For purposes of subparagraph (A)(ii), an indi-
vidual shall not be treated as covered under a 
health plan described in such subparagraph 
merely because the individual receives periodic 
hospital care or medical services for a service- 
connected disability under any law administered 
by the Secretary of Veterans Affairs but only if 
the individual is not eligible to receive such care 
or services for any condition other than a serv-
ice-connected disability.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 119. INDIVIDUALS ELIGIBLE FOR INDIAN HEALTH 
SERVICE ASSISTANCE. 
(a) IN GENERAL.—Section 223(c)(1) of the Internal 
Revenue Code of 1986, as amended by the preceding pro-
visions of this Act, is amended by adding at the end the 
following new subparagraph: 
‘‘(D) SPECIAL RULE FOR INDIVIDUALS EL-
IGIBLE
FOR
ASSISTANCE
UNDER
INDIAN 
HEALTH SERVICE PROGRAMS.—For purposes of 
subparagraph (A)(ii), an individual shall not be 
treated as covered under a health plan de-
scribed in such subparagraph merely because 
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the individual receives hospital care or medical 
services under a medical care program of the 
Indian Health Service or of a tribal organiza-
tion.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 120. INDIVIDUALS ELIGIBLE FOR TRICARE COVERAGE. 
(a) IN GENERAL.—Section 223(c)(1) of the Internal 
Revenue Code of 1986, as amended by the preceding pro-
visions of this Act, is amended by adding at the end the 
following new subparagraph: 
‘‘(E) SPECIAL RULE FOR INDIVIDUALS EL-
IGIBLE FOR ASSISTANCE UNDER TRICARE.—For 
purposes of subparagraph (A)(ii), an individual 
shall not be treated as covered under a health 
plan described in such subparagraph merely be-
cause the individual is eligible to receive hos-
pital care, medical services, or prescription 
drugs under TRICARE Extra or TRICARE 
Standard and such individual is not enrolled in 
TRICARE Prime.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
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SEC. 121. FSA AND HRA INTERACTION WITH HSAS. 
(a) ELIGIBLE INDIVIDUALS INCLUDE FSA AND HRA 
PARTICIPANTS.—Section 223(c)(1)(B) of the Internal 
Revenue Code of 1986 is amended— 
(1) by striking ‘‘and’’ at the end of clause (ii), 
(2) by striking the period at the end of clause 
(iii) and inserting ‘‘, and’’, and 
(3) by inserting after clause (iii) the following 
new clause: 
‘‘(iv) coverage under a health flexible 
spending arrangement or a health reim-
bursement arrangement in the plan year a 
qualified HSA distribution as described in 
section 106(e) is made on behalf of the in-
dividual if after the qualified HSA dis-
tribution is made and for the remaining 
duration of the plan year, the coverage 
provided under the health flexible spending 
arrangement or health reimbursement ar-
rangement is converted to— 
‘‘(I) coverage that does not pay 
or reimburse any medical expense in-
curred before the minimum annual de-
ductible under paragraph (2)(A)(i) 
(prorated for the period occurring 
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after the qualified HSA distribution is 
made) is satisfied, 
‘‘(II) coverage that, after the 
qualified HSA distribution is made, 
does not pay or reimburse any med-
ical expense incurred after the quali-
fied HSA distribution is made other 
than preventive care as defined in 
paragraph (2)(C), 
‘‘(III) coverage that, after the 
qualified HSA distribution is made, 
pays or reimburses benefits for cov-
erage described in clause (ii) (but not 
through insurance or for long-term 
care services), 
‘‘(IV) coverage that, after the 
qualified HSA distribution is made, 
pays or reimburses benefits for per-
mitted insurance or coverage de-
scribed in clause (ii) (but not for long- 
term care services), 
‘‘(V) coverage that, after the 
qualified HSA distribution is made, 
pays or reimburses only those medical 
expenses incurred after an individual’s 
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retirement (and no expenses incurred 
before retirement), or 
‘‘(VI) coverage that, after the 
qualified HSA distribution is made, is 
suspended, pursuant to an election 
made on or before the date the indi-
vidual elects a qualified HSA distribu-
tion or, if later, on the date of the in-
dividual enrolls in a high deductible 
health plan, that does not pay or re-
imburse, at any time, any medical ex-
pense incurred during the suspension 
period except as defined in the pre-
ceding subclauses of this clause.’’. 
