus-relat$ factors ) respect to ! employees ( its memb]s 7or affiliat$ memb]s71 or ! dep5d5ts ( su* employees1 & does n condition su* dues or paym5ts on ! basis ( gr\p heal? plan p>ticipation4 ,any sponsor consi/+ ( an association ( entities :i* meet ! requirem5ts ( p>agraphs 7#a71 7#b71 & 7#c7 %all be deem$ to be a sponsor describ$ 9 ?is subsection4 #hjb4 ,c]tification ( association heal? plans 7a7 ,9 ,g5]al ,! applicable au?ority %all prescribe by regulation a proc$ure "u :i*1 subject to subsection 7b71 ! applicable au?ority %all c]tify association heal? plans :i* apply = c]tification z meet+ ! requirem5ts ( ?is "p4 7b7 ,/&>ds ,"u ! proc$ure prescrib$ pursuant to subsection 7a71 9 ! case ( an association heal? plan t provides at lea/ "o b5efit option :i* does n consi/ ( heal? insurance cov]age1 ! applicable au?ority %all c]tify su* plan z meet+ ! requirem5ts ( ?is "p only if ! applicable au?ority is satisfi$ t ! applicable requirem5ts ( ?is "p are met 7or1 ^u ! date on :i* ! plan is to comm5ce op]ations1 w be met7 ) respect to ! plan4 7c7 ,requirem5ts ,applicable to ,c]tifi$ ,plans ,an association heal? plan ) respect to :i* c]tification "u ?is "p is 9 effect %all meet ! applicable requirem5ts ( ?is "p1 effective on ! date ( c]tification 7or1 if lat]1 on ! date on :i* ! plan is to comm5ce op]ations74 7d7 ,requirem5ts = ,cont9u$ ,c]tification ,! applicable au?ority may provide by regulation = cont9u$ c]tification ( association heal? plans "u ?is "p4 7e7 ,class ,c]tification = ,fully ,insur$ ,plans ,! applicable au?ority %all e/abli% a class c]tification proc$ure = association heal? plans "u :i* all b5efits consi/ ( heal? insurance cov]age4 ,"u su* proc$ure1 ! applicable au?ority %all provide = ! grant+ ( c]tification "u ?is "p to ! plans 9 ea* class ( su* association heal? plans ^u appropriate fil+ "u su* proc$ure 9 connection ) plans 9 su* class & paym5t ( ! prescrib$ fee "u section #hjg7;a74 7f7 ,c]tification ( ,self-,insur$ ,association ,heal? ,plans ,an association heal? plan :i* (f]s "o or m b5efit options :i* d n consi/ ( heal? insurance cov]age may be c]tifi$ "u ?is "p only if su* plan consi/s ( any ( ! foll[+3 7#a7 ,a plan :i* (f]$ su* cov]age on ! date ( ! enactm5t ( ! ,small ,bus9ess ,heal? ,fairness ,act ( #bjag4 7#b7 ,a plan "u :i* ! sponsor does n re/rict memb]%ip to "o or m trades & bus9esses or indu/ries & ^: eligible p>ticipat+ employ]s repres5t a broad cross-section ( trades & bus9esses or indu/ries4 7#c7 ,a plan ^: eligible p>ticipat+ employ]s repres5t "o or m trades or bus9esses1 or "o or m indu/ries1 consi/+ ( any ( ! foll[+3 agriculture2 equipm5t & automobile deal]%ips2 b>b]+ & cosmetology2 c]tifi$ public acc\nt+ practices2 *ild c>e2 con/ruction2 dance1 !atrical & or*e/ra productions2 dis9fect+ & pe/ control2 f9ancial s]vices2 fi%+2 food s]vice e/abli%m5ts2 hospitals2 labor organizations2 logg+2 manufactur+ 7metals72 m9+2 m$ical & d5tal practices2 m$ical laboratories2 pr(essional consult+ s]vices2 sanit>y s]vices2 transportation 7local & freight72 w>eh\s+2 :olesal+_/di/ribut+2 or any o!r trade or bus9ess or indu/ry :i* has be5 indicat$ z hav+ av]age or above-av]age risk or heal? claims exp]i5ce by reason ( ,/ate rate fil+s1 d5ials ( cov]age1 propos$ premium rate levels1 or o!r means demon/rat$ by su* plan 9 accordance ) regulations4 #hjc4 ,requirem5ts relat+ to sponsors & bo>ds ( tru/ees 7a7 ,sponsor ,! requirem5ts ( ?is subsection are met ) respect to an association heal? plan if ! sponsor has met 7or is deem$ "u ?is "p to h met7 ! requirem5ts ( section #hja7;b7 = a cont9u\s p]iod ( n less ?an #c ye>s end+ ) ! date ( ! application = c]tification "u ?is "p4 7b7 ,bo>d ( ,tru/ees ,! requirem5ts ( ?is subsection are met ) respect to an association heal? plan if ! foll[+ requirem5ts are met3 7#a7 ,fiscal control ,! plan is op]at$1 pursuant to a tru/ agreem5t1 by a bo>d ( tru/ees :i* has complete fiscal control ov] ! plan & :i* is responsible = all op]ations ( ! plan4 7#b7 ,rules ( op]ation & f9ancial controls ,! bo>d ( tru/ees has 9 effect rules ( op]ation & f9ancial controls1 bas$ on a #c-ye> plan ( op]ation1 adequate to c>ry out ! t]ms ( ! plan & to meet all requirem5ts ( ?is title applicable to ! plan4 7#c7 ,rules gov]n+ relation%ip to p>ticipat+ employ]s & to contractors 7,a7 ,bo>d memb]%ip 7i7 ,9 g5]al ,except z provid$ 9 clauses 7ii7 & 7iii71 ! memb]s ( ! bo>d ( tru/ees are individuals select$ f individuals :o are ! own]s1 (fic]s1 directors1 or employees ( ! p>ticipat+ employ]s or :o are p>tn]s 9 ! p>ticipat+ employ]s & actively p>ticipate 9 ! bus9ess4 7ii7 ,limitation 7,i7 ,g5]al rule ,except z provid$ 9 subclauses 7,,ii7 & 7,,iii71 no su* memb] is an own]1 (fic]1 director1 or employee (1 or p>tn] 91 a contract adm9i/rator or o!r s]vice provid] to ! plan4 7,,ii7 ,limit$ exception = provid]s ( s]vices solely on behalf ( ! sponsor ,(fic]s or employees ( a sponsor :i* is a s]vice provid] 7o!r ?an a contract adm9i/rator7 to ! plan may be memb]s ( ! bo>d if !y con/itute n m ?an #be p]c5t ( ! memb]%ip ( ! bo>d & !y d n provide s]vices to ! plan o!r ?an on behalf ( ! sponsor4 7,,iii7 ,treatm5t ( provid]s ( m$ical c>e ,9 ! case ( a sponsor :i* is an association ^: memb]%ip consi/s prim>ily ( provid]s ( m$ical c>e1 subclause 7,i7 %all n apply 9 ! case ( any s]vice provid] describ$ 9 subclause 7,i7 :o is a provid] ( m$ical c>e "u ! plan4 7iii7 ,c]ta9 plans exclud$ ,clause 7i7 %all n apply to an association heal? plan :i* is 9 exi/5ce on ! date ( ! enactm5t ( ! ,small ,bus9ess ,heal? ,fairness ,act ( #bjag4 7,b7 ,sole au?ority ,! bo>d has sole au?ority "u ! plan to approve applications = p>ticipation 9 ! plan & to contract ) a s]vice provid] to adm9i/] ! day-to-day affairs ( ! plan4 7c7 ,treatm5t ( ,fran*ise ,networks ,9 ! case ( a gr\p heal? plan :i* is e/abli%$ & ma9ta9$ by a fran*is] = a fran*ise network consi/+ ( its fran*isees-- 7#a7 ! requirem5ts ( subsection 7a7 & section #hja7;a7 %all be deem$ met if su* requirem5ts w\ld o!rwise be met if ! fran*is] 7 deem$ to be ! sponsor ref]r$ to 9 section #hja7;b71 su* network 7 deem$ to be an association describ$ 9 section #hja7;b71 & ea* fran*isee 7 deem$ to be a memb] 7( ! association & ! sponsor7 ref]r$ to 9 section #hja7;b72 & 7#b7 ! requirem5ts ( section #hjd7;a77#a7 %all be deem$ met4 ,! ,secret>y may by regulation def9e = purposes ( ?is subsection ! t]ms fran*is]1 fran*ise network1 & fran*isee4 #hjd4 ,p>ticipation & cov]age requirem5ts 7a7 ,cov]$ ,employ]s & ,individuals ,! requirem5ts ( ?is subsection are met ) respect to an association heal? plan if1 "u ! t]ms ( ! plan-- 7#a7 ea* p>ticipat+ employ] mu/ be-- 7,a7 a memb] ( ! sponsor1 7,b7 ! sponsor1 or 7,c7 an affiliat$ memb] ( ! sponsor ) respect to :i* ! requirem5ts ( subsection 7b7 are met1 except t1 9 ! case ( a sponsor :i* is a pr(essional association or o!r individual-bas$ association1 if at lea/ "o ( ! (fic]s1 directors1 or employees ( an employ]1 or at lea/ "o ( ! individuals :o are p>tn]s 9 an employ] & :o actively p>ticipates 9 ! bus9ess1 is a memb] or su* an affiliat$ memb] ( ! sponsor1 p>ticipat+ employ]s may also include su* employ]2 & 7#b7 all individuals comm5c+ cov]age "u ! plan aft] c]tification "u ?is "p mu/ be-- 7,a7 active or retir$ own]s 7includ+ self-employ$ individuals71 (fic]s1 