,,ii #aae? ,,congress #a/ ,session ,s4 #ahah ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,septemb] #ad1 #bjag,mr4 ,enzi introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to provide heal? c>e options = small bus9esses4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,small ,bus9ess ,heal? ,plans ,act ( #bjag4 #b4 ,small bus9ess heal? plans 7a7 ,9 g5]al ,not)/&+ any o!r provision ( law1 ) respect to small bus9ess heal? plans-- 7#a7 multiple1 unaffiliat$ small employ]s may pool _! employees = ! purpose ( pur*as+ heal? insurance cov]age = su* employees 9 ! l>ge gr\p m>ket2 7#b7 heal? insurance issu]s may (f] heal? plans 9 ! l>ge gr\p m>ket to employees ( ! small employ]s describ$ 9 p>agraph 7#a72 & 7#c7 privately adm9i/]$ heal? insurance ex*anges may (f] heal? plans 9 ! l>ge gr\p m>ket to a pool ( employees ( multiple1 unaffiliat$ small employ]s4 7b7 ,multi/ate p>ticipation ,not)/&+ any o!r provision ( law1 pools ( employees describ$ 9 subsection 7a77#a7 may include employ]s & employees f multiple ,/ates4 7c7 ,tax treatm5t ( small bus9ess heal? plans ,a small bus9ess heal? plan 7z def9$ 9 section #hja7;a7 ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd7 %all be treat$-- 7#a7 z a gr\p heal? plan 7z def9$ 9 section #bgia ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#ia77 = purposes ( apply+ title ,,xxvii ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg et seq47 & title ,,xxii ( su* ,act 7#db ,u4,s4,c4 #cjj;bb-#a72 7#b7 z a gr\p heal? plan 7z def9$ 9 section #ejjj7;b77#a7 ( ! ,int]nal ,rev5ue ,code ( #aihf7 = purposes ( apply+ sections #dihj;,b & #ejjj & *apt] #ajj ( ! ,int]nal ,rev5ue ,code ( #aihf2 & 7#c7 z a gr\p heal? plan 7z def9$ 9 section #gcc7;a77#a7 ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aaia;b7a77#a777 = purposes ( apply+ p>ts #f & #g ( title ,i ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aafa et seq474 7d7 ,small bus9ess heal? plans ,subtitle ,b ( title ,i ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd is am5d$ by add+ at ! end ! foll[+ new "p3 #h ,rules gov]n+ small bus9ess heal? plans #hja4 ,small bus9ess heal? plans 7a7 ,9 g5]al ,= purposes ( ?is "p1 ! t]m small bus9ess heal? plan means a fully insur$ gr\p heal? plan ^: sponsor is describ$ 9 subsection 7b74 7b7 ,plan sponsor ,! sponsor ( a gr\p heal? plan is describ$ 9 ?is subsection if su* plan sponsor-- 7#a7 receives c]tification by ! ,secret>y z a qualifi$ sponsor & files a notice ( c]tification ) ! ,/ate 9 :i* x op]ates2 7#b7 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 basis2 7#c7 is e/abli%$ z a p]man5t entity2 7#d7 is e/abli%$ = a purpose o!r ?an provid+ heal? b5efits to its memb]s1 su* z a bona fide trade association or a consortium ( su* associations1 a fran*ise1 or a section #ggje pr(essional employ] organization2 & 7#e7 does n condition memb]%ip on ! basis ( a m9imum gr\p size4 #hjb4 ,c]tification ( small bus9ess heal? plans 7a7 ,9 g5]al ,n lat] ?an #f mon?s aft] ! date ( enactm5t ( ?is "p1 ! ,secret>y %all prescribe by int]im f9al rule a proc$ure "u :i* ! ,secret>y w c]tify a qualifi$ sponsor ( a small bus9ess heal? plan4 7b7 ,requirem5ts applicable to c]tifi$ plans ,a small bus9ess 