(b) QUALIFIED HSA DISTRIBUTION SHALL NOT AF-
FECT
FLEXIBLE
SPENDING
ARRANGEMENT.—Section 
106(e)(1) of such Code is amended to read as follows: 
‘‘(1) IN GENERAL.—A plan shall not fail to be 
treated as a health flexible spending arrangement 
under this section, section 105, or section 125, or as 
a health reimbursement arrangement under this sec-
tion or section 105, merely because such plan pro-
vides for a qualified HSA distribution.’’. 
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(c) FSA BALANCES AT YEAR END SHALL NOT FOR-
FEIT.—Section 125(d)(2) of such Code is amended by 
adding at the end the following new subparagraph: 
‘‘(E) EXCEPTION FOR QUALIFIED HSA DIS-
TRIBUTIONS.—Subparagraph 
(A) 
shall 
not 
apply to the extent that there is an amount re-
maining in a health flexible spending account at 
the end of a plan year that an individual elects 
to contribute to a health savings account pursu-
ant to a qualified HSA distribution (as defined 
in section 106(e)(2)).’’. 
(d) SIMPLIFICATION OF LIMITATIONS ON FSA AND 
HRA ROLLOVERS.—Section 106(e)(2) of such Code is 
amended to read as follows: 
‘‘(2) QUALIFIED HSA DISTRIBUTION.— 
‘‘(A) IN
GENERAL.—The term ‘qualified 
HSA distribution’ means a distribution from a 
health flexible spending arrangement or health 
reimbursement arrangement to the extent that 
such distribution does not exceed the lesser 
of— 
‘‘(i) the balance in such arrangement 
as of the date of such distribution, or 
‘‘(ii) the amount determined under 
subparagraph (B). 
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Such term shall not include more than 1 dis-
tribution with respect to any arrangement. 
‘‘(B) DOLLAR LIMITATIONS.— 
‘‘(i) DISTRIBUTIONS FROM A HEALTH 
FLEXIBLE
SPENDING
ARRANGEMENT.—A 
qualified HSA distribution from a health 
flexible spending arrangement shall not ex-
ceed the applicable amount. 
‘‘(ii) DISTRIBUTIONS FROM A HEALTH 
REIMBURSEMENT
ARRANGEMENT.—A 
qualified HSA distribution from a health 
reimbursement arrangement shall not ex-
ceed— 
‘‘(I) the applicable amount di-
vided by 12, multiplied by 
‘‘(II) the number of months dur-
ing which the individual is a partici-
pant in the health reimbursement ar-
rangement. 
‘‘(iii) 
APPLICABLE
AMOUNT.—For 
purposes of this subparagraph, the applica-
ble amount is— 
‘‘(I) the dollar amount in effect 
under section 223(b)(2)(A) in the case 
of an eligible individual who has self- 
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only coverage under a high deductible 
health plan at the time of such dis-
tribution, and 
‘‘(II) twice the dollar amount in 
effect under subclause (I) in the case 
of an eligible individual who has fam-
ily coverage under a high deductible 
health plan at the time of such dis-
tribution.’’. 
(e) ELIMINATION OF ADDITIONAL TAX FOR FAILURE 
TO MAINTAIN HIGH DEDUCTIBLE HEALTH PLAN COV-
ERAGE.—Section 106(e) of such Code is amended— 
(1) by striking paragraph (3) and redesignating 
paragraphs (4) and (5) as paragraphs (3) and (4), 
respectively, and 
(2) by striking subparagraph (A) of paragraph 
(3), as so redesignated, and redesignating subpara-
graphs (B) and (C) of such paragraph as subpara-
graphs (A) and (B) thereof, respectively. 
(f) LIMITED PURPOSE FSAS AND HRAS.—Section 
106(e) of such Code, as amended by this section, is 
amended by adding at the end the following new para-
graph: 
‘‘(5) LIMITED PURPOSE FSAS AND HRAS.—A 
plan shall not fail to be a health flexible spending 
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arrangement or health reimbursement arrangement 
under this section or section 105 merely because the 
plan converts coverage for individuals who enroll in 
a high deductible health plan described in section 
223(c)(2) 
to 
coverage 
described 
in 
section 
223(c)(1)(B)(iv). Coverage for such individuals may 
be converted as of the date of enrollment in the high 
deductible health plan, without regard to the period 
of coverage under the health flexible spending ar-
rangement or health reimbursement arrangement, 
and without requiring any change in coverage to in-
dividuals who do not enroll in a high deductible 
health plan.’’. 
