SEC. 2. HEALTHSHARE POOLS DEEMED AN ‘‘EMPLOYER’’ 
FOR 
PURPOSES 
OF 
OFFERING 
GROUP 
HEALTH PLANS OR GROUP HEALTH INSUR-
ANCE COVERAGE. 
(a) DEFINITION OF EMPLOYER.—Section 3(5) of the 
Employee Retirement Income Security Act of 1974 (29 
U.S.C. 1002(5)) is amended by adding at the end the fol-
lowing: ‘‘Such term shall be deemed to include, for pur-
poses of offering a group health plan (as defined in section 
733(a)(1)) or group health insurance coverage (as defined 
in section 733(b)(4)) (which, notwithstanding any other 
provision of law, may include such a plan or coverage cov-
ering prescription or nonprescription drugs as the only 
benefit offered by the plan or coverage in accordance with 
section 735(b)(5)(B)), any entity that meets the require-
ments under section 735(b).’’. 
(b) GROUP HEALTH PLANS AND GROUP HEALTH IN-
SURANCE COVERAGE.—Part 7 of subtitle B of title I of 
the Employee Retirement Income Security Act of 1974 
(29 U.S.C. 1181 et seq.) is amended by adding at the end 
the following: 
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‘‘SEC. 735. HEALTHSHARE POOLS DEEMED AN ‘EMPLOYER’ 
FOR 
PURPOSES 
OF 
OFFERING 
GROUP 
HEALTH PLANS OR GROUP HEALTH INSUR-
ANCE COVERAGE. 
‘‘(a) IN GENERAL.—An entity (referred to in this sec-
tion as a ‘healthshare pool’) that meets the requirements 
under subsection (b) shall be deemed an employer under 
section 3(5) for purposes of offering a group health plan 
or group health insurance coverage (which, notwith-
standing any other provision of law, may include such a 
plan or coverage covering prescription or nonprescription 
drugs as the only benefit offered by the plan or coverage 
in accordance with subsection (b)(5)(B)). 
‘‘(b) REQUIREMENTS FOR HEALTHSHARE POOLS.— 
The requirements under this subsection are each of the 
following: 
‘‘(1) ORGANIZATION.—The healthshare pool 
shall— 
‘‘(A) be formed and maintained in good 
faith for a purpose that includes the formation 
of a risk pool in order to offer group health in-
surance coverage or a group health plan to its 
members; and 
‘‘(B) not condition membership in the 
healthshare pool on any health status-related 
factor relating to an individual (including an 
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employee of an employer or a dependent of an 
employee). 
‘‘(2) OFFERING
GROUP
HEALTH
PLANS
AND 
GROUP HEALTH INSURANCE COVERAGE.— 
‘‘(A) DIFFERENT GROUPS.— 
‘‘(i) IN
GENERAL.—The healthshare 
pool, which may be in conjunction with a 
health insurance issuer that offers group 
health insurance coverage through the 
healthshare pool, shall make available a 
group health plan or group health insur-
ance coverage to all members of the 
healthshare pool (and, in the case of mem-
bers that are employers, employees of the 
employers) at rates that— 
‘‘(I) 
are 
established 
by 
the 
healthshare pool, or a health insur-
ance issuer contracting with such 
healthshare pool, on a policy or prod-
uct specific basis; and 
‘‘(II) subject to sections 701 and 
702, may vary for individuals covered 
through the healthshare pool. 
‘‘(ii) PERMISSIBLE
COVERAGE
FOR 
DEPENDENTS.—Such group health plan or 
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group health insurance coverage may be 
made available under clause (i) to any de-
pendents of members of the healthshare 
pool or dependents of employees of employ-
ers that are such members. 
‘‘(B) NONDISCRIMINATION
IN
COVERAGE 
OFFERED.— 
‘‘(i) IN GENERAL.—Subject to clause 
(ii), the healthshare pool may not offer 
coverage under a group health plan or 
group health insurance coverage to a mem-
ber of the healthshare pool unless the same 
coverage is offered to all such members of 
the healthshare pool. 
‘‘(ii) 
CONSTRUCTION.—Nothing 
in 
this subsection shall be construed as re-
quiring a health insurance issuer or group 
health plan to provide coverage outside the 
service area of the issuer or plan, or pre-
venting a health insurance issuer or group 
health plan from underwriting or from ex-
cluding or limiting the coverage on any in-
dividual, subject to the requirements under 
sections 701 and 702. 
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‘‘(C) ASSUMPTION OF RISK.—The health-
share pool may provide— 
‘‘(i) group health insurance coverage 
through a contract with a health insurance 
issuer; or 
‘‘(ii) a group health plan through self- 
insurance. 
‘‘(3) GEOGRAPHIC
AREAS.—Nothing in this 
subsection shall be construed as preventing the es-
tablishment 
and 
operation 
of 
more 
than 
healthshare pool in a geographic area or as limiting 
the number of healthshare pools that may operate in 
any area. 