directors1 or employees (1 or p>tn]s 91 p>ticipat+ employ]s2 or 7,b7 ! b5efici>ies ( individuals describ$ 9 subp>agraph 7,a74 7b7 ,cov]age ( ,previ\sly ,un9sur$ ,employees ,9 ! case ( an association heal? plan 9 exi/5ce on ! date ( ! enactm5t ( ! ,small ,bus9ess ,heal? ,fairness ,act ( #bjag1 an affiliat$ memb] ( ! sponsor ( ! plan may be (f]$ cov]age "u ! plan z a p>ticipat+ employ] only if-- 7#a7 ! affiliat$ memb] 0 an affiliat$ memb] on ! date ( c]tification "u ?is "p2 or 7#b7 dur+ ! #ab-mon? p]iod prec$+ ! date ( ! (f]+ ( su* cov]age1 ! affiliat$ memb] has n ma9ta9$ or contribut$ to a gr\p heal? plan ) respect to any ( its employees :o w\ld o!rwise be eligible to p>ticipate 9 su* association heal? plan4 7c7 ,individual ,m>ket ,unaffect$ ,! requirem5ts ( ?is subsection are met ) respect to an association heal? plan if1 "u ! t]ms ( ! plan1 no p>ticipat+ employ] may provide heal? insurance cov]age 9 ! individual m>ket = any employee n cov]$ "u ! plan :i* is simil> to ! cov]age contemporane\sly provid$ to employees ( ! employ] "u ! plan1 if su* exclusion ( ! employee f cov]age "u ! plan is bas$ on a heal? /atus-relat$ factor ) respect to ! employee & su* employee w\ld1 b = su* exclusion on su* basis1 be eligible = cov]age "u ! plan4 7d7 ,prohibition ( ,discrim9ation ,aga9/ ,employ]s & ,employees ,eligible ,to ,p>ticipate ,! requirem5ts ( ?is subsection are met ) respect to an association heal? plan if-- 7#a7 "u ! t]ms ( ! plan1 all employ]s meet+ ! prec$+ requirem5ts ( ?is section are eligible to qualify z p>ticipat+ employ]s = all geographically available cov]age options1 unless1 9 ! case ( any su* employ]1 p>ticipation or contribution requirem5ts ( ! type ref]r$ to 9 section #bgaa ( ! ,public ,heal? ,s]vice ,act are n met2 7#b7 ^u reque/1 any employ] eligible to p>ticipate is furni%$ in=mation reg>d+ all cov]age options available "u ! plan2 & 7#c7 ! applicable requirem5ts ( sections #gja1 #gjb1 & #gjc are met ) respect to ! plan4 #hje4 ,o!r requirem5ts relat+ to plan docum5ts1 contribution rates1 & b5efit options 7a7 ,9 ,g5]al ,! requirem5ts ( ?is section are met ) respect to an association heal? plan if ! foll[+ requirem5ts are met3 7#a7 ,cont5ts ( gov]n+ in/rum5ts ,! in/rum5ts gov]n+ ! plan include a writt5 in/rum5t1 meet+ ! requirem5ts ( an in/rum5t requir$ "u section #djb7;a77#a71 :i*-- 7,a7 provides t ! bo>d ( tru/ees s]ves z ! nam$ fiduci>y requir$ = plans "u section #djb7;a77#a7 & s]ves 9 ! capacity ( a plan adm9i/rator 7ref]r$ to 9 section #c7af77;,a772 7,b7 provides t ! sponsor ( ! plan is to s]ve z plan sponsor 7ref]r$ to 9 section #c7af77;,b772 & 7,c7 incorporates ! requirem5ts ( section #hjf4 7#b7 ,contribution rates mu/ be nondiscrim9atory 7,a7 ,! contribution rates = any p>ticipat+ small employ] d n v>y on ! basis ( any heal? /atus-relat$ factor 9 relation to employees ( su* employ] or _! b5efici>ies & d n v>y on ! basis ( ! type ( bus9ess or indu/ry 9 :i* su* employ] is engag$4 7,b7 ,no?+ 9 ?is title or any o!r provision ( law %all be con/ru$ to preclude an association heal? plan1 or a heal? insurance issu] (f]+ heal? insurance cov]age 9 connection ) an association heal? plan1 f-- 7i7 sett+ contribution rates bas$ on ! claims exp]i5ce ( ! plan2 or 7ii7 v>y+ contribution rates = small employ]s 9 a ,/ate to ! ext5t t su* rates c\ld v>y us+ ! same me?odology employ$ 9 su* ,/ate = regulat+ premium rates 9 ! small gr\p m>ket ) respect to heal? insurance cov]age (f]$ 9 connection ) bona fide associations 7)9 ! mean+ ( section #bgia7;d77#c7 ( ! ,public ,heal? ,s]vice ,act71 subject to ! requirem5ts ( section #gjb7;b7 relat+ to contribution rates4 7#c7 ,floor = numb] ( cov]$ individuals ) respect to c]ta9 plans ,if any b5efit option "u ! plan does n consi/ ( heal? insurance cov]age1 ! plan has z ( ! beg9n+ ( ! plan ye> n few] ?an #a1jjj p>ticipants & b5efici>ies4 7#d7 ,m>ket+ requirem5ts 7,a7 ,9 g5]al ,if a b5efit option :i* consi/s ( heal? insurance cov]age is (f]$ "u ! plan1 ,/ate-lic5s$ insurance ag5ts %all be us$ to di/ribute to small employ]s cov]age :i* does n consi/ ( heal? insurance cov]age 9 a mann] comp>able to ! mann] 9 :i* su* ag5ts are us$ to di/ribute heal? insurance cov]age4 7,b7 ,/ate-lic5s$ insurance ag5ts ,= purposes ( subp>agraph 7,a71 ! t]m ,/ate-lic5s$ insurance ag5ts means "o or m ag5ts :o are lic5s$ 9 a ,/ate & are subject to ! laws ( su* ,/ate relat+ to lic5sure1 qualification1 te/+1 exam9ation1 & cont9u+ education ( p]sons au?oriz$ to (f]1 sell1 or solicit heal? insurance cov]age 9 su* ,/ate4 7#e7 ,regulatory requirem5ts ,su* o!r requirem5ts z ! applicable au?ority det]m9es are necess>y to c>ry out ! purposes ( ?is "p1 :i* %all be prescrib$ by ! applicable au?ority by regulation4 7b7 ,ability ( ,association ,heal? ,plans ,to ,design ,b5efit ,options ,subject to section #ead7;d71 no?+ 9 ?is "p or any provision ( ,/ate law 7z def9$ 9 section #ead7;c77#a77 %all be con/ru$ to preclude an association heal? plan1 or a heal? insurance issu] (f]+ heal? insurance cov]age 9 connection ) an association heal? plan1 f ex]cis+ its sole discretion 9 select+ ! specific items & s]vices consi/+ ( m$ical c>e to be includ$ z b5efits "u su* plan or cov]age1 except 7subject to section #ead7 9 ! case ( 7#a7 any law to ! ext5t t x is n preempt$ "u section #gca7;a77#a7 ) respect to matt]s gov]n$ by section #gaa1 #gab1 or #gac1 or 7#b7 any law ( ! ,/ate ) :i* fil+ & approval ( a policy type (f]$ by ! plan 0 initially obta9$ to ! ext5t t su* law prohibits an exclusion ( a specific disease f su* cov]age4 #hjf4 ,ma9t5ance ( res]ves & provisions = solv5cy = plans provid+ heal? b5efits 9 addition to heal? insurance cov]age 7a7 ,9 ,g5]al ,! requirem5ts ( ?is section are met ) respect to an association heal? plan if-- 7#a7 ! b5efits "u ! plan consi/ solely ( heal? insurance cov]age2 or 7#b7 if ! plan provides any additional b5efit options :i* d n consi/ ( heal? insurance cov]age1 ! plan-- 7,a7 e/abli%es & ma9ta9s res]ves ) respect to su* additional b5efit options1 9 am\nts recomm5d$ by ! qualifi$ actu>y1 consi/+ (-- 7i7 a res]ve suffici5t = une>n$ contributions2 7ii7 a res]ve suffici5t = b5efit liabilities :i* h be5 incurr$1 :i* h n be5 satisfi$1 & = :i* risk ( loss has n yet be5 transf]r$1 & = expect$ adm9i/rative co/s ) respect to su* b5efit liabilities2 7iii7 a res]ve suffici5t = any o!r obligations ( ! plan2 & 7iv7 a res]ve suffici5t = a m>g9 ( error & o!r fluctuations1 tak+ into acc\nt ! specific circum/ances ( ! plan2 & 7,b7 e/abli%es & ma9ta9s aggregate & specific excess_//op loss insurance & solv5cy indemnification1 ) respect to su* additional b5efit options = :i* risk ( loss has n yet be5 transf]r$1 z foll[s3 7i7 ,! plan %all secure aggregate excess_//op loss insurance = ! plan ) an atta*m5t po9t :i* is n great] ?an #abe p]c5t ( expect$ gross annual claims4 ,! applicable au?ority may by regulation provide = upw>d adju/m5ts 9 ! am\nt ( su* p]c5tage 9 specifi$ circum/ances 9 :i* ! plan specifically provides = & ma9ta9s res]ves 9 excess ( ! am\nts requir$ "u subp>agraph 7,a74 7ii7 ,! plan %all secure specific excess_//op loss insurance = ! plan ) an atta*m5t po9t :i* is at lea/ equal to an am\nt recomm5d$ by ! plan's qualifi$ actu>y4 ,! applicable au?ority may by regulation provide = adju/m5ts 9 ! am\nt ( su* insurance 9 specifi$ circum/ances 9 :i* ! plan specifically provides = & ma9ta9s res]ves 9 excess ( ! am\nts requir$ "u subp>agraph 7,a74 7iii7 ,! plan %all secure indemnification insurance = any claims :i* ! plan is unable to satisfy by reason ( a plan t]m9ation4 ,any p]son issu+ to a plan insurance describ$ 9 clause 7i71 7ii71 or 7iii7 ( subp>agraph 7,b7 %all notify ! ,secret>y ( any failure ( premium paym5t m]it+ cancellation ( ! policy prior to und]tak+ su* a cancellation4 ,any regulations prescrib$ by ! applicable au?ority pursuant to clause 7i7 or 7ii7 ( subp>agraph 7,b7 may all[ = su* adju/m5ts 9 ! requir$ levels ( excess_//op loss insurance z ! qualifi$ actu>y may recomm5d1 tak+ into acc\nt ! specific circum/ances ( ! plan4 7b7 ,m9imum ,surplus 9 ,addition to ,claims ,res]ves ,9 ! case ( any association heal? plan describ$ 9 subsection 7a77#b71 ! requirem5ts ( ?is subsection are met if ! plan e/abli%es & ma9ta9s surplus 9 an am\nt at lea/ equal to-- 7#a7 #ejj1jjj1 or 7#b7 su* great] am\nt 7b n great] ?an #b1jjj1jjj7 z may be set =? 