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 7c7 ,requirem5ts = cont9u$ c]tification ,! ,secret>y may provide by regulation = cont9u$ c]tification ( small bus9ess heal? plans "u ?is "p4 ,su* regulation %all provide = ! revocation ( a c]tification if ! applicable au?ority f9ds t ! small bus9ess heal? plan involv$ is fail+ to comply ) ! requirem5ts ( ?is "p4 7d7 ,ov]sight ( ,c]tifi$ ,plans ,! ,secret>y %all det]m9e :e!r any p]son has violat$1 or is ab\t to violate1 any provision ( ?is "p1 includ+ by conduct+ p]iodic reviews ( c]tifi$ small bus9ess heal? plans 9 accordance ) section #ejd1 & apply+ ! requirem5ts ( sections #eah1 #eai1 & #ebj4 7e7 ,exp$it$ & deem$ c]tification 7#a7 ,9 g5]al ,if ! ,secret>y fails to act on an application = c]tification "u ?is section )9 #ahj days ( receipt ( su* application1 ! apply+ small bus9ess heal? plan %all be deem$ c]tifi$ until su* "t z ! ,secret>y may d5y = cause ! application = c]tification4 7#b7 ,civil p5alty ,! ,secret>y may assess a civil p5alty aga9/ ! bo>d ( tru/ees1 plan adm9i/rator1 & plan sponsor 7jo9tly & sev]ally7 ( a small bus9ess heal? plan t is deem$ c]tifi$ "u p>agraph 7#a7 ( up to #ejj1jjj 9 ! ev5t ! ,secret>y det]m9es t ! application = c]tification ( su* small bus9ess heal? plan 0 willfully or ) gross neglig5ce incomplete or inaccurate4 #hjc4 ,requirem5ts relat+ to sponsors & bo>ds ( tru/ees 7a7 ,sponsor ,! requirem5ts ( ?is subsection are met ) respect to a small bus9ess heal? plan if ! sponsor has met 7or is deem$ "u ?is "p to h met7 ! requirem5ts ( section #hja7;b74 7b7 ,bo>d ( tru/ees or plan adm9i/rator ,! requirem5ts ( ?is subsection ) respect to a small bus9ess heal? plan are z foll[s3 7#a7 ,fiscal control ,! plan is op]at$1 pursuant to a plan docum5t1 by a bo>d ( tru/ees or plan adm9i/rator :i* has complete fiscal control ov] ! plan & :i* is responsible = all op]ations ( ! plan4 7#b7 ,rules ( op]ation & f9ancial controls ,! bo>d ( tru/ees or plan adm9i/rator has 9 effect rules ( op]ation & f9ancial controls1 bas$ 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 ,) respect to a plan op]at$ by a bo>d ( tru/ees1 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 a small bus9ess heal? plan t is 9 exi/5ce on ! date ( ! enactm5t ( ?is ,act4 7,b7 ,plan adm9i/rator ,! requirem5ts ( ?is section are met ) respect to section #ggje pr(essional employ] organizations if ! requirem5ts ( subsections 7a7 & 7b7 ( section #hjd h be5 met4 7,c7 ,sole au?ority ,! bo>d or plan adm9i/rator has sole au?ority "u ! plan to approve applications = p>ticipation 9 ! plan & to contract ) insur]s4 7c7 ,treatm5t ( fran*ises ,9 ! case ( a gr\p heal? plan t is e/abli%$ & ma9ta9$ by a fran*isor = ! b5efit ( ! employees ( ! fran*isor & its fran*isees1 by multiple fran*isors = ! b5efit ( ! employees ( su* fran*isors & _! fran*isees1 or by multiple fran*isees = ! b5efit ( ! employees ( su* fran*isees-- 7#a7 ! requirem5ts ( subsection 7a7 & section #hja7;a7 %all be deem$ met if su* requirem5ts w\ld o!rwise be met if all fran*isors or fran*isees e/abli%+ & ma9ta9+ su* plan1 z applicable1 7 deem$ to be ! sponsor describ$ 9 section #hja7;b7 & ea* employee ( su* fran*isors or fran*isees1 z applicable1 7 deem$ to be a memb] ( ! sponsor describ$ 9 