‘‘(4) PROVISION OF ADMINISTRATIVE SERVICES 
TO PURCHASERS.—The healthshare pool may pro-
vide administrative services for members. Such serv-
ices may include accounting, billing, and enrollment 
information. 
‘‘(5) DRUG COVERAGE.—The group health plan 
or group health insurance coverage offered by the 
healthshare pool may offer— 
‘‘(A) drug coverage, including coverage of 
over-the-counter drugs, in combination with 
other benefits covered by the group health plan 
or group health insurance coverage; or 
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‘‘(B) notwithstanding any other provision 
of law, drug coverage, including coverage of 
over-the-counter drugs, as the only benefit cov-
ered by the group health plan or group health 
insurance coverage. 
‘‘(6) MEMBERS.— 
‘‘(A) IN GENERAL.—With respect to an in-
dividual who is a member of the healthshare 
pool— 
‘‘(i) the individual may enroll for cov-
erage under the group health plan or 
group health insurance coverage offered by 
the healthshare pool (including, if applica-
ble, enrollment for coverage for a depend-
ent of such individual); or 
‘‘(ii) the employer of the individual 
may enroll the individual for coverage 
under the group health plan or group 
health insurance coverage offered by the 
healthshare pool (including, if applicable, 
enrollment for coverage for a dependent of 
such individual). 
‘‘(B) ELIGIBILITY.—An individual shall be 
eligible to be a member of the healthshare pool 
if such individual is— 
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‘‘(i) a member of an entity that estab-
lishes or joins the healthshare pool (or a 
dependent of such a member, as applica-
ble); 
‘‘(ii) an employee of a member of an 
entity described in clause (i) (or a depend-
ent of such an employee, as applicable); or 
‘‘(iii) an employee of an entity (or a 
dependant of such an employee, as applica-
ble) controlled by a member of an entity 
described in clause (i). 
‘‘(C) RULES FOR ENROLLMENT.—Nothing 
in this paragraph shall preclude the healthshare 
pool from establishing rules of enrollment and 
reenrollment of members. Such rules shall be 
applied consistently to all members within the 
healthshare pool and shall not be based in any 
manner on health status-related factors in ac-
cordance with sections 701 and 702. 
‘‘(c) DETERMINATION OF EMPLOYER AND JOINT EM-
PLOYER STATUS.—Participating in or facilitating a group 
health plan or group health insurance coverage under this 
section shall not be construed as establishing under any 
Federal or State law— 
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‘‘(1) an employer relationship for any purpose 
other than offering the group health plan or group 
health insurance coverage; or 
‘‘(2) a joint employer relationship for any pur-
pose. 
‘‘(d) DEFINITION.—In this section, the term ‘depend-
ent’, as applied to a group health plan or group health 
insurance coverage offered in a State, shall have the mean-
ing applied to such term with respect to such plan or cov-
erage under the State law applying to such plan or cov-
erage. Such term may include the spouse and children of 
the individual involved in accordance with such State 
law.’’. 
SEC. 3. CONFORMING AMENDMENTS. 
Section 3 of the Employee Retirement Income Secu-
rity Act of 1974 (29 U.S.C. 1002) is amended— 
(1) in paragraph (6), by inserting before the pe-
riod ‘‘, except (with respect to an entity meeting the 
requirements under section 735(b)) such term in-
cludes any member of such entity’’; 
(2) in paragraph (21)— 
(A) in subparagraph (A), by striking ‘‘sub-
paragraph (B)’’ and inserting ‘‘subparagraphs 
(B) and (C)’’; and 
(B) by adding at the end the following: 
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‘‘(C) With respect to a person that is a member of 
an entity (referred to in section 735 and this subpara-
graph as a ‘healthshare pool’) that meets the requirements 
of subsection (b) of such section and offers a group health 
plan (as defined in section 733(a)(1)) or group health in-
surance coverage (as defined in section 733(b)(4)) (which, 
notwithstanding any other provision of law, may include 
such a plan or coverage covering prescription or non-
prescription drugs as the only benefit offered by the plan 
or coverage), membership in the healthshare pool shall not 
by itself cause the person to be a fiduciary with respect 
to the group health plan or group health insurance cov-
erage.’’; and 
(3) in paragraph (40)(A)— 
(A) in clause (ii), by striking ‘‘, or’’ and in-
serting ‘‘,’’; 
(B) in clause (iii), by striking the period 
and inserting ‘‘, or’’; and 
(C) by adding at the end the following: 
‘‘(iv) as a group health plan (as defined in sec-
tion 733(a)(1)), or group health insurance coverage 
(as defined in section 733(b)(4)), offered by an enti-
ty meeting the requirements under section 735(b) 
(which, notwithstanding any other provision of law, 
may include such an entity offering such a plan or 
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coverage covering prescription or nonprescription 
drugs as the only benefit offered by the plan or cov-
erage).’’. 
Æ 
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