9 regulations prescrib$ by ! applicable au?ority1 consid]+ ! level ( aggregate & specific excess_//op loss insurance provid$ ) respect to su* plan & o!r factors relat$ to solv5cy risk1 su* z ! plan's project$ levels ( p>ticipation or claims1 ! nature ( ! plan's liabilities1 & ! types ( assets available to assure t su* liabilities are met4 7c7 ,additional ,requirem5ts ,9 ! case ( any association heal? plan describ$ 9 subsection 7a77#b71 ! applicable au?ority may provide su* additional requirem5ts relat+ to res]ves1 excess_//op loss insurance1 & indemnification insurance z ! applicable au?ority consid]s appropriate4 ,su* requirem5ts may be provid$ by regulation ) respect to any su* plan or any class ( su* plans4 7d7 ,adju/m5ts = ,excess_/,/op ,loss ,insurance ,! applicable au?ority may provide = adju/m5ts to ! levels ( res]ves o!rwise requir$ "u subsections 7a7 & 7b7 ) respect to any plan or class ( plans to take into acc\nt excess_//op loss insurance provid$ ) respect to su* plan or plans4 7e7 ,alt]native ,means ( ,compliance ,! applicable au?ority may p]mit an association heal? plan describ$ 9 subsection 7a77#b7 to sub/itute1 = all or "p ( ! requirem5ts ( ?is section 7except subsection 7a77#b77;,b77iii771 su* security1 gu>antee1 hold-h>mless arrangem5t1 or o!r f9ancial arrangem5t z ! applicable au?ority det]m9es to be adequate to enable ! plan to fully meet all its f9ancial obligations on a timely basis & is o!rwise no less protective ( ! int]e/s ( p>ticipants & b5efici>ies ?an ! requirem5ts = :i* x is sub/itut$4 ,! applicable au?ority may take into acc\nt1 = purposes ( ?is subsection1 evid5ce provid$ by ! plan or sponsor :i* demon/rates an assumption ( liability ) respect to ! plan4 ,su* evid5ce may be 9 ! =m ( a contract ( indemnification1 li51 bond+1 insurance1 lett] ( cr$it1 rec\rse "u applicable t]ms ( ! plan 9 ! =m ( assessm5ts ( p>ticipat+ employ]s1 security1 or o!r f9ancial arrangem5t4 7f7 ,measures ,to ,ensure ,cont9u$ ,paym5t ( ,b5efits by ,c]ta9 ,plans 9 ,di/ress 7#a7 ,paym5ts by c]ta9 plans to association heal? plan fund 7,a7 ,9 g5]al ,9 ! case ( an association heal? plan describ$ 9 subsection 7a77#b71 ! requirem5ts ( ?is subsection are met if ! plan makes paym5ts into ! ,association ,heal? ,plan ,fund "u ?is subp>agraph :5 !y are due4 ,su* paym5ts %all consi/ ( annual paym5ts 9 ! am\nt ( #e1jjj1 &1 9 addition to su* annual paym5ts1 su* supplem5tal paym5ts z ! ,secret>y may det]m9e to be necess>y "u p>agraph 7#b74 ,paym5ts "u ?is p>agraph are payable to ! ,fund at ! "t det]m9$ by ! ,secret>y4 ,initial paym5ts are due 9 advance ( c]tification "u ?is "p4 ,paym5ts %all cont9ue to accrue until a plan's assets are di/ribut$ pursuant to a t]m9ation proc$ure4 7,b7 ,p5alties = failure to make paym5ts ,if any paym5t is n made by a plan :5 x is due1 a late paym5t *>ge ( n m ?an #ajj p]c5t ( ! paym5t :i* 0 n timely paid %all be payable by ! plan to ! ,fund4 7,c7 ,cont9u$ duty ( ! secret>y ,! ,secret>y %all n cease to c>ry out ! provisions ( p>agraph 7#b7 on acc\nt ( ! failure ( a plan to pay any paym5t :5 due4 7#b7 ,paym5ts by secret>y to cont9ue excess_//op loss insurance cov]age & indemnification insurance cov]age = c]ta9 plans ,9 any case 9 :i* ! applicable au?ority det]m9es t !re is1 or t !re is reason to believe t !re w be3 7,a7 ,a failure to take necess>y corrective actions "u section #hji7;a7 ) respect to an association heal? plan describ$ 9 subsection 7a77#b72 or 7,b7 a t]m9ation ( su* a plan "u section #hji7;b7 or #haj7;b77#h7 7&1 if ! applicable au?ority is n ! ,secret>y1 c]tifies su* det]m9ation to ! ,secret>y71 ! ,secret>y %all det]m9e ! am\nts necess>y to make paym5ts to an insur] 7designat$ by ! ,secret>y7 to ma9ta9 9 =ce excess_//op loss insurance cov]age or indemnification insurance cov]age = su* plan1 if ! ,secret>y det]m9es t !re is a reasonable expectation t1 )\t su* paym5ts1 claims w\ld n be satisfi$ by reason ( t]m9ation ( su* cov]age4 ,! ,secret>y %all1 to ! ext5t provid$ 9 advance 9 appropriation ,acts1 pay su* am\nts s det]m9$ to ! insur] designat$ by ! ,secret>y4 7#c7 ,association heal? plan fund 7,a7 ,9 g5]al ,!re is e/abli%$ on ! books ( ! ,treasury a fund to be kn[n z ! ,association ,heal? ,plan ,fund4 ,! ,fund %all be available = mak+ paym5ts pursuant to p>agraph 7#b74 ,! ,fund %all be cr$it$ ) paym5ts receiv$ pursuant to p>agraph 7#a77;,a71 p5alties receiv$ pursuant to p>agraph 7#a77;,b72 & e>n+s on inve/m5ts ( am\nts ( ! ,fund "u subp>agraph 7,b74 7,b7 ,inve/m5t ,:5ev] ! ,secret>y det]m9es t ! moneys ( ! fund are 9 excess ( curr5t ne$s1 ! ,secret>y may reque/ ! inve/m5t ( su* am\nts z ! ,secret>y det]m9es advisable by ! ,secret>y ( ! ,treasury 9 obligations issu$ or gu>ante$ by ! ,unit$ ,/ates4 7g7 ,excess_/,/op ,loss ,insurance ,= purposes ( ?is section-- 7#a7 ,aggregate excess_//op loss insurance ,! t]m aggregate excess_//op loss insurance means1 9 connection ) an association heal? plan1 a contract-- 7,a7 "u :i* an insur] 7meet+ su* m9imum /&>ds z ! applicable au?ority may prescribe by regulation7 provides = paym5t to ! plan ) respect to aggregate claims "u ! plan 9 excess ( an am\nt or am\nts specifi$ 9 su* contract2 7,b7 :i* is gu>ante$ r5ewable2 & 7,c7 :i* all[s = paym5t ( premiums by any ?ird p>ty on behalf ( ! insur$ plan4 7#b7 ,specific excess_//op loss insurance ,! t]m specific excess_//op loss insurance means1 9 connection ) an association heal? plan1 a contract-- 7,a7 "u :i* an insur] 7meet+ su* m9imum /&>ds z ! applicable au?ority may prescribe by regulation7 provides = paym5t to ! plan ) respect to claims "u ! plan 9 connection ) a cov]$ individual 9 excess ( an am\nt or am\nts specifi$ 9 su* contract 9 connection ) su* cov]$ individual2 7,b7 :i* is gu>ante$ r5ewable2 & 7,c7 :i* all[s = paym5t ( premiums by any ?ird p>ty on behalf ( ! insur$ plan4 7h7 ,indemnification ,insurance ,= purposes ( ?is section1 ! t]m indemnification insurance means1 9 connection ) an association heal? plan1 a contract-- 7#a7 "u :i* an insur] 7meet+ su* m9imum /&>ds z ! applicable au?ority may prescribe by regulation7 provides = paym5t to ! plan ) respect to claims "u ! plan :i* ! plan is unable to satisfy by reason ( a t]m9ation pursuant to section #hji7;b7 7relat+ to m&atory t]m9ation72 7#b7 :i* is gu>ante$ r5ewable & noncancellable = any reason 7except z ! applicable au?ority may prescribe by regulation72 & 7#c7 :i* all[s = paym5t ( premiums by any ?ird p>ty on behalf ( ! insur$ plan4 7i7 ,res]ves ,= purposes ( ?is section1 ! t]m res]ves means1 9 connection ) an association heal? plan1 plan assets :i* meet ! fiduci>y /&>ds "u "p #d & su* additional requirem5ts reg>d+ liquidity z ! applicable au?ority may prescribe by regulation4 7j7 ,solv5cy ,/&>ds ,work+ ,gr\p 7#a7 ,9 g5]al ,)9 #ij days aft] ! date ( ! enactm5t ( ! ,small ,bus9ess ,heal? ,fairness ,act ( #bjag1 ! applicable au?ority %all e/abli% a ,solv5cy ,/&>ds ,work+ ,gr\p4 ,9 prescrib+ ! initial regulations "u ?is section1 ! applicable au?ority %all take into acc\nt ! recomm5dations ( su* ,work+ ,gr\p4 7#b7 ,memb]%ip ,! ,work+ ,gr\p %all consi/ ( n m ?an #ae memb]s appo9t$ by ! applicable au?ority4 ,! applicable au?ority %all include among p]sons invit$ to memb]%ip on ! ,work+ ,gr\p at lea/ "o ( ea* ( ! foll[+3 7,a7 ,a repres5tative ( ! ,national ,association ( ,insurance ,commission]s4 7,b7 ,a repres5tative ( ! ,am]ican ,academy ( ,actu>ies4 7,c7 ,a repres5tative ( ! ,/ate gov]nm5ts1 or _! int]e/s4 7,d7 ,a repres5tative ( exi/+ self-insur$ arrangem5ts1 or _! int]e/s4 7,e7 ,a repres5tative ( associations ( ! type ref]r$ to 9 section #hja7;b77#a71 or _! int]e/s4 7,f7 ,a repres5tative ( multiemploy] plans t are gr\p heal? plans1 or _! int]e/s4 #hjg4 ,requirem5ts = application & relat$ requirem5ts 7a7 ,fil+ ,fee ,"u ! proc$ure prescrib$ pursuant to section #hjb7;a71 an association heal? plan %all pay to ! applicable au?ority at ! "t ( fil+ an application = c]tification "u ?is "p a fil+ fee 9 ! am\nt ( #e1jjj1 :i* %all be available 9 ! case ( ! ,secret>y1 to ! ext5t provid$ 9 appropriation ,acts1 = ! sole purpose ( adm9i/]+ ! c]tification proc$ures applicable ) respect to association heal? plans4 7b7 ,in=mation ,to ,be ,includ$ 9 ,application = ,c]tification ,an application = c]tification "u ?is "p meets ! requirem5ts ( ?is section only if x includes1 9 a mann] & =m :i* %all be prescrib$ by ! applicable au?ority by regulation1 at lea/ ! foll[+ in=mation3 7#a7 ,id5tify+ in=mation ,! names & addresses (-- 7,a7 ! sponsor2 & 7,b7 ! memb]s ( ! bo>d ( tru/ees ( ! plan4 7#b7 ,/ates 9 :i* plan int5ds to d bus9ess ,! ,/ates 9 :i* p>ticipants & b5efici>ies "u ! plan are to be locat$ & ! numb] ( !m expect$ to be locat$ 9 ea* su* ,/ate4 7#c7 ,bond+ requirem5ts ,evid5ce provid$ by ! bo>d ( tru/ees t ! bond+ requirem5ts ( section #dab w be met z ( ! date ( ! application or 7if lat]7 comm5cem5t ( op]ations4 7#d7 ,plan docum5ts ,a copy ( ! docum5ts gov]n+ ! plan 7includ+ any bylaws & tru/ agreem5ts71 ! summ>y plan description1 & o!r mat]ial describ+ ! b5efits t w be provid$ to p>ticipants & b5efici>ies "u ! plan4 7#e7 ,agreem5ts ) s]vice provid]s ,a copy ( any agreem5ts betwe5 ! plan & contract adm9i/rators & o!r s]vice provid]s4 7#f7 ,fund+ report ,9 ! case ( association heal? plans provid+ b5efits options 9 addition to heal? insurance cov]age1 a report sett+ =? in=mation ) respect to su* additional b5efit options det]m9$ z ( a date )9 ! #abj-;day p]iod end+ ) ! date ( ! application1 includ+ ! foll[+3 7,a7 ,res]ves ,a /atem5t1 c]tifi$ by ! bo>d ( tru/ees ( ! plan1 & a /atem5t ( actu>ial op9ion1 sign$ by a qualifi$ actu>y1 t all applicable requirem5ts ( section #hjf are or w be met 9 accordance ) regulations :i* ! applicable au?ority %all prescribe4 7,b7 ,adequacy ( contribution rates ,a /atem5t ( actu>ial op9ion1 sign$ by a qualifi$ actu>y1 :i* sets =? a description ( ! ext5t to :i* contribution rates are adequate to provide = ! paym5t ( all obligations & ! ma9t5ance ( requir$ res]ves "u ! plan = ! #ab-mon? p]iod beg9n+ ) su* date )9 su* #abj-;day p]iod1 tak+ into acc\nt ! expect$ cov]age & exp]i5ce ( ! plan4 ,if ! contribution rates are n fully adequate1 ! /atem5t ( actu>ial op9ion %all indicate ! ext5t to :i* ! rates are inadequate & ! *anges ne$$ to ensure adequacy4 7,c7 ,curr5t & project$ value ( assets & liabilities ,a /atem5t ( actu>ial op9ion sign$ by a qualifi$ actu>y1 :i* sets =? ! curr5t value ( ! assets & liabilities accumulat$ "u ! plan & a projection ( ! assets1 liabilities1 income1 & exp5ses ( ! plan = ! #ab-mon? p]iod ref]r$ to 9 subp>agraph 7,b74 ,! income /atem5t %all id5tify sep>ately ! plan's adm9i/rative exp5ses & claims4 7,d7 ,co/s ( cov]age to be *>g$ & o!r exp5ses ,a /atem5t ( ! co/s ( cov]age to be *>g$1 includ+ an itemization ( am\nts = adm9i/ration1 res]ves1 & o!r exp5ses associat$ ) ! op]ation ( ! plan4 7,e7 ,o!r in=mation ,any o!r in=mation z may be det]m9$ by ! applicable au?ority1 by regulation1 z necess>y to c>ry out ! purposes ( ?is "p4 7c7 ,fil+ ,notice ( ,c]tification ,) ,/ates ,a c]tification grant$ "u ?is "p to an association heal? plan %all n be effective unless writt5 notice ( su* c]tification is fil$ ) ! applicable ,/ate au?ority ( ea* ,/ate 9 :i* at lea/ #be p]c5t ( ! p>ticipants & b5efici>ies "u ! plan are locat$4 ,= purposes ( ?is subsection1 an individual %all be consid]$ to be locat$ 9 ! ,/ate 9 :i* a kn[n address ( su* individual is locat$ or 9 :i* su* individual is employ$4 7d7 ,notice ( ,mat]ial ,*anges ,9 ! case ( any association heal? plan c]tifi$ "u ?is "p1 descriptions ( mat]ial *anges 9 any in=mation :i* 0 requir$ to be submitt$ ) ! application = ! c]tification "u ?is "p %all be fil$ 9 su* =m & mann] z %all be prescrib$ by ! applicable au?ority by regulation4 ,! applicable au?ority may require by regulation prior notice ( mat]ial *anges ) respect to specifi$ matt]s :i* might s]ve z ! basis = susp5sion or revocation ( ! c]tification4 7e7 ,report+ ,requirem5ts = ,c]ta9 ,association ,heal? ,plans ,an association heal? plan c]tifi$ "u ?is "p :i* provides b5efit options 9 addition to heal? insurance cov]age = su* plan ye> %all meet ! requirem5ts ( section #ajc by fil+ an annual report "u su* section :i* %all include in=mation describ$ 9 subsection 7b77#f7 ) respect to ! plan ye> &1 not)/&+ section #ajd7;a77#a77;,a71 %all be fil$ ) ! applicable au?ority n lat] ?an #ij days aft] ! close ( ! plan ye> 7or on su* lat] date z may be prescrib$ by ! applicable au?ority74 ,! applicable au?ority may require by regulation su* int]im reports z x consid]s appropriate4 7f7 ,engagem5t ( ,qualifi$ ,actu>y ,! bo>d ( tru/ees ( ea* association heal? plan :i* provides b5efits options 9 addition to heal? insurance cov]age & :i* is apply+ = c]tification "u ?is "p or is c]tifi$ "u ?is "p %all engage1 on behalf ( all p>ticipants & b5efici>ies1 a qualifi$ actu>y :o %all be responsible = ! prep>ation ( ! mat]ials compris+ in=mation necess>y to be submitt$ by a qualifi$ actu>y "u ?is "p4 ,! qualifi$ actu>y %all utilize su* assumptions & te*niques z are necess>y to enable su* actu>y to =m an op9ion z to :e!r ! cont5ts ( ! matt]s report$ "u ?is "p-- 7#a7 are 9 ! aggregate reasonably relat$ to ! exp]i5ce ( ! plan & to reasonable expectations2 & 7#b7 repres5t su* actu>y's be/ e/imate ( anticipat$ exp]i5ce "u ! plan4 ,! op9ion by ! qualifi$ actu>y %all be made ) respect to1 & %all be made a "p (1 ! annual report4 #hjh4 ,notice requirem5ts = volunt>y t]m9ation ,except z provid$ 9 section #hji7;b71 an association heal? plan :i* is