,,ii  #aai? ,,congress  #a/ ,session    
,s4 #ahdg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #ba1 #bjbe,mr4    
,paul 7= himself & ,mr4 ,wick]7         
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d ! ,employee         
,retirem5t ,income ,security ,act (     
#aigd to cl>ify ! treatm5t ( c]ta9      
association heal? plans z employ]s1 & = 
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,association ,heal?    
,plans ,act4  #b4 ,treatm5t ( gr\p or   
association ( employ]s  7a7 ,9 g5]al    
,section #c7e7 ( ! ,employee ,retirem5t 
,income ,security ,act ( #aigd 7#bi     
,u4,s4,c4 #ajjb7e77 is am5d$-- 7#a7 by  
/rik+ ,! t]m & ins]t+ 7,a7 ,! t]m2 &    
7#b7 by add+ at ! end ! foll[+3  7,b7 ,=
 purposes ( subp>agraph 7,a71 a gr\p or 
association ( employ]s %all be treat$ z 
an employ]1 reg>dless ( :e!r ! employ]s 
compos+ su* gr\p or association are 9 ! 
same indu/ry1 trade1 or pr(ession1 if   

su* gr\p or association-- 7i7 7,i7 has  
e/abli%$ & ma9ta9s an employee welf>e   
b5efit plan t is a gr\p heal? plan 7z   
def9$ 9 section #gcc7;a77#a772  7,,ii7  
provides cov]age "u su* plan to at lea/ 
#ea employees aft] all ( ! employees    
employ$ by all ( ! employ] memb]s ( su* 
gr\p or association h be5 aggregat$ &   
c\nt$ toge!r z describ$ 9 subp>agraph   
7,d72  7,,iii7 has be5 actively 9       
exi/5ce = at lea/ #b ye>s2  7,,iv7 has  
be5 =m$ & ma9ta9$ 9 good fai? = purposes
 o!r ?an provid+ m$ical c>e 7z def9$ 9  
section #gcc7;a77#b77 ?r\gh ! pur*ase ( 
insurance or o!rwise2  7,v7 does n      
condition memb]%ip 9 ! gr\p or          
association on any heal? /atus-relat$   
factor 7z describ$ 9 section            
#gjb7;a77#a77 relat+ to any individual2 
7,,vi7 makes cov]age "u su* plan        
available to all employ] memb]s ( su*   
gr\p or association reg>dless ( any     
heal? /atus-relat$ factor 7z describ$ 9 
section #gjb7;a77#a77 relat+ to su*     
employ] memb]s2  7,,vii7 does n provide 

cov]age "u su* plan to any individual   
o!r ?an an employee ( an employ] memb] (
 su* gr\p or association2  7,,viii7 has 
e/abli%$ a gov]n+ bo>d ) by-laws or o!r 
simil> indications ( =mality to manage &
 op]ate su* plan 9 bo? =m & sub/ance1 ( 
:i* at lea/ #ge p]c5t ( ! bo>d memb]s   
%all be made up ( employ] memb]s ( su*  
gr\p or association p>ticipat+ 9 ! plan 
t are duly elect$ by ea* p>ticipat+     
employ] memb] ca/+ #a vote dur+ a s*$ul$
 election2  7,,ix7 is n a heal?         
insurance issu] 7z def9$ 9 section      
#gcc7;b77#b771 & is n own$ or controll$ 
by su* a heal? insurance issu] or by a  
subsidi>y or affiliate ( su* a heal?    
insurance issu]1 o!r ?an to ! ext5t su* 
a heal? insurance issu] may p>ticipate 9
 ! gr\p or association z a memb]2  7ii7 
is /ructur$ 9 good fai? ) any set (     
crit]ia to qualify = su* treatm5t 9 any 
advisory op9ion issu$ prior to ! date ( 
enactm5t ( ! ,association ,heal? ,plans 
,act2 or  7iii7 meets any o!r set (     
crit]ia to qualify = su* treatm5t t !   