(g) DISCLAIMER OF DISQUALIFYING COVERAGE.— 
Section 223(c)(1)(B) of such Code, as amended by this 
section, is amended— 
(1) by striking ‘‘and’’ at the end of clause (iii), 
(2) by striking the period at the end of clause 
(iv) and inserting ‘‘, and’’, and 
(3) by inserting after clause (iv) the following 
new clause: 
‘‘(v) any coverage (including prospec-
tive coverage) under a health plan that is 
not a high deductible health plan which is 
disclaimed in writing, at the time of the 
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creation or organization of the health sav-
ings account, including by execution of a 
trust 
described 
in 
subsection 
(d)(1) 
through a governing instrument that in-
cludes such a disclaimer, or by acceptance 
of an amendment to such a trust that in-
cludes such a disclaimer.’’. 
(h) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 122. SPECIAL RULE FOR CERTAIN MEDICAL EXPENSES 
INCURRED BEFORE ESTABLISHMENT OF AC-
COUNT. 
(a) IN GENERAL.—Section 223(d)(2) of the Internal 
Revenue Code of 1986 is amended by adding at the end 
the following new subparagraph: 
‘‘(D) CERTAIN
MEDICAL
EXPENSES
IN-
CURRED BEFORE ESTABLISHMENT OF ACCOUNT 
TREATED AS QUALIFIED.—An expense shall not 
fail to be treated as a qualified medical expense 
solely because such expense was incurred before 
the establishment of the health savings account 
if such expense was incurred— 
‘‘(i) during either— 
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‘‘(I) the taxable year in which the 
health savings account was estab-
lished, or 
‘‘(II) the preceding taxable year 
in the case of a health savings ac-
count established after the taxable 
year in which such expense was in-
curred but before the time prescribed 
by law for filing the return for such 
taxable year (not including extensions 
thereof), and 
‘‘(ii) for medical care of an individual 
during a period that such individual was 
covered by a high deductible health plan 
and met the requirements of subsection 
(c)(1)(A)(ii) (after application of sub-
section (c)(1)(B)).’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 123. PREVENTIVE CARE PRESCRIPTION DRUG CLARI-
FICATION. 
(a) CLARIFY
USE
OF
DRUGS
IN
PREVENTIVE 
CARE.—Section 223(c)(2)(C) of the Internal Revenue 
Code of 1986 is amended by adding at the end the fol-
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lowing: ‘‘Preventive care shall include prescription and 
over-the-counter drugs and medicines which have the pri-
mary purpose of preventing the onset of, further deteriora-
tion from, or complications associated with chronic condi-
tions, illnesses, or diseases.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
December 31, 2003. 
SEC. 124. ADMINISTRATIVE ERROR CORRECTION BEFORE 
DUE DATE OF RETURN. 
(a) IN GENERAL.—Section 223(f)(4) of the Internal 
Revenue Code of 1986 is amended by adding at the end 
the following new subparagraph: 
‘‘(D) EXCEPTION
FOR
ADMINISTRATIVE 
ERRORS CORRECTED BEFORE DUE DATE OF RE-
TURN.—Subparagraph (A) shall not apply if 
any payment or distribution is made to correct 
an administrative, clerical or payroll contribu-
tion error and if— 
‘‘(i) such distribution is received by 
the individual on or before the last day 
prescribed by law (including extensions of 
time) for filing such individual’s return for 
such taxable year, and 
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‘‘(ii) such distribution is accompanied 
by the amount of net income attributable 
to such contribution. 
Any net income described in clause (ii) shall be 
included in the gross income of the individual 
for the taxable year in which it is received.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall take effect on the date of the enactment 
of this Act. 
SEC. 125. MEMBERS OF HEALTH CARE SHARING MIN-
ISTRIES ELIGIBLE TO ESTABLISH HEALTH 
SAVINGS ACCOUNTS. 