section #hja7;b72 7#b7 ! requirem5ts ( section #hjd7;a77#a7 %all be deem$ met2 & 7#c7 ! e/abli%m5t & ma9t5ance ( su* a gr\p heal? plan %all n cause any "o or m fran*isor or fran*isee employ]s p>ticipat+ 9 su* a gr\p heal? plan to be treat$ z ! employ]1 co-employ]1 or jo9t employ] ( ! employees ( ano!r p>ticipat+ fran*isor or fran*isee employ] = any purpose4 #hjd4 ,p>ticipation & cov]age requirem5ts 7a7 ,cov]$ employ]s & individuals ,! requirem5ts ( ?is subsection are met ) respect to a small bus9ess heal? plan if1 "u ! t]ms ( ! plan-- 7#a7 ea* p>ticipat+ employ] mu/ be-- 7,a7 a memb] ( ! sponsor2 7,b7 ! sponsor2 or 7,c7 an affiliat$ memb] ( ! sponsor1 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 ! dep5d5ts ( individuals describ$ 9 subp>agraph 7,a74 7b7 ,individual m>ket unaffect$ ,! requirem5ts ( ?is subsection are met ) respect to a small bus9ess 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 ! 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 7c7 ,prohibition ( discrim9ation aga9/ employ]s & employees eligible ,to p>ticipate ,! requirem5ts ( ?is subsection are met ) respect to a small bus9ess heal? plan if-- 7#a7 "u ! t]ms ( ! plan1 all employ]s meet+ ! requirem5ts ( subsections 7a7 & 7b7 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 #bgje ( ! ,public ,heal? ,s]vice ,act are n met2 7#b7 in=mation reg>d+ all cov]age options available "u ! plan is made readily available to any employ] eligible to p>ticipate2 & 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 a small bus9ess heal? plan if ! foll[+ requirem5ts are met3 7#a7 ,cont5ts ( gov]n+ in/rum5ts 7,a7 ,9 g5]al ,! in/rum5ts gov]n+ ! plan include a writt5 in/rum5t :i*-- 7i7 provides t ! bo>d ( tru/ees or plan adm9i/rator 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 & 7ii7 provides t ! sponsor ( ! plan is to s]ve z plan sponsor 7ref]r$ to 9 section #c7af77;,b774 7,b7 ,description ( mat]ial provisions ,! t]ms ( ! heal? insurance cov]age 7includ+ ! t]ms ( any individual c]tificates t may be (f]$ to individuals 9 connection ) su* cov]age71 if any1 describe ! mat]ial b5efit & rat+1 & o!r provisions set =? 9 ?is section & su* mat]ial provisions are includ$ 9 ! summ>y plan description4 7#b7 ,contribution rates mu/ be nondiscrim9atory ,! contribution rates = any p>ticipat+ small employ] %all n v>y on ! basis ( any heal? /atus-relat$ factor 9 relation to employees ( su* employ] or _! b5efici>ies & %all n v>y on ! basis ( ! type ( bus9ess or indu/ry 9 :i* su* employ] is engag$1 subject to ! t]ms ( ?is title4 7#c7 ,exceptions reg>d+ self-employ$ & l>ge employ]s 7,a7 ,self-employ$ ,small bus9ess heal? plans ) p>ticipat+ employ]s :o are self-employ$ individuals 7& _! dep5d5ts7 %all enroll su* self-employ$ p>ticipat+ employ]s 9 accordance ) rat+ rules t d n violate ! rat+ rules = self-employ$ individuals 9 ! ,/ate 9 :i* su* self-employ$ p>ticipat+ employ]s are locat$4 7,b7 ,l>ge employ]s ,small bus9ess heal? plans ) p>ticipat+ employ]s t are l>g] ?an small employ]s 7z def9$ 9 section #hji7;a77 %all enroll su* l>ge p>ticipat+ employ]s 9 accordance ) rat+ rules t d n violate ! rat+ rules = l>ge employ]s 9 ! ,/ate 9 :i* su* l>ge p>ticipat+ employ]s are locat$4 7#d7 ,regulatory