,secret>y by regulation may provide4    
7,c7 7i7 ,= purposes ( subp>agraph 7,b71
 a self-employ$ individual %all be      
treat$ z-- 7,i7 an employ] :o may become
 a memb] ( a gr\p or association (      
employ]s2  7,,ii7 an employee :o may    
p>ticipate 9 an employee welf>e b5efit  
plan e/abli%$ & ma9ta9$ by su* gr\p or  
association2 &  7,,iii7 a p>ticipant (  
su* plan subject to ! eligibility       
det]m9ation & monitor+ requirem5ts set  
=? 9 clause 7iii74  7ii7 ,= purposes (  
?is subp>agraph1 ! t]m self-employ$     
individual means an individual :o-- 7,i7
 does n h any common law employees2     
7,,ii7 has a bona fide own]%ip "r 9 a   
trade or bus9ess1 reg>dless ( :e!r su*  
trade or bus9ess is incorporat$ or      
un9corporat$2  7,,iii7 e>ns wages 7z    
def9$ 9 section #caba7;a7 ( ! ,int]nal  
,rev5ue ,code ( #aihf7 or self-employm5t
 income 7z def9$ 9 section #adjb7;b7 (  
su* ,code7 f su* trade or bus9ess2 &    
7,,iv7 works at lea/ #aj h\rs a week or 
#dj h\rs p] mon? provid+ p]sonal s]vices

 to su* trade or bus9ess4  7iii7 ,! bo>d
 ( a gr\p or association ( employ]s     
%all-- 7,i7 initially det]m9e :e!r an   
individual meets ! requirem5ts "u clause
 7ii7 to be consid]$ to a self-employ$  
individual = ! purposes ( be+ treat$ z  
an-- 7aa7 employ] memb] ( su* gr\p or   
association 79 accordance ) clause      
7i77,i772 &  7bb7 employee :o may       
p>ticipate 9 ! employee welf>e b5efit   
plan e/abli%$ & ma9ta9$ by su* gr\p or  
association 79 accordance ) clause      
7i77,,ii772  7,,ii7 ?r\gh reasonable    
monitor+ proc$ures1 p]iodically det]m9e 
:e!r ! individual cont9ues to meet su*  
requirem5ts2 &  7,,iii7 if ! bo>d       
det]m9es t an individual no long] meets 
su* requirem5ts1 n make su* plan cov]age
 available to su* individual 7or        
dep5d5ts !re(7 = any plan ye> foll[+ !  
plan ye> dur+ :i* ! bo>d makes su*      
det]m9ation4 ,if1 subsequ5t to a        
det]m9ation t an individual no long]    
meets su* requirem5ts1 su* individual   
furni%es evid5ce ( satisfy+ su*         

requirem5ts1 su* individual 7& dep5d5ts 
!re(7 %all be eligible to receive plan  
cov]age4  7,d7 ,= purposes ( subp>agraph
 7,b71 all ( ! employees 7includ+       
self-employ$ individuals7 employ$ by all
 ( ! employ] memb]s 7includ+            
self-employ$ individuals7 ( a gr\p or   
association ( employ]s %all be-- 7i7    
treat$ z p>ticipants 9 a s+le plan      
multiple employ] welf>e arrangem5t2 &   
7ii7 aggregat$ & c\nt$ toge!r = purposes
 ( any regulation ( an employee welf>e  
b5efit plan e/abli%$ & ma9ta9$ by su*   
gr\p or association4  4  7b7            
,det]m9ation ( employ] or jo9t employ]  
/atus ,! provision ( employee welf>e    
b5efit plan cov]age by a gr\p or        
association ( employ]s %all n be con/ru$
 z evid5ce = e/abli%+ an employ] or jo9t
 employ] relation%ip "u any ,f$]al or   
,/ate law4  #c4 ,rules applicable to    
employee welf>e b5efit plans e/abli%$ & 
ma9ta9$ by a gr\p or association (      
employ]s ,"p #g ( subtitle ,b ( title ,i
 ( ! ,employee ,retirem5t ,income       

