under title XVIII of the Social Security Act; the 
Medicaid program under title XIX of such Act; the 
Children’s Health Insurance Program under title 
XXI of such Act; or Tricare under chapter 55 of 
title 10, United States Code. 
(2) INCARCERATED
INDIVIDUALS.—An indi-
vidual who is incarcerated (as specified by the Direc-
tor). 
(c) TREATMENT OF ELECTED OFFICIALS.—A mem-
ber of Congress (as defined under section 2106 of title 
5, United States Code) or the President may enroll in ei-
ther a qualified CCHBP health plan under this Act or an 
FEHBP plan under title 5, United States Code, but may 
not be enrolled in both types of plans at the same time. 
(d) CONFIRMATION OF IMMIGRATION STATUS.—The 
Director, in consultation with each entity offering a quali-
fied CCHBP plan, shall promulgate regulations for the 
use of the automated system known as the Systematic 
Alien Verification for Entitlements, as provided for by sec-
tion 404 of the Illegal Immigrations Reform and Immi-
grant Responsibility Act of 1996 (110 Stat. 3009–664) 
to verify the legal presence of the status of an individual, 
other than a United States citizen, who seeks to enroll 
in a qualified CCHBP plan. 
(e) EMPLOYER OPTION.— 
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(1) IN GENERAL.—An employer may choose to 
participate in CCHBP and offer qualified CCHBP 
health plans to employees of such employer as em-
ployer-sponsored health insurance. 
(2) NOTICE.—The employer shall inform the 
Director that the employer is taking such option in 
a form and manner determined by the Director. 
(3) MAINTENANCE OF EFFORT REQUIRED.—An 
employer who provides notice under paragraph (2) 
must pay the percentage of the cost of the premium, 
as determined under section 7, for each employee 
that enrolls in a qualified CCHBP health plan, that 
is the same as the percentage of the cost of the pre-
mium of the health insurance plan that such em-
ployer offered to its employees before the employer 
provided notice under paragraph (2). 
(4) TAX TREATMENT.—For purposes of the In-
ternal Revenue Code of 1986, a qualified CCHBP 
health plan offered by an employer under this sub-
section shall not fail to be treated as employer-pro-
vided coverage solely because such employer provides 
such plan through the CCHBP. 
SEC. 6. ENROLLMENT. 
(a) ENROLLMENT PROCESS.—The Director shall es-
tablish a process to enroll eligible individuals and their 
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families in qualified CCHBP health plans. Such process 
shall be conducted in a manner that is similar to the man-
ner enrollment is conducted under FEHBP. To the extent 
consistent with eligibility under section 3, the Director 
shall provide rules similar to the rules under FEHBP for 
the enrollment of family members who are CCHBP-eligi-
ble individuals in the same plan. 
(b) ENROLLMENT PERIOD.— 
(1) ENROLLMENT UPON INITIAL ELIGIBILITY.— 
(A) IN GENERAL.—An eligible individual 
may enroll in a qualified CCHBP health plan— 
(i) at any time during the 1-year pe-
riod beginning on the date that the Citi-
zen’s Congressional Health Benefits Pro-
gram begins to operate; or, if later, 
(ii) at any time during the 3-month 
period beginning on the date that such in-
dividual becomes eligible to enroll in any 
qualified CCHBP health plan. 
(B) TREATMENT OF PREEXISTING CONDI-
TIONS.—An individual who enrolls during the 
periods under paragraph (1) shall not be sub-
ject to exclusions or additional costs due to any 
preexisting conditions that such individual de-
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veloped before the date such individual enrolled 
in a qualified CCHBP plan. 
(2) ANNUAL ENROLLMENT.— 
(A) IN GENERAL.—An eligible individual 
who does not enroll in a qualified CCHBP 
health plan under paragraph (1) may enroll in 
such a plan during an annual enrollment period 
of not more than 1 month, as determined by 
the Director. 