(a) IN GENERAL.—Section 223 of the Internal Rev-
enue Code of 1986, as amended by the preceding provi-
sions of this Act, is amended by adding at the end the 
following new subsection: 
‘‘(j) APPLICATION TO HEALTH CARE SHARING MIN-
ISTRIES.—For purposes of this section, membership in a 
health care sharing ministry (as defined in section 
5000A(d)(2)(B)(ii)) shall be treated as coverage under a 
high deductible health plan.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
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SEC. 126. HIGH DEDUCTIBLE HEALTH PLANS RENAMED 
HSA QUALIFIED PLANS. 
(a) IN GENERAL.—Section 223 of the Internal Rev-
enue Code of 1986, as amended by this Act, is amended 
by striking ‘‘high deductible health plan’’ each place it ap-
pears and inserting ‘‘HSA qualified health plan’’. 
(b) CONFORMING AMENDMENTS.— 
(1) Section 106(e) of such Code, as amended by 
this Act, is amended by striking ‘‘high deductible 
health plan’’ each place it appears and inserting 
‘‘HSA qualified health plan’’. 
(2) The heading for section 223(c)(2) of such 
Code is amended by striking ‘‘HIGH DEDUCTIBLE 
HEALTH
PLAN’’ and inserting ‘‘HSA QUALIFIED 
HEALTH PLAN’’. 
(3) Section 408(d)(9) of such Code is amend-
ed— 
(A) by striking ‘‘high deductible health 
plan’’ each place it appears in subparagraph 
(C) and inserting ‘‘HSA qualified health plan’’, 
and 
(B) 
by 
striking 
‘‘HIGH
DEDUCTIBLE 
HEALTH PLAN’’ in the heading of subparagraph 
(D) and inserting ‘‘HSA QUALIFIED HEALTH 
PLAN’’. 
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SEC. 127. TREATMENT OF DIRECT PRIMARY CARE SERVICE 
ARRANGEMENTS. 
(a) IN GENERAL.—Section 223(c) of the Internal 
Revenue Code of 1986 is amended by adding at the end 
the following new paragraph: 
‘‘(6) TREATMENT
OF
DIRECT
PRIMARY
CARE 
SERVICE ARRANGEMENTS.—An arrangement under 
which an individual is provided coverage restricted to 
primary care services in exchange for a fixed peri-
odic fee— 
‘‘(A) shall not be treated as a health plan 
for purposes of paragraph (1)(A)(ii), and 
‘‘(B) shall not be treated as insurance for 
purposes of subsection (d)(2)(B).’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 128. CERTAIN PROVIDER FEES TO BE TREATED AS 
MEDICAL CARE. 
(a) IN GENERAL.—Section 213(d) of the Internal 
Revenue Code of 1986 is amended by adding at the end 
the following new paragraph: 
‘‘(12) PERIODIC
PROVIDER
FEES.—The term 
‘medical care’ shall include periodic fees paid to a 
primary care physician for the right to receive med-
ical services on an as-needed basis.’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
SEC. 129. CLARIFICATION OF TREATMENT OF CAPITATED 
PRIMARY CARE PAYMENTS AS AMOUNTS 
PAID FOR MEDICAL CARE. 
(a) IN GENERAL.—Section 213(d) of the Internal 
Revenue Code of 1986, as amended by the preceding pro-
vision of this Act, is amended by adding at the end the 
following new paragraph: 
‘‘(13) TREATMENT
OF
CAPITATED
PRIMARY 
CARE PAYMENTS.—Capitated primary care payments 
shall be treated as amounts paid for medical care.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
Subtitle C—Other Provisions 
SEC. 131. LIMITATION ON EMPLOYER-PROVIDED HEALTH 
CARE COVERAGE. 
(a) IN GENERAL.—Section 106 of the Internal Rev-
enue Code of 1986, as amended by the preceding provi-
sions of this Act, is amended by adding at the end the 
following new subsection: 
‘‘(f) LIMITATION ON EMPLOYER-PROVIDED HEALTH 
CARE COVERAGE.— 
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‘‘(1) IN GENERAL.—The amount of any exclu-
sion under subsection (a) for any taxable year with 
respect to— 
‘‘(A) 
any 
employer-provided 
coverage 
under an accident or health plan which con-
stitutes medical care, and 
‘‘(B) any employer contribution to an Ar-
cher MSA or a health savings account which is 
treated by subsection (b) or (d) as employer- 
provided coverage for medical expenses under 
an accident or health plan, 
shall not exceed $8,000 per employee for self-only 
coverage and $20,000 for family coverage. 