or has be5 c]tifi$ "u ?is "p may t]m9ate 7^u or at any "t aft] cessation ( accruals 9 b5efit liabilities7 only if ! bo>d ( tru/ees1 n less ?an #fj days be=e ! propos$ t]m9ation date-- 7#a7 provides to ! p>ticipants & b5efici>ies a writt5 notice ( int5t to t]m9ate /at+ t su* t]m9ation is int5d$ & ! propos$ t]m9ation date2 7#b7 develops a plan = w9d+ up ! affairs ( ! plan 9 connection ) su* t]m9ation 9 a mann] :i* w result 9 timely paym5t ( all b5efits = :i* ! plan is obligat$2 & 7#c7 submits su* plan 9 writ+ to ! applicable au?ority4 ,actions requir$ "u ?is section %all be tak5 9 su* =m & mann] z may be prescrib$ by ! applicable au?ority by regulation4 #hji4 ,corrective actions & m&atory t]m9ation 7a7 ,actions ,to ,avoid ,depletion ( ,res]ves ,an association heal? plan :i* is c]tifi$ "u ?is "p & :i* provides b5efits o!r ?an heal? insurance cov]age %all cont9ue to meet ! requirem5ts ( section #hjf1 irrespective ( :e!r su* c]tification cont9ues 9 effect4 ,! bo>d ( tru/ees ( su* plan %all det]m9e qu>t]ly :e!r ! requirem5ts ( section #hjf are met4 ,9 any case 9 :i* ! bo>d det]m9es t !re is reason to believe t !re is or w be a failure to meet su* requirem5ts1 or ! applicable au?ority makes su* a det]m9ation & s notifies ! bo>d1 ! bo>d %all imm$iately notify ! qualifi$ actu>y engag$ by ! plan1 & su* actu>y %all1 n lat] ?an ! end ( ! next foll[+ mon?1 make su* recomm5dations to ! bo>d = corrective action z ! actu>y det]m9es necess>y to ensure compliance ) section #hjf4 ,n lat] ?an #cj days aft] receiv+ f ! actu>y recomm5dations = corrective actions1 ! bo>d %all notify ! applicable au?ority 79 su* =m & mann] z ! applicable au?ority may prescribe by regulation7 ( su* recomm5dations ( ! actu>y = corrective action1 toge!r ) a description ( ! actions 7if any7 t ! bo>d has tak5 or plans to take 9 response to su* recomm5dations4 ,! bo>d %all !reaft] report to ! applicable au?ority1 9 su* =m & frequ5cy z ! applicable au?ority may specify to ! bo>d1 reg>d+ corrective action tak5 by ! bo>d until ! requirem5ts ( section #hjf are met4 7b7 ,m&atory ,t]m9ation ,9 any case 9 :i*-- 7#a7 ! applicable au?ority has be5 notifi$ "u subsection 7a7 7or by an issu] ( excess_//op loss insurance or indemnity insurance pursuant to section #hjf7;a77 ( a failure ( an association heal? plan :i* is or has be5 c]tifi$ "u ?is "p & is describ$ 9 section #hjf7;a77#b7 to meet ! requirem5ts ( section #hjf & has n be5 notifi$ by ! bo>d ( tru/ees ( ! plan t corrective action has re/or$ compliance ) su* requirem5ts2 & 7#b7 ! applicable au?ority det]m9es t !re is a reasonable expectation t ! plan w cont9ue to fail to meet ! requirem5ts ( section #hjf1 ! bo>d ( tru/ees ( ! plan %all1 at ! direction ( ! applicable au?ority1 t]m9ate ! plan &1 9 ! c\rse ( ! t]m9ation1 take su* actions z ! applicable au?ority may require1 includ+ satisfy+ any claims ref]r$ to 9 section #hjf7;a77#b77;,b77iii7 & recov]+ = ! plan any liability "u subsection 7a77#b77;,b77iii7 or 7e7 ( section #hjf1 z necess>y to ensure t ! affairs ( ! plan w be1 to ! maximum ext5t possible1 w\nd up 9 a mann] :i* w result 9 timely provision ( all b5efits = :i* ! plan is obligat$4 #haj4 ,tru/ee%ip by ! ,secret>y ( insolv5t association heal? plans provid+ heal? b5efits 9 addition to heal? insurance cov]age 7a7 ,appo9tm5t ( ,secret>y z ,tru/ee = ,insolv5t ,plans ,:5ev] ! ,secret>y det]m9es t an association heal? plan :i* is or has be5 c]tifi$ "u ?is "p & :i* is describ$ 9 section #hjf7;a77#b7 w be unable to provide b5efits :5 due or is o!rwise 9 a f9ancially haz>d\s condition1 z %all be def9$ by ! ,secret>y by regulation1 ! ,secret>y %all1 ^u notice to ! plan1 apply to ! appropriate ,unit$ ,/ates di/rict c\rt = appo9tm5t ( ! ,secret>y z tru/ee to adm9i/] ! plan = ! duration ( ! insolv5cy4 ,! plan may appe> z a p>ty & o!r int]e/$ p]sons may int]v5e 9 ! proce$+s at ! discretion ( ! c\rt4 ,! c\rt %all appo9t su* ,secret>y tru/ee if ! c\rt det]m9es t ! tru/ee%ip is necess>y to protect ! int]e/s ( ! p>ticipants & b5efici>ies or provid]s ( m$ical c>e or to avoid any unreasonable det]ioration ( ! f9ancial condition ( ! plan4 ,! tru/ee%ip ( su* ,secret>y %all cont9ue until ! conditions describ$ 9 ! fir/ s5t5ce ( ?is subsection are rem$i$ or ! plan is t]m9at$4 7b7 ,p[]s z ,tru/ee ,! ,secret>y1 ^u appo9tm5t z tru/ee "u subsection 7a71 %all h ! p[]-- 7#a7 to d any act au?oriz$ by ! plan1 ?is title1 or o!r applicable provisions ( law to be done by ! plan adm9i/rator or any tru/ee ( ! plan2 7#b7 to require ! transf] ( all 7or any "p7 ( ! assets & records ( ! plan to ! ,secret>y z tru/ee2 7#c7 to inve/ any assets ( ! plan :i* ! ,secret>y holds 9 accordance ) ! provisions ( ! plan1 regulations prescrib$ by ! ,secret>y1 & applicable provisions ( law2 7#d7 to require ! sponsor1 ! plan adm9i/rator1 any p>ticipat+ employ]1 & any employee organization repres5t+ plan p>ticipants to furni% any in=mation ) respect to ! plan :i* ! ,secret>y z tru/ee may reasonably ne$ 9 ord] to adm9i/] ! plan2 7#e7 to collect = ! plan any am\nts due ! plan & to recov] reasonable exp5ses ( ! tru/ee%ip2 7#f7 to comm5ce1 prosecute1 or def5d on behalf ( ! plan any suit or proce$+ involv+ ! plan2 7#g7 to issue1 publi%1 or file su* notices1 /atem5ts1 & reports z may be requir$ by ! ,secret>y by regulation or requir$ by any ord] ( ! c\rt2 7#h7 to t]m9ate ! plan 7or provide = its t]m9ation 9 accordance ) section #hji7;b77 & liquidate ! plan assets1 to re/ore ! plan to ! responsibility ( ! sponsor1 or to cont9ue ! tru/ee%ip2 7#i7 to provide = ! enrollm5t ( plan p>ticipants & b5efici>ies "u appropriate cov]age options2 & 7#aj7 to d su* o!r acts z may be necess>y to comply ) ?is title or any ord] ( ! c\rt & to protect ! int]e/s ( plan p>ticipants & b5efici>ies & provid]s ( m$ical c>e4 7c7 ,notice ( ,appo9tm5t ,z soon z practicable aft] ! ,secret>y's appo9tm5t z tru/ee1 ! ,secret>y %all give notice ( su* appo9tm5t to-- 7#a7 ! sponsor & plan adm9i/rator2 7#b7 ea* p>ticipant2 7#c7 ea* p>ticipat+ employ]2 & 7#d7 if applicable1 ea* employee organization :i*1 = purposes ( collective b>ga9+1 repres5ts plan p>ticipants4 7d7 ,additional ,duties ,except to ! ext5t inconsi/5t ) ! provisions ( ?is title1 or z may be o!rwise ord]$ by ! c\rt1 ! ,secret>y1 ^u appo9tm5t z tru/ee "u ?is section1 %all be subject to ! same duties z ^? ( a tru/ee "u section #gjd ( title #aa1 ,unit$ ,/ates ,code1 & %all h ! duties ( a fiduci>y = purposes ( ?is title4 7e7 ,o!r ,proce$+s ,an application by ! ,secret>y "u ?is subsection may be fil$ not)/&+ ! p5d5cy 9 ! same or any o!r c\rt ( any bankruptcy1 mortgage =eclosure1 or equity receiv]%ip proce$+1 or any proce$+ to reorganize1 cons]ve1 or liquidate su* plan or its prop]ty1 or any proce$+ to en=ce a li5 aga9/ prop]ty ( ! plan4 7f7 ,jurisdiction ( ,c\rt 7#a7 ,9 g5]al ,^u ! fil+ ( an application = ! appo9tm5t z tru/ee or ! issuance ( a decree "u ?is section1 ! c\rt to :i* ! application is made %all h exclusive jurisdiction ( ! plan involv$ & its prop]ty :]ev] locat$ ) ! p[]s1 to ! ext5t consi/5t ) ! purposes ( ?is section1 ( a c\rt ( ! ,unit$ ,/ates hav+ jurisdiction ov] cases "u *apt] #aa ( title #aa1 ,unit$ ,/ates ,code4 ,p5d+ an adjudication "u ?is section su* c\rt %all /ay1 & ^u appo9tm5t by x ( ! ,secret>y z tru/ee1 su* c\rt %all cont9ue ! /ay (1 any p5d+ mortgage =eclosure1 equity receiv]%ip1 or o!r proce$+ to reorganize1 cons]ve1 or liquidate ! plan1 ! sponsor1 or prop]ty ( su* plan or sponsor1 & any o!r suit aga9/ any receiv]1 cons]vator1 or tru/ee ( ! plan1 ! sponsor1 or prop]ty ( ! plan or sponsor4 ,p5d+ su* adjudication & ^u ! appo9tm5t by x ( ! ,secret>y z tru/ee1 ! c\rt may /ay any proce$+ to en=ce a li5 aga9/ prop]ty ( ! plan or ! sponsor or any o!r suit aga9/ ! plan or ! sponsor4 7#b7 ,v5ue ,an action "u ?is section may be br\ght 9 ! judicial di/rict :]e ! sponsor or ! plan adm9i/rator resides or does bus9ess or :]e any asset ( ! plan is situat$4 ,a di/rict c\rt 9 :i* su* action is br\ght may issue process ) respect to su* action 9 any o!r judicial di/rict4 7g7 ,p]sonnel ,9 accordance ) regulations :i* %all be prescrib$ by ! ,secret>y1 ! ,secret>y %all appo9t1 reta91 & comp5sate acc\ntants1 actu>ies1 & o!r pr(essional s]vice p]sonnel z may be necess>y 9 connection ) ! ,secret>y's s]vice z tru/ee "u ?is section4 #haa4 ,/ate assessm5t au?ority 7a7 ,9 ,g5]al ,not)/&+ section #ead1 a ,/ate may impose by law a contribution tax on an association heal? plan describ$ 9 section #hjf7;a77#b71 if ! plan comm5c$ op]ations 9 su* ,/ate aft] ! date ( ! enactm5t ( ! ,small ,bus9ess ,heal? ,fairness ,act ( #bjag4 7b7 ,contribution ,tax ,= purposes ( ?is section1 ! t]m contribution tax impos$ by a ,/ate on an association heal? plan means any tax impos$ by su* ,/ate if-- 7#a7 su* tax is comput$ by apply+ a rate to ! am\nt ( premiums or contributions1 ) respect to individuals cov]$ "u ! plan :o are resid5ts ( su* ,/ate1 :i* are receiv$ by ! plan f p>ticipat+ employ]s locat$ 9 su* ,/ate or f su* individuals2 7#b7 ! rate ( su* tax does n exce$ ! rate ( any tax impos$ by su* ,/ate on premiums or contributions receiv$ by insur]s or heal? ma9t5ance organizations = heal? insurance cov]age (f]$ 9 su* ,/ate 9 connection ) a gr\p heal? plan2 7#c7 su* tax is o!rwise nondiscrim9atory2 & 7#d7 ! am\nt ( any su* tax assess$ on ! plan is r$uc$ by ! am\nt ( any tax or assessm5t o!rwise impos$ by ! ,/ate on premiums1 contributions1 or bo? receiv$ by insur]s or heal? ma9t5ance organizations = heal? insurance cov]age1 aggregate excess_//op loss insurance 7z def9$ 9 section #hjf7;g77#a771 specific excess_//op loss insurance 7z def9$ 9 section #hjf7;g77#b771 o!r insurance relat$ to ! provision ( m$ical c>e "u ! plan1 or any comb9ation !re( provid$ by su* insur]s or heal? ma9t5ance organizations 9 su* ,/ate 9 connection ) su* plan4 #hab4 ,def9itions & rules ( con/ruction 7a7 ,def9itions ,= purposes ( ?is "p-- 7#a7 ,gr\p heal? plan ,! t]m gr\p heal? plan has ! mean+ provid$ 9 section #gcc7;a77#a7 7aft] apply+ subsection 7b7 ( ?is section74 7#b7 ,m$ical c>e ,! t]m m$ical c>e has ! mean+ provid$ 9 section #gcc7;a77#b74 7#c7 ,heal? insurance cov]age ,! t]m heal? insurance cov]age has ! mean+ provid$ 9 section #gcc7;b77#a74 7#d7 ,heal? insurance issu] ,! t]m heal? insurance issu] has ! mean+ provid$ 9 section #gcc7;b77#b74 7#e7 ,applicable au?ority ,! t]m applicable au?ority means ! ,secret>y1 except t1 9 connection ) any ex]cise ( ! ,secret>y's au?ority reg>d+ :i* ! ,secret>y is requir$ "u section #ejf7;d7 to consult ) a ,/ate1 su* t]m means ! ,secret>y1 9 consultation ) su* ,/ate4 7#f7 ,heal? /atus-relat$ factor ,! t]m heal? /atus-relat$ factor has ! mean+ provid$ 9 section #gcc7;d77#b74 7#g7 ,individual m>ket 7,a7 ,9 g5]al ,! t]m individual m>ket means ! m>ket = heal? insurance cov]age (f]$ to individuals o!r ?an 9 connection ) a gr\p heal? plan4 7,b7 ,treatm5t ( v small gr\ps 7i7 ,9 g5]al ,subject to clause 7ii71 su* t]m includes cov]age (f]$ 9 connection ) a gr\p heal? plan t has few] ?an #b p>ticipants z curr5t employees or p>ticipants describ$ 9 section #gcb7;d77#c7 on ! fir/ day ( ! plan ye>4 7ii7 ,/ate exception ,clause 7i7 %all n apply 9 ! case ( heal? insurance cov]age (f]$ 9 a ,/ate if su* ,/ate regulates ! cov]age describ$ 9 su* clause 9 ! same mann] & to ! same ext5t z cov]age 9 ! small gr\p m>ket 7z def9$ 9 section #bgia7;e77#e7 ( ! ,public ,heal? ,s]vice ,act7 is regulat$ by su* ,/ate4 7#h7 ,p>ticipat+ employ] ,! t]m p>ticipat+ employ] means1 9 connection ) an association heal? plan1 any employ]1 if any individual :o is an employee ( su* employ]1 a p>tn] 9 su* employ]1 or a self-employ$ individual :o is su* employ] 7or any dep5d5t1 z def9$ "u ! t]ms ( ! plan1 ( su* individual7 is or 0 cov]$ "u su* plan 9 connection ) ! /atus ( su* individual z su* an employee1 p>tn]1 or self-employ$ individual 9 relation to ! plan4 7#i7 ,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 ( title ,,xxvii ( ! ,public ,heal? ,s]vice ,act = ! ,/ate involv$ ) respect to su* issu]4 7#aj7 ,qualifi$ actu>y ,! t]m qualifi$ actu>y means an individual :o is a memb] ( ! ,am]ican ,academy ( ,actu>ies4 7#aa7 ,affiliat$ memb] ,! t]m affiliat$ memb] means1 9 connection ) a sponsor-- 7,a7 a p]son :o is o!rwise eligible to be a memb] ( ! sponsor b :o elects an affiliat$ /atus ) ! sponsor1 7,b7 9 ! case ( a sponsor ) memb]s :i* consi/ ( associations1 a p]son :o is a memb] ( any su* association & elects an affiliat$ /atus ) ! sponsor1 or 7,c7 9 ! case ( an association heal? plan 9 exi/5ce on ! date ( ! enactm5t ( ! ,small ,bus9ess ,heal? ,fairness ,act ( #bjag1 a p]son eligible to be a memb] ( ! sponsor or "o ( its memb] associations4 7#ab7 ,l>ge employ] ,! t]m l>ge employ] means1 9 connection ) a gr\p heal? plan ) respect to a plan ye>1 an employ] :o employ$ an av]age ( at lea/ #ea employees on bus9ess days dur+ ! prec$+ cal5d> ye> & :o employs at lea/ #b employees on ! fir/ day ( ! plan ye>4 7#ac7 ,small employ] ,! t]m small employ] means1 9 connection ) a gr\p heal? plan ) respect to a plan ye>1 an employ] :o is n a l>ge employ]4 7b7 ,rules ( ,con/ruction 7#a7 ,employ]s & employees ,= purposes ( det]m9+ :e!r a plan1 fund1 or program is an employee welf>e b5efit plan :i* is an association heal? plan1 & = purposes ( apply+ ?is title 9 connection ) su* plan1 fund1 or program s det]m9$ to be su* an employee welf>e b5efit plan-- 7,a7 9 ! case ( a p>tn]%ip1 ! t]m employ] 7z def9$ 9 section #c7e77 includes ! p>tn]%ip 9 relation to ! p>tn]s1 & ! t]m employee 7z def9$ 9 section #c7f77 includes any p>tn] 9 relation to ! p>tn]%ip2 & 7,b7 9 ! case ( a self-employ$ individual1 ! t]m employ] 7z def9$ 9 section #c7e77 & ! t]m employee 7z def9$ 9 section #c7f77 %all include su* individual4 7#b7 ,plans1 funds1 & programs treat$ z employee welf>e b5efit plans ,9 ! case ( any plan1 fund1 or program :i* 0 e/abli%$ or is ma9ta9$ = ! purpose ( provid+ m$ical c>e 7?r\gh ! pur*ase ( insurance or o!rwise7 = employees 7or _! dep5d5ts7 cov]$ !reund] & :i* demon/rates to ! ,secret>y t all requirem5ts = c]tification "u ?is "p w\ld be met ) respect to su* plan1 fund1 or program if su* plan1 fund1 or program 7 a gr\p heal? plan1 su* plan1 fund1 or program %all be treat$ = purposes ( ?is title z an employee welf>e b5efit plan on & aft] ! date ( su* demon/ration4 4 7b7 ,con=m+ ,am5dm5ts to ,preemption ,rules 7#a7 ,section #ead7;b77#f7 ( su* ,act 7#bi ,u4,s4,c4 #aadd7;b77#f77 is am5d$ by add+ at ! end ! foll[+ new subp>agraph3 7,e7 ,! prec$+ subp>agraphs ( ?is p>agraph d n apply ) respect to any ,/ate law 9 ! case ( an association heal? plan :i* is c]tifi$ "u "p #h4 4 7#b7 ,section #ead ( su* ,act 7#bi ,u4,s4,c4 #aadd7 is am5d$-- 7,a7 9 subsection 7b77#d71 by /rik+ ,subsection 7a7 & ins]t+ ,subsections 7a7 & 7f72 7,b7 9 subsection 7b77#e71 by /rik+ subsection 7a7 9 subp>agraph 7,a7 & ins]t+ subsection 7a7 ( ?is section & subsections 7a77#b77;,b7 & 7b7 ( section #hje1 & by /rik+ subsection 7a7 9 subp>agraph 7,b7 & ins]t+ subsection 7a7 ( ?is section or subsection 7a77#b77;,b7 or 7b7 ( section #hje2 & 7,c7 by add+ at ! end ! foll[+ new subsection3 7f7 7#a7 ,except z provid$ 9 subsection 7b77#d71 ! provisions ( ?is title %all sup]s$e any & all ,/ate laws ins(> z !y may n[ or h]eaft] preclude1 or h ! effect ( preclud+1 a heal? insurance issu] f (f]+ heal? insurance cov]age 9 connection ) an association heal? plan :i* is c]tifi$ "u "p #h4 7#b7 ,except z provid$ 9 p>agraphs 7#d7 & 7#e7 ( subsection 7b7 ( ?is section-- 7,a7 ,9 any case 9 :i* heal? insurance cov]age ( any policy type is (f]$ "u an association heal? plan c]tifi$ "u "p #h to a p>ticipat+ employ] op]at+ 9 su* ,/ate1 ! provisions ( ?is title %all sup]s$e any & all laws ( su* ,/ate ins(> z !y may preclude a heal? insurance issu] f (f]+ heal? insurance cov]age ( ! same policy type to o!r employ]s op]at+ 9 ! ,/ate :i* are eligible = cov]age "u su* association heal? plan1 :e!r or n su* o!r employ]s are p>ticipat+ employ]s 9 su* plan4 7,b7 ,9 any case 9 :i* heal? insurance cov]age ( any policy type is (f]$ 9 a ,/ate "u an association heal? plan c]tifi$ "u "p #h & ! fil+1 ) ! applicable ,/ate au?ority 7z def9$ 9 section #hab7;a77#i771 ( ! policy =m 9 connection ) su* policy type is approv$ by su* ,/ate au?ority1 ! provisions ( ?is title %all sup]s$e any & all laws ( any o!r ,/ate 9 :i* heal? insurance cov]age ( su* type is (f]$1 ins(> z !y may preclude1 ^u ! fil+ 9 ! same =m & mann] ( su* policy =m ) ! applicable ,/ate au?ority 9 su* o!r ,/ate1 ! approval ( ! fil+ 9 su* o!r ,/ate4 7#c7 ,no?+ 9 subsection 7b77#f77;,e7 or ! prec$+ provisions ( ?is subsection %all be con/ru$1 ) respect to heal? insurance issu]s or heal? insurance cov]age1 to sup]s$e or impair ! law ( any ,/ate-- 7,a7 provid+ solv5cy /&>ds or simil> /&>ds reg>d+ ! adequacy ( insur] capital1 surplus1 res]ves1 or contributions1 or 7,b7 relat+ to prompt paym5t ( claims4 7#d7 ,= additional provisions relat+ to association heal? plans1 see subsections 7a77#b77;,b7 & 7b7 ( section #hje4 7#e7 ,= purposes ( ?is subsection1 ! t]m association heal? plan has ! mean+ provid$ 9 section #hja7;a71 & ! t]ms heal? insurance cov]age1 p>ticipat+ employ]1 & heal? insurance issu] h ! mean+s provid$ su* t]ms 9 section #hab1 respectively4 4 7#c7 ,section #ead7;b77#f77;,a7 ( su* ,act 7#bi ,u4,s4,c4 #aadd7;b77#f77;,a77 is am5d$-- 7,a7 9 clause 7i77,,ii71 by /rik+ & at ! end2 7,b7 9 clause 7ii71 by ins]t+ & :i* does n provide m$ical c>e 7)9 ! mean+ ( section #gcc7;a77#b771 aft] arrangem5t11 & by /rik+ title4 & ins]t+ title1 &2 & 7,c7 by add+ at ! end ! foll[+ new clause3 7iii7 subject to subp>agraph 7,e71 9 ! case ( any o!r employee welf>e b5efit plan :i* is a multiple employ] welf>e arrangem5t & :i* provides m$ical c>e 7)9 ! mean+ ( section #gcc7;a77#b771 any law ( any ,/ate :i* regulates insurance may apply4 4 7#d7 ,section #ead7;d7 ( su* ,act 7#bi ,u4,s4,c4 #aadd7;d77 is am5d$-- 7,a7 by /rik+ ,no?+ & ins]t+ 7#a7 ,except z provid$ 9 p>agraph 7#b71 no?+2 & 7,b7 by add+ at ! end ! foll[+ new p>agraph3 7#b7 ,no?+ 9 any o!r provision ( law enact$ on or aft] ! date ( ! enactm5t ( ! ,small ,bus9ess ,heal? ,fairness ,act ( #bjag %all be con/ru$ to alt]1 am5d1 modify1 invalidate1 impair1 or sup]s$e any provision ( ?is title1 except by specific cross-ref]5ce to ! affect$ section4 4 7c7 ,plan ,sponsor ,section #c7af77;,b7 ( su* ,act 7#bi ,u4,s4,c4 #ajb7af77;,b77 is am5d$ by add+ at ! end ! foll[+ new s5t5ce3 ,su* t]m also includes a p]son s]v+ z ! sponsor ( an association heal? plan "u "p #h44 7d7 ,disclosure ( ,solv5cy ,protections ,relat$ to ,self-,insur$ & ,fully ,insur$ ,options ,"u ,association ,heal? ,plans ,section #ajb7;b7 ( su* ,act 7#bi ,u4,s4,c4 #ajb7;b77 is am5d$ by add+ at ! end ! foll[+3 ,an association heal? plan %all include 9 its summ>y plan description1 9 connection ) ea* b5efit option1 a description ( ! =m ( solv5cy or gu>antee fund protection secur$ pursuant to ?is ,act or applicable ,/ate law1 if any44 7e7 ,sav+s ,clause ,section #gca7;c7 ( su* ,act is am5d$ by ins]t+ or "p #h aft] ?is "p4 7f7 ,report to ! ,congress ,reg>d+ ,c]tification ( ,self-,insur$ ,association ,heal? ,plans ,n lat] ?an ,janu>y #a1 #bjbb1 ! ,secret>y ( ,labor %all report to ! ,committee on ,education & ! ,work=ce ( ! ,h\se ( ,repres5tatives & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate ! effect association heal? plans h _h1 if any1 on r$uc+ ! numb] ( un9sur$ individuals4 7g7 ,cl]ical ,am5dm5t ,! table ( cont5ts 9 section #a ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd is am5d$ by ins]t+ aft] ! item relat+ to section #gcd ! foll[+ new items3 ,"p #h4 ,rules ,gov]n+ ,association ,heal? ,plans #hja4 ,association heal? plans4 #hjb4 ,c]tification ( association heal? plans4 #hjc4 ,requirem5ts relat+ to sponsors & bo>ds ( tru/ees4 #hjd4 ,p>ticipation & cov]age requirem5ts4 #hje4 ,o!r requirem5ts relat+ to plan docum5ts1 contribution rates1 & b5efit options4 #hjf4 ,ma9t5ance ( res]ves & provisions = solv5cy = plans provid+ heal? b5efits 9 addition to heal? insurance cov]age4 #hjg4 ,requirem5ts = application & relat$ requirem5ts4 #hjh4 ,notice requirem5ts = volunt>y t]m9ation4 #hji4 ,corrective actions & m&atory t]m9ation4 #haj4 ,tru/ee%ip by ! ,secret>y ( insolv5t association heal? plans provid+ heal? b5efits 9 addition to heal? insurance cov]age4 #haa4 ,/ate assessm5t au?ority4 #hab4 ,def9itions & rules ( con/ruction4 4 #c4 ,cl>ification ( treatm5t ( s+le employ] arrangem5ts ,section #c7dj77;,b7 ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #ajjb7dj77;,b77 is am5d$-- 7#a7 9 clause 7i71 by ins]t+ aft] control gr\p1 ! foll[+3 except t1 9 any case 9 :i* ! b5efit ref]r$ to 9 subp>agraph 7,a7 consi/s ( m$ical c>e 7z def9$ 9 section #hab7;a77#b771 two or m trades or bus9esses1 :e!r or n incorporat$1 %all be deem$ a s+le employ] = any plan ye> ( su* plan1 or any fiscal ye> ( su* o!r arrangem5t1 if su* trades or bus9esses are )9 ! same control gr\p dur+ su* ye> or at any "t dur+ ! prec$+ #a-ye> p]iod12 7#b7 9 clause 7iii71 by /rik+ 7iii7 ! det]m9ation & ins]t+ ! foll[+3 7iii7 7,i7 9 any case 9 :i* ! b5efit ref]r$ to 9 subp>agraph 7,a7 consi/s ( m$ical c>e 7z def9$ 9 section #hab7;a77#b771 ! det]m9ation ( :e!r a trade or bus9ess is "u common control ) ano!r trade or bus9ess %all be det]m9$ "u regulations ( ! ,secret>y apply+ pr9ciples consi/5t & coext5sive ) ! pr9ciples appli$ 9 det]m9+ :e!r employees ( two or m trades or bus9esses are treat$ z employ$ by a s+le employ] "u section #djja7;b71 except t1 = purposes ( ?is p>agraph1 an int]e/ ( great] ?an #be p]c5t may n be requir$ z ! m9imum int]e/ necess>y = common control1 or 7,,ii7 9 any o!r case1 ! det]m9ation 2 7#c7 by r$esignat+ clauses 7iv7 & 7v7 z clauses 7v7 & 7vi71 respectively2 & 7#d7 by ins]t+ aft] clause 7iii7 ! foll[+ new clause3 7iv7 9 any case 9 :i* ! b5efit ref]r$ to 9 subp>agraph 7,a7 consi/s ( m$ical c>e 7z