requirem5ts ,su* o!r requirem5ts z ! ,secret>y det]m9es are necess>y to c>ry out ! purposes ( ?is "p1 :i* %all be prescrib$ by ! ,secret>y by regulation4 7b7 ,domicile & non-,domicile ,/ates 7#a7 ,domicile ,/ate ,cov]age %all be issu$ by a heal? insurance issu] to a small bus9ess heal? plan 9 ! ,/ate 9 :i* ! sponsor's pr9cipal place ( bus9ess is locat$4 7#b7 ,non-domicile ,/ates ,) respect to a ,/ate 7o!r ?an ! domicile ,/ate7 9 :i* p>ticipat+ employ]s ( a small bus9ess heal? plan are locat$ b 9 :i* ! insur] ( ! small bus9ess heal? plan 9 ! domicile ,/ate is n yet lic5s$1 ! foll[+ %all apply3 7,a7 ,tempor>y preemption ,if1 ^u ! expiration ( ! #ahj-;day p]iod foll[+ ! submission ( a lic5sure application by su* insur] 7t includes a c]tifi$ copy ( an approv$ lic5sure application z submitt$ by su* insur] 9 ! domicile ,/ate7 to su* ,/ate1 su* ,/ate has n approv$ or d5i$ su* application1 su* ,/ate's heal? insurance lic5sure laws %all be tempor>ily preempt$ & ! insur] %all be p]mitt$ to op]ate 9 su* ,/ate1 subject to ! foll[+ t]ms3 7i7 ,application ( non-domicile ,/ate law ,except ) respect to lic5sure1 ! laws & au?ority ( ! non-domicile ,/ate %all rema9 9 full =ce & effect4 7ii7 ,revocation ( preemption ,! preemption ( a non-domicile ,/ate's heal? insurance lic5sure laws pursuant to ?is subp>agraph1 %all be t]m9at$ ^u ! occurr5ce ( ei!r ( ! foll[+3 7,i7 ,approval or d5ial ( application ,! approval or d5ial ( an insur]'s lic5sure application1 foll[+ ! laws & regulations ( ! non-domicile ,/ate ) respect to lic5sure4 7,,ii7 ,det]m9ation ( mat]ial violation ,a det]m9ation by a non-domicile ,/ate t an insur] op]at+ 9 a non-domicile ,/ate pursuant to ! preemption provid$ = 9 ?is subp>agraph is 9 mat]ial violation ( ! insurance laws 7o!r ?an lic5sure ( su* ,/ate74 7,b7 ,no prohibition on promotion ,no?+ 9 ?is p>agraph %all be con/ru$ to prohibit a small bus9ess heal? plan or an insur] f promot+ cov]age prior to ! expiration ( ! #ahj-;day p]iod provid$ = 9 subp>agraph 7,a71 except t no enrollm5t or collection ( contributions %all occur be=e ! expiration ( su* #ahj-;day p]iod4 7,c7 ,lic5sure ,except ) respect to ! application ( ! tempor>y preemption provision ( ?is p>agraph1 no?+ 9 ?is "p %all be con/ru$ to limit ! requirem5t t insur]s issu+ cov]age to small bus9ess heal? plans %all be lic5s$ 9 ea* ,/ate 9 :i* ! small bus9ess heal? plans op]ate4 7,d7 ,s]vic+ by lic5s$ insur]s ,not)/&+ subp>agraph 7,c71 ! requirem5ts ( ?is subsection may also be satisfi$ if ! p>ticipat+ employ]s ( a small bus9ess heal? plan are s]vic$ by a lic5s$ insur] 9 t ,/ate1 ev5 :]e su* insur] is n ! insur] ( su* small bus9ess heal? plan 9 ! ,/ate 9 :i* su* small bus9ess heal? plan is domicil$4 #hjf4 ,requirem5ts = application & relat$ requirem5ts 7a7 ,fil+ fee ,"u ! proc$ure prescrib$ pursuant to section #hjb7;a71 a small bus9ess heal? plan %all pay to ! ,secret>y at ! "t ( fil+ an application = c]tification "u ?is "p a fil+ fee 9 ! am\nt ( #e1jjj :i* %all be made available to ! ,secret>y1 = ! sole purpose ( adm9i/]+ ! c]tification proc$ures applicable ) respect to small bus9ess heal? plans4 7b7 ,in=mation ,to be includ$ 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 or ! plan adm9i/rator ( ! 