‘‘(2) INFLATION ADJUSTMENT.—In the case of 
any taxable year beginning in a calendar year after 
2016, each dollar amount contained in paragraph 
(1) shall be increased by an amount equal to— 
‘‘(A) such dollar amount, multiplied by 
‘‘(B) the cost-of-living adjustment deter-
mined under section 1(f)(3) for the calendar 
year in which the taxable year begins, deter-
mined by substituting ‘calendar year 2015’ for 
‘calendar year 1992’ in subparagraph (B) 
thereof. 
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Any increase determined under the preceding sen-
tence shall be rounded to the nearest multiple of 
$50. 
‘‘(3) MEDICAL CARE DEFINED.—For purposes 
of paragraph (1), the term ‘medical care’ has the 
meaning given to such term in section 213(d) deter-
mined without regard to— 
‘‘(A) paragraph (1)(C) thereof, and 
‘‘(B) so much of paragraph (1)(D) thereof 
as relates to qualified long-term care insur-
ance.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
this section shall apply to taxable years beginning after 
December 31, 2015. 
SEC. 132. LIMITATION ON ABORTION FUNDING. 
No funds authorized under, or credits or deductions 
allowed under the Internal Revenue Code of 1986 by rea-
son of, this Act (or any amendment made by this Act) 
may be used to pay for any abortion or to cover any part 
of the costs of any health plan that includes coverage of 
abortion, except in the case where a woman suffers from 
a physical disorder, physical injury, or physical illness that 
would, as certified by a physician, place the woman in dan-
ger of death unless an abortion is performed, including 
a life-endangering physical condition caused by or arising 
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from the pregnancy itself, or unless the pregnancy is the 
result of an act of rape or incest. 
SEC. 133. NO GOVERNMENT DISCRIMINATION AGAINST 
CERTAIN HEALTH CARE ENTITIES. 
(a) NON-DISCRIMINATION.—A Federal agency or 
program, and any State or local government that receives 
Federal financial assistance under this Act or any amend-
ment made by this Act (either directly or indirectly), may 
not subject any individual or institutional health care enti-
ty to discrimination on the basis that the health care enti-
ty does not provide, pay for, provide coverage of, or refer 
for abortions. 
(b) HEALTH CARE ENTITY DEFINED.—For purposes 
of this section, the term ‘‘health care entity’’ includes an 
individual physician or other health care professional, a 
hospital, a provider-sponsored organization, a health 
maintenance organization, a health insurance plan, or any 
other kind of health care facility, organization, or plan. 
(c) REMEDIES.— 
(1) IN GENERAL.—The courts of the United 
States shall have jurisdiction to prevent and redress 
actual or threatened violations of this section by 
issuing any form of legal or equitable relief, includ-
ing— 
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(A) injunctions prohibiting conduct that 
violates this section; and 
(B) orders preventing the disbursement of 
all or a portion of Federal financial assistance 
to a State or local government, or to a specific 
offending agency or program of a State or local 
government, until such time as the conduct pro-
hibited by this section has ceased. 
(2) COMMENCEMENT
OF
ACTION.—An action 
under this subsection may be instituted by— 
(A) any health care entity that has stand-
ing to complain of an actual or threatened vio-
lation of this section; or 
(B) the Attorney General of the United 
States. 
(d) ADMINISTRATION.—The Secretary of Health and 
Human Services shall designate the Director of the Office 
for Civil Rights of the Department of Health and Human 
Services— 
(1) to receive complaints alleging a violation of 
this section; 
(2) subject to paragraph (3), to pursue the in-
vestigation of such complaints in coordination with 
the Attorney General; and 
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(3) in the case of a complaint related to a Fed-
eral agency (other than with respect to the Depart-
ment of Health and Human Services) or program 
administered through such other agency or any 
State or local government receiving Federal financial 
assistance through such other agency, to refer the 
complaint to the appropriate office of such other 
agency. 