(B) TREATMENT OF PREEXISTING CONDI-
TIONS.—Subject to rules developed by the Di-
rector, the entity offering the qualified CCHBP 
health plan may exclude such individual from 
enrolling in such a plan under this paragraph 
due to any preexisting condition which such in-
dividual develops before the date of such annual 
enrollment period. Upon excluding such indi-
vidual, the entity offering the qualified CCHBP 
health plan shall provide such individual with 
notice of such exclusion and information about 
enrolling in a high risk pool. 
(c) CHANGES IN ENROLLMENT.—The Director shall 
establish enrollment procedures that include an annual 
open season of at least 1 month and permit changes in 
enrollment with qualified health plans at other times (such 
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as by reason of changes in marital or dependent status 
or eligibility). Such procedures shall be based on the en-
rollment procedures established under FEHBP. The Di-
rector shall provide for termination of such enrollment for 
an individual at the time the individual is no longer an 
eligible individual. 
(d) 
ENROLLMENT
OF
EMPLOYEES.—Notwith-
standing subsection (b)(2), the employees of an employer 
that provides notice to the Director under section 5(e)(2) 
may enroll in a qualified CCHBP health plan during ei-
ther the 3-month period beginning on the date that such 
employer provides such notice or the 3-month period be-
ginning on the date that such employee begins working 
for such employer, whichever is later. Such employee shall 
not be subject to any costs related to such employee’s pre- 
existing conditions if so enrolled during such period. 
(e) ENROLLMENT GUIDES.—The Director shall pro-
vide for the broad dissemination of information on quali-
fied CCHBP health plans offered under this title. Such 
information shall be provided in a comparative manner, 
similar to that used under FEHBP, and shall include in-
formation, collected through surveys of enrollees, on meas-
ures of enrollee satisfaction with the different plans. 
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SEC. 7. PREMIUMS. 
The premiums established for a qualified CCHBP 
health plan under this Act for individual or family cov-
erage— 
(1) based on the rating system used under 
FEHBP; and 
(2) shall not vary based on age, gender, health 
status (including genetic information), or other fac-
tors. 
SEC. 8. HIGH-RISK REINSURANCE FUND. 
The Director shall establish an arrangement among 
the entities offering qualified health plans under which 
such entities contribute in an equitable manner (as deter-
mined by the Director) into a fund that provides payment 
to plans for a percentage (specified by the Director and 
not to exceed 90 percent) of the costs that they incur for 
enrollees beyond a predetermined threshold specified by 
the Director. Such fund shall be funded exclusively by 
such entities. 
SEC. 9. DEFINITIONS. 
For purposes of this Act: 
(1) The term ‘‘CCHBP-eligible individual’’ 
means an individual described in section 5. 
(2) The term ‘‘Director’’ means the Director of 
the Office of Personnel Management. 
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(3) The term ‘‘FEHBP’’ means the program 
under chapter 89 of title 5, United States Code. 
(4) The term ‘‘qualified CCHBP health plan’’ 
means a fee-for-service plan, health maintenance or-
ganization plan, high deductible health insurance 
plan, or other health insurance plan that meets the 
requirements for a health insurance plan under 
FEHBP and is offered through the CCHBP under 
this Act by an entity that is qualified to offer such 
plans. 
SEC. 10. EFFECTIVE DATE AND TREATMENT OF COLLEC-
TIVE BARGAINING AGREEMENTS. 
(a) EFFECTIVE DATE.—Benefits shall first be made 
available under this title for items and services furnished 
on or after the last day of the 9-month period beginning 
on the date of the enactment of this Act. 
(b) NON-PREEMPTION
OF EXISTING COLLECTIVE 
BARGAINING AGREEMENTS.—Nothing in this Act shall be 
construed as preempting any collective bargaining agree-
ment that is in effect as of the date of the enactment of 
this Act, during the period in which such agreement is 
in effect (without regard to any extension of such agree-
ment effected as of such date of enactment). 
Æ 
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