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] ( p>ticipants & b5efici>ies 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 ! plan1 heal? insurance issu]1 & contract adm9i/rators & o!r s]vice provid]s4 7c7 ,fil+ notice ( c]tification ) ,/ates ,a c]tification grant$ "u ?is "p to a small bus9ess heal? plan %all n be effective unless writt5 notice ( su* c]tification is fil$ ) ! applicable ,/ate au?ority ( ea* ,/ate 9 :i* ! small bus9ess heal? plans op]ate4 7d7 ,notice ( mat]ial *anges ,9 ! case ( any small bus9ess 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 #hjg4 ,notice requirem5ts = volunt>y t]m9ation 7a7 ,9 g5]al ,a small bus9ess 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 or ! plan adm9i/rator1 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$2 & 7#c7 submits su* plan 9 writ+ to ! applicable au?ority4 7b7 ,regulations ,actions requir$ "u ?is section %all be tak5 9 su* =m & mann] z may be prescrib$ by ! applicable au?ority by regulation4 #hjh4 ,implem5tation & application au?ority by ,secret>y ,! ,secret>y %all1 ?r\gh promulgation & implem5tation ( su* regulations z ! ,secret>y may reasonably det]m9e necess>y or appropriate1 & 9 consultation ) a balanc$ spectrum ( effect$ entities & p]sons1 modify ! implem5tation & application ( ?is "p to accommodate ) m9imum disruption su* *anges to ,/ate or ,f$]al law provid$ 9 ?is "p & ! 7& ! am5dm5ts made by su* ,act7 or 9 regulations issu$ !reto4 #hji4 ,def9itions & rules ( con/ruction 7a7 ,def9itions ,= purposes ( ?is "p3 7#a7 ,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 or 7,b7 9 ! case ( a sponsor ) memb]s :i* consi/ ( associations1 a p]son :o is a memb] or employee ( any su* association & elects an affiliat$ /atus ) ! sponsor4 7#b7 ,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#c7 ,fran*isor2 fran*isee ,! t]ms fran*isor & fran*isee h ! mean+s giv5 su* t]ms = purposes ( sections #dcf4b7;a7 ?r\gh #dcf4b7;c7 ( title #af1 ,code ( ,f$]al ,regulations 7includ+ any su* am5dm5ts to su* regulation aft] ! date ( enactm5t ( ?is "p74 7#d7 ,gr\p heal? plan ,! t]m gr\p heal? plan has ! mean+ provid$ 9 section #gcc7;a77#a74 7#e7 ,heal? insurance cov]age ,! t]m heal? insurance cov]age has ! mean+ provid$ 9 section #gcc7;b77#a71 except t su* t]m %all n include except$ b5efits 7z def9$ 9 section #gcc7;c774 7#f7 ,heal? insurance issu] ,! t]m heal? insurance issu] has ! mean+ provid$ 9 section #gcc7;b77#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 ! t]m individual m>ket 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 ,m$ical c>e ,! t]m m$ical c>e has ! mean+ provid$ 9 section #gcc7;a77#b74 7#i7 ,p>ticipat+ employ] ,! t]m p>ticipat+ employ] means1 9 connection ) a small bus9ess 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#aj7 ,section #ggje pr(essional employ] organization ,! t]m section #ggje pr(essional employ] organization means an organization provid+ s]vices = a cu/om] pursuant to a contract meet+ ! conditions ( subp>agraphs 7,a7 ?r\gh 7,e7 ( subsection 7e77#b7 ( section #ggje ( ! ,int]nal ,rev5ue ,code ( #aihf1 )\t reg>d to subsection 7a7 ( su* section4 ,su* t]m includes an entity t is "p ( a controll$ gr\p or is "u common control ) respect to a section #ggje pr(essional employ] organization 7)9 ! mean+ ( section #dad ( su* ,code74 ,solely = purposes ( ?is "p1 ref]5ces 9 ?is "p to memb] %all include su* a cu/om] ( a section #ggje pr(essional employ] organization except z appli$ to ref]5ces to memb] or memb]s 9 p>agraph 7#a7 ( ?is subsection 7relat+ to ! def9ition ( affiliat$ memb]74 7#aa7 ,small employ] ,! t]m small employ]1 9 connection ) a gr\p heal? plan ) respect to a plan ye>1 has ! mean+ giv5 ! t]m small bus9ess conc]n 9 ! ,small ,bus9ess ,act4 7b7 ,rule ( con/ruction ,= purposes ( det]m9+ :e!r a plan1 fund1 or program is an employee welf>e b5efit plan :i* is a small bus9ess 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 7c7 ,r5ewal ,not)/&+ any provision ( law to ! contr>y1 a p>ticipat+ employ] 9 a small bus9ess heal? plan %all n be deem$ to be a plan sponsor 9 apply+ requirem5ts relat+ to cov]age r5ewal4 4 7e7 ,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 ,subp>agraphs 7,a7 ?r\gh 7,d7 d n apply ) respect to any ,/ate law 9 ! case ( a small bus9ess heal? plan :i* is c]tifi$ "u "p #h4 4 7#b7 ,section #ead ( su* ,act 7#bi ,u4,s4,c4 #aadd7 is am5d$-- 7,a7 9 subsection 7b77#d71 by /rik+ ,subsection 7a7 & ins]t+ ,subsections 7a7 & 7d72 7,b7 9 subsection 7b77#e7-- 7i7 9 subp>agraph 7,a71 by /rik+ subsection 7a7 & ins]t+ subsection 7a7 ( ?is section & subsections 7a77#b77;,b7 & 7b7 ( section #hjd2 & 7ii7 9 subp>agraph 7,b71 by /rik+ subsection 7a7 & ins]t+ subsection 7a7 ( ?is section or subsection 7a77#b77;,b7 or 7b7 ( section #hje2 7,c7 by r$esignat+ subsection 7d7 z subsection 7e72 & 7,d7 by ins]t+ aft] subsection 7c7 ! foll[+ new subsection3 7d7 ,except z provid$ 9 subsection 7b77#d71 ! provisions ( ?is title %all sup]s$e any & all ,/ate laws ins(> z !y may n[ or h]eaft] preclude a heal? insurance issu] f (f]+ heal? insurance cov]age to a small bus9ess heal? plan sponsor t is c]tifi$ "u "p #h4 4 7f7 ,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 ( a small bus9ess heal? plan "u "p #h44 7g7 ,sav+s clause ,section #gca7;c7 ( su* ,act is am5d$ by ins]t+ or "p #h aft] ?is "p4 7h7 ,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 #h--,rules gov]n+ small bus9ess heal? plans#hja4 ,small bus9ess heal? plans4#hjb4 ,c]tification ( small bus9ess 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 ,requirem5ts = application & relat$ requirem5ts4#hjg4 ,notice requirem5ts = volunt>y t]m9ation4#hjh4 ,implem5tation & application au?ority by ,secret>y4#hji4 ,def9itions & rules ( con/ruction4 4 #c4 ,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 small bus9ess heal? plans 7#a7 ,agreem5ts ) ,/ates ,! ,secret>y %all consult ) ! ,/ate recogniz$ "u p>agraph 7#b7 ) respect to a small bus9ess 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 small bus9ess heal? plans "u "p #h 9 accordance ) regulations ( ! ,secret>y applicable to c]tification "u "p #h4 7#b7 ,recognition ( 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> small bus9ess heal? plan1 z ! ,/ate ) :i* consultation is requir$4 ,9 c>ry+ out ?is p>agraph su* ,/ate %all be ! domicile ,/ate1 z def9$ 9 section #hje7;b74 4 #d4 ,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 #f mon?s aft] ! date ( ! enactm5t ( ?is ,act4