SEC. 134. EQUAL EMPLOYER CONTRIBUTION RULE TO PRO-
MOTE CHOICE. 
(a) IN GENERAL.—Section 5000 of the Internal Rev-
enue Code of 1986 is amended by adding at the end the 
following new subsection: 
‘‘(e) HEALTH CARE CONTRIBUTION ELECTION.— 
‘‘(1) IN
GENERAL.—Subsection (a) shall not 
apply in the case of a group health plan with respect 
to which the requirements of paragraphs (2) and (3) 
are met. 
‘‘(2) CONTRIBUTION ELECTION.—The require-
ment of this paragraph is met with respect to a 
group health plan if any employee of an employer 
(who but for this paragraph would be covered by 
such plan) may elect to have the employer or em-
ployee organization pay an amount which is not less 
than the contribution amount to any provider of 
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health insurance coverage (other than excepted bene-
fits as defined in section 9832(c)) which constitutes 
medical care of the individual or individual’s spouse 
or dependents in lieu of such group health plan cov-
erage otherwise provided or contributed to by the 
employer with respect to such employee. 
‘‘(3) PRE-EXISTING CONDITIONS.— 
‘‘(A) IN
GENERAL.—The requirement of 
this paragraph is met with respect to health in-
surance coverage provided to a participant or 
beneficiary by any health insurance issuer if, 
under such plan the requirements of section 
9801 are met with respect to the participant or 
beneficiary. 
‘‘(B) ENFORCEMENT
WITH
RESPECT
TO 
INDIVIDUAL ELECTION.—For purposes of sub-
paragraph (A), any health insurance coverage 
with respect to the participant or beneficiary 
shall be treated as health insurance coverage 
under a group health plan to which section 
9801 applies. 
‘‘(4) CONTRIBUTION
AMOUNT.—For purposes 
of this section, the term ‘contribution amount’ 
means, with respect to an individual under a group 
health plan, the portion of the applicable premium of 
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such individual under such plan (as determined 
under section 4980B(f)(4)) which is not paid by the 
individual. In the case that the employer offers more 
than one group health plan, the contribution amount 
shall be the average amount of the applicable pre-
miums under such plans. 
‘‘(5) GROUP HEALTH PLAN.—For purpose of 
this subsection, subsection (d) shall not apply. 
‘‘(6) 
APPLICATION
TO
FEHBP.—Notwith-
standing any other provision of law, the Office of 
Personnel Management shall carry out the health 
benefits program under chapter 89 of title 5, United 
States Code, consistent with the requirements of this 
subsection.’’. 
(b) REQUIREMENT OF EQUAL CONTRIBUTIONS TO 
ALL FEHBP PLANS.—Section 8906 of title 5, United 
States Code, is amended by adding at the end the fol-
lowing new subsection: 
‘‘(j) Notwithstanding the previous provisions of this 
section the Office of Personnel Management shall revise 
the amount of the Government contribution made under 
this section in a manner so that— 
‘‘(1) the amount of such contribution does not 
change based on the health benefits plan in which 
the individual is enrolled; and 
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‘‘(2) the aggregate amount of such contribu-
tions is estimated to be equal to the aggregate 
amount of such contributions if this subsection did 
not apply.’’. 
(c) EMPLOYEE RETIREMENT INCOME SECURITY ACT 
OF 1974 CONFORMING AMENDMENTS.— 
(1) EXCEPTION
FROM
HIPAA
REQUIREMENTS 
FOR
BENEFITS
PROVIDED
UNDER
HEALTH
CARE 
CONTRIBUTION ELECTION.—Section 732 of the Em-
ployee Retirement Income Security Act of 1974 (29 
U.S.C. 1191a) is amended by adding at the end the 
following new subsection: 
‘‘(e) HEALTH CARE CONTRIBUTION ELECTION.— 
‘‘(1) IN GENERAL.—The requirements of this 
part shall not apply in the case of health insurance 
coverage (other than excepted benefits as defined in 
section 9832(c) of the Internal Revenue Code of 
1986)— 
‘‘(A) which is provided to a participant or 
beneficiary by a health insurance issuer under 
a group health plan, and 
‘‘(B) with respect to which the require-
ments of paragraphs (2) and (3) are met. 
