,,ib ,union ,cal5d> ,no4 #hc #aah?      
,,congress  #a/ ,session  ,h4 ,r4 #cgii 
,report ,no4 #aah-ajg ,,9 ,,! ,,h\se ,,(
 ,,repres5tatives  ,june #e1 #bjbc,mr4  
,h]n introduc$ ! foll[+ bill2 :i* 0     
ref]r$ to ! ,committee on ,ways & ,means
  ,june #ab1 #bjbc;,additional sponsor3 
,ms4 ,malliotakis  ,june #ab1           
#bjbc,report$ ) an am5dm5t1 committ$ to 
! ,committee ( ! ,:ole ,h\se on ! ,/ate 
( ! ,union1 & ord]$ to be printed,strike
 out all aft] ! enact+ clause & ins]t ! 
"p pr9t$ 9 italic,for text ( introduc$  
bill1 see copy ( bill z introduc$ on    
,june #e1 #bjbc  ,a ,,bill  ,to am5d !  
,int]nal ,rev5ue ,code ( #aihf to       
provide = heal? reimbursem5t arrangem5ts
 integrat$ ) individual heal? insurance 
cov]age4  #a4 ,%ort title ,?is ,act may 
be cit$ z ! ,cu/om ,heal? ,option &     
,individual ,c>e ,exp5se ,arrangem5t    
,act or ! ,,*oice ,arrangem5t ,act4  #b4
 ,treatm5t ( heal? reimbursem5t         
arrangem5ts integrat$ ) individual m>ket
 cov]age  7a7 ,9 g5]al ,section         

#ihae7;b7 ( ! ,int]nal ,rev5ue ,code (  
#aihf is am5d$-- 7#a7 by /rik+          
,exception4--,not)/&+ subsection 7a7 &  
ins]t+ ! foll[+3 ,exceptions4-- 7#a7    
,self-insur$ gr\p heal? plans ,not)/&+  
subsection 7a7  1 &  7#b7 by add+ at !  
end ! foll[+ new p>agraph3  7#b7 ,cu/om 
heal? option & individual c>e exp5se    
arrangem5ts  7,a7 ,9 g5]al ,= purposes (
 ?is sub*apt]1 a cu/om heal? option &   
individual c>e exp5se arrangem5t %all be
 treat$ z meet+ ! requirem5ts ( section 
#bgaa & #bgac ( title ,,xxvii ( !       
,public ,heal? ,s]vice ,act4  7,b7      
,cu/om heal? option & individual c>e    
exp5se arrangem5ts def9$ ,= purposes (  
?is section1 ! t]m cu/om heal? option & 
individual c>e exp5se arrangem5t means a
 heal? reimbursem5t arrangem5t-- 7i7 :i*
 is an employ]-provid$ gr\p heal? plan  
fund$ solely by employ] contributions to
 provide paym5ts or reimbursem5ts =     
m$ical c>e subject to a maximum fix$    
doll> am\nt = a p]iod1  7ii7 "u :i* su* 
paym5ts or reimbursem5ts may only be    

made = m$ical c>e provid$ dur+ p]iods   
dur+ :i* ! individual is cov]$-- 7,i7 "u
 individual heal? insurance cov]age 7o!r
 ?an cov]age t consi/s solely ( except$ 
b5efits71 or  7,,ii7 "u "p ,a & ,b (    
title ,,xviii ( ! ,social ,security ,act
 or "p ,c ( su* title1  7iii7 :i* meets 
! nondiscrim9ation requirem5ts (        
subp>agraph 7,c71  7iv7 :i* meets !     
sub/antiation requirem5ts ( subp>agraph 
7,d71 &  7v7 :i* meets ! notice         
requirem5ts ( subp>agraph 7,e74  7,c7   
,nondiscrim9ation  7i7 ,9 g5]al ,an     
arrangem5t meets ! requirem5ts ( ?is    
subp>agraph if an employ] (f]+ su*      
arrangem5t to an employee )9 a specifi$ 
class ( employee-- 7,i7 (f]s su*        
arrangem5t to all employees )9 su*      
specifi$ class on ! same t]ms1 &  7,,ii7
 does n (f] any o!r gr\p heal? plan to  
any employees )9 su* specifi$ class4    
7ii7 ,specifi$ class ( employee ,=      
purposes ( ?is subp>agraph1 any ( !     
foll[+ may be designat$ z a specifi$    
class ( employee3 7,i7 ,full-"t         

employees4  7,,ii7 ,"p-"t employees4    
7,,iii7 ,sal>i$ employees4  7,,iv7      
,non-sal>i$ employees4  7,v7 ,employees 
^: prim>y site ( employm5t is 9 ! same  
rat+ area4  7,,vi7 ,employees :o are    
includ$ 9 a unit ( employees cov]$ "u a 
collective b>ga9+ agreem5t to :i* !     
employ] is subject 7det]m9$ "u rules    
simil> to ! rules ( section #aje7;h774  
7,,vii7 ,employees :o h n met a gr\p    
heal? plan1 or heal? insurance issu]    
(f]+ gr\p heal? insurance cov]age1 wait+
 p]iod requirem5t t satisfies ! (       
section #bgjh ( ! ,public ,heal? ,s]vice
 ,act4  7,,viii7 ,seasonal employees4   
7,,ix7 ,employees :o are nonresid5t     
ali5s & :o receive no e>n$ income 7)9 ! 
mean+ ( section #iaa7;d77#b77 f !       
employ] :i* con/itutes income f s\rces  
)9 ! ,unit$ ,/ates 7)9 ! mean+ ( section
 #hfa7;a77#c774  7,x7 ,su* o!r classes (
 employees z ! ,secret>y may designate4 
,an employ] may designate 79 su* mann] z
 is prescrib$ by ! ,secret>y7 two or m (
 ! classes describ$ 9 ! prec$+          

