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ployed an average of at least 2 but not more than 50
employees on business days during the preceding cal-
endar year.
‘‘(2) APPLICATION OF CERTAIN RULES IN DETER-
MINATION OF EMPLOYER SIZE.—For purposes of this
subsection—
‘‘(A) APPLICATION OF AGGREGATION RULE
FOR
EMPLOYERS.—Rules similar to the rules
under subsections (b), (c), (m), and (o) of section
414 of the Internal Revenue Code of 1986 shall
apply for purposes of treating persons as a single
employer.
‘‘(B) EMPLOYERS
NOT
IN
EXISTENCE
IN
PRECEDING YEAR.—In the case of an employer
which was not in existence throughout the pre-
ceding calendar year, the determination of
whether such employer is a small employer shall
be based on the average number of employees
that it is reasonably expected such employer will
employ on business days in the current calendar
year.
‘‘(C) PREDECESSORS.—Any reference in
this paragraph to an employer shall include a
reference to any predecessor of such employer.
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‘‘(d) SEPARATE APPLICATION TO EACH OPTION OF-
FERED.—In the case of a group health plan that offers a
participant or beneficiary two or more benefit package op-
tions under the plan, the requirements of this section shall
be applied separately with respect to each such option.
‘‘(e) IN-NETWORK AND OUT-OF-NETWORK RULES.—In
the case of a plan or coverage option that provides in-net-
work mental health benefits, out-of-network mental health
benefits may be provided using treatment limitations or fi-
nancial requirements that are not comparable to the limita-
tions and requirements applied to medical and surgical
benefits if the plan or coverage provides such in-network
mental health benefits in accordance with subsection (a)
and provides reasonable access to in-network providers and
facilities.
‘‘(f) DEFINITIONS.—For purposes of this section—
‘‘(1) FINANCIAL REQUIREMENTS.—The term ‘fi-
nancial requirements’ includes deductibles, coinsur-
ance, co-payments, other cost sharing, and limitations
on the total amount that may be paid by a partici-
pant, beneficiary or enrollee with respect to benefits
under the plan or health insurance coverage and shall
include the application of annual and lifetime limits.
‘‘(2) MEDICAL
OR
SURGICAL
BENEFITS.—The
term ‘medical or surgical benefits’ means benefits
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with respect to medical or surgical services, as defined
under the terms of the plan or coverage (as the case
may be), but does not include mental health benefits.
‘‘(3) MENTAL
HEALTH
BENEFITS.—The term
‘mental health benefits’ means benefits with respect to
services, as defined under the terms and conditions of
the plan or coverage (as the case may be), for all cat-
egories of mental health conditions listed in the Diag-
nostic and Statistical Manual of Mental Disorders,
Fourth Edition (DSM IV–TR), or the most recent
edition if different than the Fourth Edition, if such
services are included as part of an authorized treat-
ment plan that is in accordance with standard proto-
cols and such services meet the plan or issuer’s med-
ical necessity criteria. Such term does not include
benefits with respect to the treatment of substance
abuse or chemical dependency.
‘‘(4) 
TREATMENT
LIMITATIONS.—The 
term
‘treatment limitations’ means limitations on the fre-
quency of treatment, number of visits or days of cov-
erage, or other similar limits on the duration or scope
of treatment under the plan or coverage.’’.
(b) EFFECTIVE DATE.—The amendment made by
paragraph (1) shall take effect on January 1, 2003 and
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shall apply with respect to plan years beginning on or after
such date.
SEC. 704. PREEMPTION.
Nothing in the amendments made by this title shall
be construed to preempt any provision of State law, with
respect to health insurance coverage offered by a health in-
surance issuer in connection with a group health plan, that
provides protections to enrollees that are greater than the
protections provided under such amendments. Nothing in
the amendments made by this title shall be construed to af-
fect or modify section 514 of the Employee Retirement In-
come Security Act of 1974 (29 U.S.C. 1144).
SEC. 705. GENERAL ACCOUNTING OFFICE STUDY.
(a) STUDY.—The Comptroller General shall conduct a
study that evaluates the effect of the implementation of the
amendments made by this title on the cost of health insur-
ance coverage, access to health insurance coverage (includ-
ing the availability of in-network providers), the quality
of health care, and other issues as determined appropriate
by the Comptroller General.
(b) REPORT.—Not later than 2 years after the date
of enactment of this Act, the Comptroller General shall pre-
pare and submit to the appropriate committees of Congress
a report containing the results of the study conducted under
subsection (a).
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SEC. 706. NO IMPACT ON SOCIAL SECURITY TRUST FUND.
(a) IN GENERAL.—Nothing in this title (or an amend-
ment made by this title) shall be construed to alter or
amend the Social Security Act (or any regulation promul-
gated under that Act).
(b) TRANSFERS.—
(1) ESTIMATE OF SECRETARY.—The Secretary of
the Treasury shall annually estimate the impact that
the enactment of this title has on the income and bal-
ances of the trust funds established under section 201
of the Social Security Act (42 U.S.C. 401).
(2) TRANSFER OF FUNDS.—If, under paragraph
(1), the Secretary of the Treasury estimates that the
enactment of this title has a negative impact on the
income and balances of the trust funds established
under section 201 of the Social Security Act (42
U.S.C. 401), the Secretary shall transfer, not less fre-
quently than quarterly, from the general revenues of
the Federal Government an amount sufficient so as to
ensure that the income and balances of such trust
funds are not reduced as a result of the enactment of
such title.
SEC. 707. CONGRESSIONAL BUDGET ACT.
Notwithstanding Rule 3 of the Budget Scorekeeping
Guidelines set forth in the joint explanatory statement of
the committee of conference accompanying Conference Re-
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port 105–217, the provisions of this title that would have
been estimated by the Office of Management and Budget
as changing direct spending or receipts under section 252
of the Balanced Budget and Emergency Deficit Control Act
of 1985 were it included in an Act other than an appropria-
tions Act shall be treated as direct spending or receipts leg-
islation, as appropriate, under section 252 of the Balanced
Budget and Emergency Deficit Control Act of 1985, and
by the Chairman of the Senate Budget Committee, as ap-
propriate, under the Congressional Budget Act.
TITLE VIII—INFORMATION ON
PASSENGERS AND CARGO
SEC. 801. MANDATORY ADVANCED ELECTRONIC INFORMA-
TION FOR AIR CARGO AND PASSENGERS EN-
TERING THE UNITED STATES.
(a) AIR CARGO INFORMATION.—
(1) IN GENERAL.—Section 431(b) of the Tariff
Act of 1930 (19 U.S.C. 1431(b)) is amended—
(A) by striking ‘‘(b) PRODUCTION OF MANI-
FEST.—Any manifest’’ and inserting the fol-
lowing:
‘‘(b) PRODUCTION OF MANIFEST.—
‘‘(1) IN GENERAL.—Any manifest’’;
(B) by indenting the margin of paragraph
(1), as so designated, two ems; and