,i  #aae? ,,congress  #a/ ,session  ,h4 
,r4 #dfbj  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #ab1         
#bjag,mrs4 ,noem 7= h]self & ,ms4       
,s9ema7 introduc$ ! foll[+ bill2 :i* 0  
ref]r$ to ! ,committee on ,en]gy &      
,comm]ce1 & 9 addition to ! ,committee  
on ,ways & ,means1 = 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 am5d ! ,pati5t  
,protection & ,af=dable ,c>e ,act to    
provide tempor>y relief f ! annual fee  
impos$ on heal? insurance provid]s4  #a4
 ,%ort title ,?is ,act may be cit$ z !  
,protect+ ,families & ,small ,bus9esses 
,act ( #bjag4  #b4 ,relief f annual fee 
on heal? insurance provid]s  7a7 ,p>tial
 relief = #bjah = c]ta9 provid]s  7#a7  
,9 g5]al ,section #ijaj ( ! ,pati5t     
,protection & ,af=dable ,c>e ,act is    
am5d$ by add+ at ! end ! foll[+ new     
subsection3  7k7 ,optional relief =     
#bjah  7#a7 ,9 g5]al ,9 ! case ( a cov]$

 entity t meets ! requirem5ts ( p>agraph
 7#b71 ! fee describ$ 9 subsection      
7a77#a7 %all be r$uc$ by ! sum ( !      
premium rebates provid$ pursuant to     
p>agraph 7#b74  7#b7 ,rebates =         
individuals ,a cov]$ entity meets !     
requirem5ts ( ?is p>agraph if su* entity
 demon/rates to ! satisfaction ( !      
,secret>y ( ! ,treasury 79 consultation 
) ! ,secret>y ( ,heal? & ,human         
,s]vices1 ,adm9i/rator ( ! ,c5t]s =     
,m$ic>e & ,m$icaid ,s]vices1 & !        
,national ,association ( ,insurance     
,commission]s1 z appropriate7 t su*     
entity w provide--  7,a7 n lat] ?an     
,april #cj1 #bjai1 to ea* individual    
enroll$ 9 cal5d> ye> #bjah 9 a qualifi$ 
rebate plan (f]$ by su* entity a premium
 rebate equal to ! less] (--  7i7 #b    
p]c5t ( ! net premiums writt5 = cov]age 
"u su* plan = su* individual = cal5d>   
ye> #bjah1 or  7ii7 ! am\nt ( ! premiums
 describ$ 9 subp>agraph 7,a7 paid by su*
 individual1 &  7,b7 = individuals :o w 
receive a premium rebate describ$ 9     

subp>agraph 7,a7 aft] ,septemb] #cj1    
#bjah1 notice to su* individuals by su* 
date ( su* premium rebate4  7#c7        
,qualifi$ rebate plan ,= purposes ( ?is 
subsection1 ! t]m qualifi$ rebate plan  
means1 ) respect to a cov]$ entity1 any 
comb9ation1 z elect$ by ! cov]$ entity1 
( ! foll[+ categories ( heal? plans3    
7,a7 ,a heal? plan (f]$ 9 ! individual  
m>ket4  7,b7 ,a heal? plan (f]$ 9 ! gr\p
 m>ket4  7,c7 ,a ,m$ic>e ,advantage plan
 "u "p ,c ( title ,,xviii ( ! ,social   
,security ,act4  7,d7 ,a prescription   
drug plan (f]$ "u "p ,d ( su* title     
,,xviii4  7#d7 ,r$uction 9 premiums     
treat$ z rebates ,= purposes ( ?is      
subsection1 a r$uction 9 premiums ow$ by
 an individual = a mon? %all be treat$ z
 a premium rebate paid to su* individual
 on ! fir/ day ( su* mon?4  7l7 ,m$icaid
 manag$ c>e plans r$uction = #bjah ,9 ! 
case ( a m$icaid manag$ c>e organization
 7z def9$ 9 section #aijc7m77#a77;,a7 ( 
! ,social ,security ,act71 ! fee        
describ$ 9 subsection 7a77#a7 %all be   

r$uc$ by an am\nt equal to #b p]c5t ( ! 
net premiums writt5 = cov]age "u a      
m$icaid manag$ c>e plan 7"u section     
#aijc7m7 or section #aicb ( su* ,act7 = 
cal5d> ye> #bjah4  4  7#b7 ,con=m+      
am5dm5t ,p>agraph 7#a7 ( section        
#ijaj7;b7 ( ! ,pati5t ,protection &     
,af=dable ,c>e ,act is am5d$ by /rik+ ! 
fee "u ?is section & ins]t+ ! am\nt     
det]m9$ "u ?is subsection4  7b7 ,relief 
= #bjai  7#a7 ,9 g5]al ,section         
#ijaj7;j7 ( ! ,pati5t ,protection &     
,af=dable ,c>e ,act is am5d$ by /rik+ & 
at ! end ( p>agraph 7#a71 by /rik+ !    
p]iod at ! end ( p>agraph 7#b7 & ins]t+ 
1 & end+ be=e ,janu>y #a1 #bjai1 &1 & by
 add+ at ! end ! foll[+ new p>agraph3   
7#c7 beg9n+ aft] ,decemb] #ca1 #bjai4  4
  7c7 ,m$ical loss ratio ,section #bgah 
( ! ,public ,heal? ,s]vice ,act is am5d$
 by add+ at ! end ! foll[+ new          
subsection3  7f7 ,am\nts exp5d$ =       
premium rebates n includ$ ,no am\nt     
exp5d$ pursuant to subsections 7k7 or   
7l7 ( section #ijaj ( ! ,pati5t         

,protection & ,af=dable ,c>e ,act %all  
be tak5 into acc\nt = purposes ( ?is    
section4  4  7d7 ,effective date  7#a7  
,! am5dm5ts made by subsections 7a7 &   
7b7 %all apply ) respect to cal5d> ye>s 
beg9n+ aft] ,decemb] #ca1 #bjag4  7#b7  
,! am5dm5t made by subsection 7c7 %all  
apply ) respect to plan ye>s beg9n+ aft]
 ,decemb] #ca1 #bjag4