‘‘(2) CONTRIBUTION ELECTION.—The require-
ment of this paragraph is met with respect to health 
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insurance coverage provided to a participant or ben-
eficiary by any health insurance issuer under a 
group health plan if, under such plan— 
‘‘(A) the participant may elect such cov-
erage for any period of coverage in lieu of 
health insurance coverage otherwise provided 
under such plan for such period, and 
‘‘(B) in the case of such an election, the 
plan sponsor is required to pay to such issuer 
for the elected coverage for such period an 
amount which is not less than the contribution 
amount for such health insurance coverage oth-
erwise provided under such plan for such pe-
riod. 
‘‘(3) PRE-EXISTING CONDITIONS.— 
‘‘(A) IN
GENERAL.—The requirement of 
this paragraph is met with respect to health in-
surance coverage provided to a participant or 
beneficiary by any health insurance issuer if, 
under such plan the requirements of section 
701 are met with respect to the participant or 
beneficiary. 
‘‘(B) ENFORCEMENT
WITH
RESPECT
TO 
INDIVIDUAL ELECTION.—For purposes of sub-
paragraph (A), any health insurance coverage 
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with respect to the participant or beneficiary 
shall be treated as health insurance coverage 
under a group health plan to which section 701 
applies. 
‘‘(4) CONTRIBUTION AMOUNT.— 
‘‘(A) IN GENERAL.—For purposes of this 
section, the term ‘contribution amount’ means, 
with respect to any period of health insurance 
coverage offered to a participant or beneficiary, 
the portion of the applicable premium of such 
participant or beneficiary under such plan 
which is not paid by such participant or bene-
ficiary. In the case that the employer offers 
more than one group health plan, the contribu-
tion amount shall be the average amount of the 
applicable premiums under such plans. 
‘‘(B) APPLICABLE
PREMIUM.—For pur-
poses of subparagraph (A), the term ‘applicable 
premium’ means, with respect to any period of 
health insurance coverage of a participant or 
beneficiary under a group health plan, the cost 
to the plan for such period of such coverage for 
similarly situated beneficiaries (without regard 
to whether such cost is paid by the plan spon-
sor or the participant or beneficiary).’’. 
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(2) EXEMPTION FROM FIDUCIARY LIABILITY.— 
Section 404 of such Act (29 U.S.C. 1104) is amend-
ed by adding at the end the following new sub-
section: 
‘‘(e) The plan sponsor of a group health plan (as de-
fined in section 733(a)) shall not be treated as breaching 
any of the responsibilities, obligations, or duties imposed 
upon fiduciaries by this title in the case of any individual 
who is a participant or beneficiary under such plan solely 
because of the extent to which the plan sponsor provides, 
in the case of such individual, some or all of such benefits 
by means of payment of contribution amounts pursuant 
to a contribution election under section 732(e), irrespec-
tive of the amount or type of benefits that would otherwise 
be provided to such individual under such plan.’’. 
(d) EXCEPTION
FROM
HIPAA REQUIREMENTS 
UNDER IRC FOR BENEFITS PROVIDED UNDER HEALTH 
CARE CONTRIBUTION ELECTION.—Section 9831 of the 
Internal Revenue Code of 1986 (relating to general excep-
tions) is amended by adding at the end the following new 
subsection: 
‘‘(d) HEALTH CARE CONTRIBUTION ELECTION.— 
‘‘(1) IN GENERAL.—The requirements of this 
chapter shall not apply in the case of health insur-
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ance coverage (other than excepted benefits as de-
fined in section 9832(c))— 
‘‘(A) which is provided to a participant or 
beneficiary by a health insurance issuer under 
a group health plan, and 
‘‘(B) with respect to which the require-
ments of paragraphs (2) and (3) are met. 
‘‘(2) CONTRIBUTION ELECTION.—The require-
ment of this paragraph is met with respect to health 
insurance coverage provided to a participant or ben-
eficiary by any health insurance issuer under a 
group health plan if, under such plan— 
‘‘(A) the participant may elect such cov-
erage for any period of coverage in lieu of 
health insurance coverage otherwise provided 
under such plan for such period, and 
‘‘(B) in the case of such an election, the 
plan sponsor is required to pay to such issuer 
for the elected coverage for such period an 
amount which is not less than the contribution 
amount for such health insurance coverage oth-
erwise provided under such plan for such pe-
riod. 
