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‘‘(A) the premium amount determined
under paragraph (1), and
‘‘(B) the premium class factor established
by the Board for that class under section 1531.
‘‘(3) AREA ADJUSTMENT.—
‘‘(A) IN
GENERAL.—The Secretary shall
adjust the premiums determined under this
subsection for each community-rating area for
area differences in health care costs.
‘‘(B) BASIS FOR ADJUSTMENT.—Such ad-
justment—
‘‘(i) may reflect the final weighted av-
erage per capita premium rate (as defined
in section 6004(a)) for community-rated
plans offered in the area compared to the
weighted average of all such rates, and
‘‘(ii) shall be made in a manner that
does not result in a change in the average
of the premium amounts under this sub-
section.
‘‘(b) SPECIAL RULES FOR DETERMINING FAMILY
SHARE OF PREMIUMS.—In the case of a family enrolled
in the AMCARE plan—
‘‘(1) FAMILY SHARE.—The family share of the
premium shall be determined by the Secretary in a
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manner similar to the determination described in
section 6101(b), but based upon the plan premium
rate determined under subsection (a).
‘‘(2) REPAYMENT
OF
FAMILY
EMPLOYMENT
CREDIT.—The Secretary shall promulgate rules re-
lating to the repayment of the family employment
credit in a manner similar to that provided under
subpart B of part 1 of subtitle A of title VI.
‘‘(3) APPLICATION
OF
LOW-INCOME
SUBSIDY
PROVISIONS.—In carrying out paragraphs (1) and
(2), section 6104 (relating to premium discount
based on income) and section 6113 (relating to limi-
tation of liability based on income) shall apply.
‘‘(c) CONTRIBUTIONS
BY EMPLOYERS.—The em-
ployer share of the premium for an individual enrolled in
the AMCARE plan shall be determined by the Secretary,
based upon the premium rate specified in subsection (a)
and taking into account the rules applicable to the estab-
lishment of employer premiums for community-rated em-
ployers under subpart A of part 2 of subtitle B of title
VI.
‘‘(d) APPLICATION OF RISK ADJUSTMENT AND REIN-
SURANCE METHODOLOGY.—
‘‘(1) IN GENERAL.—The Board shall establish
rules under which transfers are made between the
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AMCARE Trust Fund (established under subsection
(e)) and premium clearinghouses in States (acting
on behalf of community-rated plans offered in the
State) in a manner that reflects (using the meth-
odology developed under section 1541) the payment
adjustments that would have been made with respect
to the AMCARE plan and community-rated plans in
the State under section 6201(a)(3) if the AMCARE
plan were a community-rated plan in the State.
‘‘(2) REINSURANCE SYSTEM.—If the Board in-
cludes a mandatory reinsurance system under the
methodology developed section 1541(c), the Board
shall establish rules under which the AMCARE plan
is treated as a health plan for purposes of applying
such system.
‘‘(e) ESTABLISHMENT OF AMCARE TRUST FUND.—
‘‘(1) IN GENERAL.—There is hereby established
in the Treasury of the United States a fund to be
known as the ‘AMCARE Trust Fund’ (in this sub-
section referred to as the ‘Fund’).
‘‘(2) TRANSFERS.—
‘‘(A) PREMIUMS
COLLECTED.—There is
hereby deposited into the Fund amounts equiv-
alent to the amounts of the premiums collected
under this part.
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‘‘(B) SUBSIDIES.—There is hereby trans-
ferred to the Fund, an amount equivalent to
the amount by which—
‘‘(i) the total amount of premiums
payable (without regard to premium dis-
counts) under this part, exceeds
‘‘(ii) the total amounts of the pre-
miums collected under this part.
‘‘(C) 
EXPENDITURES
FROM
FUND.—
Amounts in the Fund are available to the Sec-
retary for the purpose of carrying out this part.
Amounts in the Fund shall remain available
until expended.
‘‘(D) ADDITIONAL TRANSFERS.—The Sec-
retary shall make payments from the Trust
Fund with respect to the AMCARE plan in the
same amounts and in the same manner as
States provide for payment to the Secretary
under section 1263 with respect to community-
rated plans offered in the State. Such payments
shall be transferred to the Wrap-Around Fund
under section 1803, the annual health profes-
sions workforce account under section 3034(a),
the annual teaching hospital account under sec-
tion 3103(a), and the Rural Health Care Fund
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under section 3901(a) in the same manner as
payments made under section 1263 are trans-
ferred to such funds under this Act.
‘‘(3) INCORPORATION OF PROVISIONS.—
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the provisions of subsections (b)
through (e), (h), (i), and (j) of section 1817 of
the Social Security Act shall apply to the Fund
and this part in the same manner as they apply
to the Federal Hospital Insurance Trust Fund
and part A of title XVIII of the Social Security
Act.
‘‘(B) EXCEPTIONS.—In applying subpara-
graph (A)—
‘‘(i) the Board of Trustees and Man-
aging Trustee of the Fund shall be com-
posed of the members of the Board of
Trustees and the Managing Trustee, re-
spectively, of the Federal Hospital Insur-
ance Trust Fund;
‘‘(ii) any reference in section 1817 of
the Social Security Act to the Federal
Hospital Insurance Trust Fund, to title
XVIII of such Act (or part A thereof), or
(in subsection (f)(1)) to section 3102(b) of
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the Internal Revenue Code of 1986 is
deemed a reference to the Fund under this
subsection, this part, and to section
3151(a)(2) of such Code, respectively; and
‘‘(iii) the authority specified in section
1817(j) of the Social Security Act may be
exercised with respect to the Fund without
regard to any dates or time limitations
specified in such section.’’.
Æ