def9$ 9 section #hab7;a77#b771 9 det]m9+1 aft] ! application ( clause 7i71 :e!r b5efits are provid$ to employees ( two or m employ]s1 ! arrangem5t %all be treat$ z hav+ only "o p>ticipat+ employ] if1 aft] ! application ( clause 7i71 ! numb] ( individuals :o are employees & =m] employees ( any "o p>ticipat+ employ] & :o are cov]$ "u ! arrangem5t is great] ?an #ge p]c5t ( ! aggregate numb] ( all individuals :o are employees or =m] employees ( p>ticipat+ employ]s & :o are cov]$ "u ! arrangem5t1 4 #d4 ,en=cem5t provisions relat+ to association heal? plans 7a7 ,crim9al ,p5alties = ,c]ta9 ,willful ,misrepres5tations ,section #eja ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aaca7 is am5d$ by add+ at ! end ! foll[+ new subsection3 7c7 ,any p]son :o willfully falsely repres5ts1 to any employee1 any employee's b5efici>y1 any employ]1 ! ,secret>y1 or any ,/ate1 a plan or o!r arrangem5t e/abli%$ or ma9ta9$ = ! purpose ( (f]+ or provid+ any b5efit describ$ 9 section #c7a7 to employees or _! b5efici>ies z-- 7#a7 be+ an association heal? plan :i* has be5 c]tifi$ "u "p #h2 7#b7 hav+ be5 e/abli%$ or ma9ta9$ "u or pursuant to "o or m collective b>ga9+ agreem5ts :i* are rea*$ pursuant to collective b>ga9+ describ$ 9 section #h7;d7 ( ! ,national ,labor ,relations ,act 7#bi ,u4,s4,c4 #aeh7;d77 or p>agraph ,f\r? ( section #b ( ! ,railway ,labor ,act 7#de ,u4,s4,c4 #aeb1 p>agraph ,f\r?7 or :i* are rea*$ pursuant to labor-managem5t negotiations "u simil> provisions ( ,/ate public employee relations laws2 or 7#c7 be+ a plan or arrangem5t describ$ 9 section #c7dj77;,a77i71 %all1 ^u conviction1 be imprison$ n m ?an #e ye>s1 be f9$ "u title #ah1 ,unit$ ,/ates ,code1 or bo?4 4 7b7 ,cease ,activities ,ord]s ,section #ejb ( su* ,act 7#bi ,u4,s4,c4 #aacb7 is am5d$ by add+ at ! end ! foll[+ new subsection3 7n7 ,association ,heal? ,plan ,cease & ,desi/ ,ord]s 7#a7 ,9 g5]al ,subject to p>agraph 7#b71 ^u application by ! ,secret>y %[+ ! op]ation1 promotion1 or m>ket+ ( an association heal? plan 7or simil> arrangem5t provid+ b5efits consi/+ ( m$ical c>e 7z def9$ 9 section #gcc7;a77#b777 t-- 7,a7 is n c]tifi$ "u "p #h1 is subject "u section #ead7;b77#f7 to ! insurance laws ( any ,/ate 9 :i* ! plan or arrangem5t (f]s or provides b5efits1 & is n lic5s$1 regi/]$1 or o!rwise approv$ "u ! insurance laws ( su* ,/ate2 or 7,b7 is an association heal? plan c]tifi$ "u "p #h & is n op]at+ 9 accordance ) ! requirem5ts "u "p #h = su* c]tification1 a di/rict c\rt ( ! ,unit$ ,/ates %all ent] an ord] requir+ t ! plan or arrangem5t cease activities4 7#b7 ,exception ,p>agraph 7#a7 %all n apply 9 ! case ( an association heal? plan or o!r arrangem5t if ! plan or arrangem5t %[s t-- 7,a7 all b5efits "u x ref]r$ to 9 p>agraph 7#a7 consi/ ( heal? insurance cov]age2 & 7,b7 ) respect to ea* ,/ate 9 :i* ! plan or arrangem5t (f]s or provides b5efits1 ! plan or arrangem5t is op]at+ 9 accordance ) applicable ,/ate laws t are n sup]s$$ "u section #ead4 7#c7 ,additional equitable relief ,! c\rt may grant su* additional equitable relief1 includ+ any relief available "u ?is title1 z x deems necess>y to protect ! int]e/s ( ! public & ( p]sons hav+ claims = b5efits aga9/ ! plan4 4 7c7 ,responsibility = ,claims ,proc$ure ,section #ejc ( su* ,act 7#bi ,u4,s4,c4 #aacc7 is am5d$ by ins]t+ 7a7 ,9 g5]al4-- be=e ,9 accordance1 & by add+ at ! end ! foll[+ new subsection3 7b7 ,association ,heal? ,plans ,! t]ms ( ea* association heal? plan :i* is or has be5 c]tifi$ "u "p #h %all require ! bo>d ( tru/ees or ! nam$ fiduci>y 7z applicable7 to ensure t ! requirem5ts ( ?is section are met 9 connection ) claims fil$ "u ! plan4 4 #e4 ,coop]ation betwe5 ,f$]al & ,/ate au?orities ,section #ejf ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aacf7 is am5d$ by add+ at ! end ! foll[+ new subsection3 7d7 ,consultation ,) ,/ates ,) ,respect to ,association ,heal? ,plans 7#a7 ,agreem5ts ) /ates ,! ,secret>y %all consult ) ! ,/ate recogniz$ "u p>agraph 7#b7 ) respect to an association heal? plan reg>d+ ! ex]cise (-- 7,a7 ! ,secret>y's au?ority "u sections #ejb & #ejd to en=ce ! requirem5ts = c]tification "u "p #h2 & 7,b7 ! ,secret>y's au?ority to c]tify association heal? plans "u "p #h 9 accordance ) regulations ( ! ,secret>y applicable to c]tification "u "p #h4 7#b7 ,recognition ( prim>y domicile /ate ,9 c>ry+ out p>agraph 7#a71 ! ,secret>y %all ensure t only "o ,/ate w be recogniz$1 ) respect to any p>ticul> association heal? plan1 z ! ,/ate ) :i* consultation is requir$4 ,9 c>ry+ out ?is p>agraph-- 7,a7 9 ! case ( a plan :i* provides heal? insurance cov]age 7z def9$ 9 section #hab7;a77#c771 su* ,/ate %all be ! ,/ate ) :i* fil+ & approval ( a policy type (f]$ by ! plan 0 initially obta9$1 & 7,b7 9 any o!r case1 ! ,secret>y %all take into acc\nt ! places ( resid5ce ( ! p>ticipants & b5efici>ies "u ! plan & ! ,/ate 9 :i* ! tru/ is ma9ta9$4 4 #f4 ,effective date & transitional & o!r rules 7a7 ,effective ,date ,! am5dm5ts made by ?is ,act %all take effect #a ye> aft] ! date ( ! enactm5t ( ?is ,act4 ,! ,secret>y ( ,labor %all fir/ issue all regulations necess>y to c>ry out ! am5dm5ts made by ?is ,act )9 #a ye> aft] ! date ( ! enactm5t ( ?is ,act4 7b7 ,treatm5t ( ,c]ta9 ,exi/+ ,heal? ,b5efits ,programs 7#a7 ,9 g5]al ,9 any case 9 :i*1 z ( ! date ( ! enactm5t ( ?is ,act1 an arrangem5t is ma9ta9$ 9 a ,/ate = ! purpose ( provid+ b5efits consi/+ ( m$ical c>e = ! employees & b5efici>ies ( its p>ticipat+ employ]s1 at lea/ #bjj p>ticipat+ employ]s make contributions to su* arrangem5t1 su* arrangem5t has be5 9 exi/5ce = at lea/ #aj ye>s1 & su* arrangem5t is lic5s$ "u ! laws ( "o or m ,/ates to provide su* b5efits to its p>ticipat+ employ]s1 ^u ! fil+ ) ! applicable au?ority 7z def9$ 9 section #hab7;a77#e7 ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7z am5d$ by ?is subtitle77 by ! arrangem5t ( an application = c]tification ( ! arrangem5t "u "p #h ( subtitle ,b ( title ,i ( su* ,act-- 7,a7 su* arrangem5t %all be deem$ to be a gr\p heal? plan = purposes ( title ,i ( su* ,act2 7,b7 ! requirem5ts ( sections #hja7;a7 & #hjc7;a7 ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd %all be deem$ met ) respect to su* arrangem5t2 7,c7 ! requirem5ts ( section #hjc7;b7 ( su* ,act %all be deem$ met1 if ! arrangem5t is op]at$ by a bo>d ( directors :i*-- 7i7 is elect$ by ! p>ticipat+ employ]s1 ) ea* employ] hav+ "o vote2 & 7ii7 has complete fiscal control ov] ! arrangem5t & :i* is responsible = all op]ations ( ! arrangem5t2 7,d7 ! requirem5ts ( section #hjd7;a7 ( su* ,act %all be deem$ met ) respect to su* arrangem5t2 & 7,e7 ! arrangem5t may be c]tifi$ by any applicable au?ority ) respect to its op]ations 9 any ,/ate only if x op]ates 9 su* ,/ate on ! date ( c]tification4 ,! provisions ( ?is subsection %all cease to apply ) respect to any su* arrangem5t at su* "t aft] ! date ( ! enactm5t ( ?is ,act z ! applicable requirem5ts ( ?is subsection are n met ) respect to su* arrangem5t4 7#b7 ,def9itions ,= purposes ( ?is subsection1 ! t]ms gr\p heal? plan1 m$ical c>e1 & p>ticipat+ employ] %all h ! mean+s provid$ 9 section #hab ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd1 except t ! ref]5ce 9 p>agraph 7#g7 ( su* section to an association heal? plan %all be deem$ a ref]5ce to an arrangem5t ref]r$ to 9 ?is subsection4