,security ,act ( #aigd 7#bi ,u4,s4,c4   
#aaha et seq47 is am5d$ by add+ at ! end
 ! foll[+3  #gcf4 ,rules applicable to  
employee welf>e b5efit plans e/abli%$ & 
ma9ta9$ by a gr\p or association (      
employ]s  7a7 ,premium rates = a gr\p or
 association ( employ]s  7#a7 7,a7 ,9 ! 
case ( an employee welf>e b5efit plan   
e/abli%$ & ma9ta9$ by a gr\p or         
association ( employ]s describ$ 9       
section #c7e77;,b71 su* plan may1 to !  
ext5t n prohibit$ "u ,/ate law-- 7i7    
e/abli% base premium rates =m$ on an    
actu>ially s\nd1 modifi$ community rat+ 
me?odology t consid]s ! pool+ ( all plan
 p>ticipant claims2 &  7ii7 utilize !   
specific risk pr(ile ( ea* employ] memb]
 ( su* gr\p or association to det]m9e   
contribution rates = ea* su* employ]    
memb]'s %>e ( a premium by actu>ially   
adju/+ above or bel[ ! e/abli%$ base    
premium rates4  7,b7 ,= purposes (      
p>agraph 7#a71 ! t]m employ] memb]      
means-- 7i7 an employ] :o is a memb] (  
su* gr\p or association ( employ]s &    

employs at lea/ #a common law employee2 
or  7ii7 a gr\p made up solely (        
self-employ$ individuals1 )9 :i* all ( !
 self-employ$ individual memb]s ( su*   
gr\p or association are aggregat$ toge!r
 z a s+le employ] memb] gr\p1 provid$ ! 
gr\p includes at lea/ #bj self-employ$  
individual memb]s4  7#b7 ,9 ! ev5t a    
gr\p or association is made up solely ( 
self-employ$ individuals 7& no employ]s 
) at lea/ #a common law employee are    
memb]s ( su* gr\p or association71 !    
employee welf>e b5efit plan e/abli%$ by 
su* gr\p or association %all-- 7,a7     
treat all self-employ$ individuals :o   
are memb]s ( su* gr\p or association z a
 s+le risk pool2  7,b7 pool all plan    
p>ticipant claims2 &  7,c7 *>ge ea* plan
 p>ticipant ! same premium rate4  7b7   
,discrim9ation & pre-,exi/+ condition   
protections ,an employee welf>e b5efit  
plan e/abli%$ & ma9ta9$ by a gr\p or    
association ( employ]s describ$ 9       
section #c7e77;,b7 %all be prohibit$ f--
 7#a7 e/abli%+ any rule = eligibility   

7includ+ cont9u$ eligibility7 ( any     
individual 7includ+ an employee ( an    
employ] memb] or a self-employ$         
individual1 or a dep5d5t ( su* employee 
or self-employ$ individual7 to enroll = 
b5efits "u ! t]ms ( ! plan t            
discrim9ates bas$ on any heal?          
/atus-relat$ factor t relates to su*    
individual 7consi/5t ) ! rules "u       
section #gjb7;a77#a772  7#b7 requir+ an 
individual 7includ+ an employee ( an    
employ] memb] or a self-employ$         
individual1 or a dep5d5t ( su* employee 
or self-employ$ individual71 z a        
condition ( enrollm5t or cont9u$        
enrollm5t "u ! plan1 to pay a premium or
 contribution t is great] ?an ! premium 
or contribution = a simil>ly situat$    
individual enroll$ 9 ! plan bas$ on any 
heal? /atus-relat$ factor t relates to  
su* individual 7consi/5t ) ! rules "u   
section #gjb7;b77#a772 &  7#c7 d5y+     
cov]age "u su* plan on ! basis ( a      
pre-exi/+ condition 7consi/5t ) ! rules 
"u section #bgjd ( ! ,public ,heal?     

,s]vice ,act74  4  #d4 ,rule (          
con/ruction ,no?+ 9 ?is ,act %all be    
con/ru$ to exempt a gr\p heal? plan :i* 
is an employee welf>e b5efit plan (f]$  
?r\gh a gr\p or association ( employ]s f
 ! requirem5ts ( "p #g ( subtitle ,b (  
title ,i ( ! ,employee ,retirem5t       
,income ,security ,act ( #aigd 7#bi     
,u4,s4,c4 #aaha et seq471 includ+ !     
provisions ( "p ,a ( title ,,xxvii ( !  
,public ,heal? ,s]vice ,act z           
incorporat$ by ref]5ce into ?is ,act    
?r\gh section #gae4