subclauses z ! specifi$ class (         
employees to :i* ! arrangem5t is (f]$ = 
purposes ( apply+ ?is subp>agraph4      
7iii7 ,special rule = new hires ,an     
employ] may designate prospectively s   
mu* ( a specifi$ class ( employees z are
 hir$ aft] a date set by ! employ]4 ,su*
 subclass ( employees %all be treat$ z !
 specifi$ class = purposes ( apply+     
clause 7i74  7iv7 ,rules = det]m9+ type 
( employee ,= purposes = clause 7ii71   
any det]m9ation ( full-"t1 "p-"t1 or    
seasonal employm5t /atus %all be made "u
 rules simil> to ! rules ( section      
#aje7;h7 or #dihj;,h1 :i*ev] ! employ]  
elects = ! plan ye>4 ,su* election %all 
apply ) respect to all employees ( !    
employ] = ! plan ye>4  7v7 ,p]mitt$     
v>iation ,= purposes ( clause 7i77,i71  
an arrangem5t %all n fail to be treat$ z
 provid$ on ! same t]ms )9 a specifi$   
class m]ely because ! maximum doll>     
am\nt ( paym5ts & reimbursem5ts :i* may 
be made "u ! t]ms ( ! arrangem5t = ! ye>
 ) respect to ea* employee )9 su*       

class-- 7,i7 increases z additional     
dep5d5ts ( ! employee are cov]$ "u !    
arrangem5t1 &  7,,ii7 increases )       
respect to a p>ticipant z ! age ( !     
p>ticipant increases1 b n 9 excess ( an 
am\nt equal to #cjj p]c5t ! l[e/ maximum
 doll> am\nt ) respect to su* a         
p>ticipant det]m9$ )\t reg>d to age4    
7,d7 ,sub/antiation requirem5ts ,an     
arrangem5t meets ! requirem5ts ( ?is    
subp>agraph if ! arrangem5t has         
reasonable proc$ures to sub/antiate--   
7i7 t ! p>ticipant is1 or w be1 enroll$ 
9 cov]age describ$ 9 subp>agraph        
7,b77ii7 z ( ! beg9n+ ( ! plan ye> ( !  
arrangem5t 7or z ( ! beg9n+ ( cov]age "u
 ! arrangem5t 9 ! case ( an employee :o 
fir/ becomes eligible to p>ticipate 9 ! 
arrangem5t aft] ! date notice is giv5 ) 
respect to ! plan "u subp>agraph 7,e7   
7det]m9$ )\t reg>d to clause 7iii7      
!re(71 &  7ii7 any reque/s made = paym5t
 or reimbursem5t ( m$ical c>e "u !      
arrangem5t & t ! p>ticipant rema9s s    
enroll$4  7,e7 ,notice  7i7 ,9 g5]al    

,except z provid$ 9 clause 7iii71 an    
arrangem5t meets ! requirem5ts ( ?is    
subp>agraph if1 "u ! arrangem5t1 ea*    
employee eligible to p>ticipate is1 n   
lat] ?an #ij days be=e ! beg9n+ ( ! plan
 ye>1 giv5 writt5 notice ( ! employee's 
rights & obligations "u ! arrangem5t    
:i*-- 7,i7 is suffici5tly accurate &    
compreh5sive to appraise ! employee (   
su* rights & obligations1 &  7,,ii7 is  
writt5 9 a mann] calculat$ to be        
und]/ood by ! av]age employee eligible  
to p>ticipate4  7ii7 ,notice requirem5ts
 ,su* notice %all include su* in=mation 
z ! ,secret>y may by regulation         
prescribe4  7iii7 ,notice deadl9e =     
c]ta9 employees ,9 ! case ( an          
employee-- 7,i7 :o fir/ becomes eligible
 to p>ticipate 9 ! arrangem5t aft] !    
date notice is giv5 ) respect to ! plan 
"u clause 7i7 7det]m9$ )\t reg>d to ?is 
clause71 or  7,,ii7 ^: employ] is fir/  
e/abli%$ few] ?an #abj days be=e !      
beg9n+ ( ! fir/ plan ye> ( ! arrangem5t1
  ! requirem5ts ( ?is subp>agraph %all  

be treat$ z met if ! notice requir$ "u  
clause 7i7 is provid$ n lat] ?an ! date 
! arrangem5t may take effect ) respect  
to su* employee4  4  7b7 ,no inf]5ce ,to
 ! ext5t n inconsi/5t ) ! am5dm5ts made 
by ?is section-- 7#a7 no inf]5ce %all be
 made f su* am5dm5ts ) respect to !     
rules prescrib$ 9 ! ,f$]al ,regi/] on   
,june #bj1 #bjai1 7#hd ,f$4 ,reg4       
#bhhhh7 relat+ to heal? reimbursem5t    
arrangem5ts & o!r acc\nt-bas$ gr\p heal?
 plans1 &  7#b7 any ref]5ce to cu/om    
heal? option & individual c>e exp5se    
arrangem5ts %all = purposes ( su* rules 
be treat$ z includ+ a ref]5ce to        
individual cov]age heal? reimbursem5t   
arrangem5ts4  7c7 ,effective date ,!    
am5dm5ts made by ?is section %all apply 
to plan ye>s beg9n+ aft] ,decemb] #ca1  
#bjbc4  ,june #ab1 #bjbc,report$ ) an   
am5dm5t1 committ$ to ! ,committee ( !   
,:ole ,h\se on ! ,/ate ( ! ,union1 &    
ord]$ to be pr9t$