‘‘(3) PRE-EXISTING CONDITIONS.— 
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tribution amount shall be the average amount 
of the applicable premiums under such plans. 
‘‘(B) APPLICABLE
PREMIUM.—For pur-
poses of subparagraph (A), the term ‘applicable 
premium’ means, with respect to any period of 
health insurance coverage of a participant or 
beneficiary under a group health plan, the cost 
to the plan for such period of such coverage for 
similarly situated beneficiaries (without regard 
to whether such cost is paid by the plan spon-
sor or the participant or beneficiary).’’. 
(e) EXCEPTION
FROM
HIPAA REQUIREMENTS 
UNDER THE PHSA FOR BENEFITS PROVIDED UNDER 
HEALTH CARE CONTRIBUTION ELECTION.—Section 2721 
of the Public Health Service Act (42 U.S.C. 300gg–21) 
is amended— 
(1) by redesignating subsection (e) as sub-
section (f); and 
(2) by inserting after subsection (d) the fol-
lowing new subsection: 
‘‘(e) HEALTH CARE CONTRIBUTION ELECTION.— 
‘‘(1) IN GENERAL.—The requirements of sub-
parts 1 through 3 shall not apply in the case of 
health insurance coverage (other than excepted bene-
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smartinez on DSK4TPTVN1PROD with BILLS
fits as defined in section 9832(c) of the Internal 
Revenue Code of 1986)— 
‘‘(A) which is provided to a participant or 
beneficiary by a health insurance issuer under 
a group health plan, and 
‘‘(B) with respect to which the require-
ments of paragraphs (2) and (3) are met. 
‘‘(2) CONTRIBUTION ELECTION.—The require-
ment of this paragraph is met with respect to health 
insurance coverage provided to a participant or ben-
eficiary by any health insurance issuer under a 
group health plan if, under such plan— 
‘‘(A) the participant may elect such cov-
erage for any period of coverage in lieu of 
health insurance coverage otherwise provided 
under such plan for such period, and 
‘‘(B) in the case of such an election, the 
plan sponsor is required to pay to such issuer 
for the elected coverage for such period an 
amount which is not less than the contribution 
amount for such health insurance coverage oth-
erwise provided under such plan for such pe-
riod. 
‘‘(3) PRE-EXISTING CONDITIONS.— 
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smartinez on DSK4TPTVN1PROD with BILLS
‘‘(A) IN
GENERAL.—The requirement of 
this paragraph is met with respect to health in-
surance coverage provided to a participant or 
beneficiary by any health insurance issuer if, 
under such plan the requirements of section 
2701 are met with respect to the participant or 
beneficiary. 
‘‘(B) ENFORCEMENT
WITH
RESPECT
TO 
INDIVIDUAL ELECTION.—For purposes of sub-
paragraph (A), any health insurance coverage 
with respect to the participant or beneficiary 
shall be treated as health insurance coverage 
under a group health plan to which section 
2701 applies. 
‘‘(4) CONTRIBUTION AMOUNT.— 
‘‘(A) IN GENERAL.—For purposes of this 
section, the term ‘contribution amount’ means, 
with respect to any period of health insurance 
coverage offered to a participant or beneficiary, 
the portion of the applicable premium of such 
participant or beneficiary under such plan 
which is not paid by such participant or bene-
ficiary. In the case that the employer offers 
more than one group health plan, the contribu-
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tion amount shall be the average amount of the 
applicable premiums under such plans. 
‘‘(B) APPLICABLE
PREMIUM.—For pur-
poses of subparagraph (A), the term ‘applicable 
premium’ means, with respect to any period of 
health insurance coverage of a participant or 
beneficiary under a group health plan, the cost 
to the plan for such period of such coverage for 
similarly situated beneficiaries (without regard 
to whether such cost is paid by the plan spon-
sor or the participant or beneficiary).’’. 
SEC. 135. LIMITATIONS ON STATE RESTRICTIONS ON EM-
PLOYER AUTO-ENROLLMENT. 
(a) IN GENERAL.—No State shall establish a law 
that prevents an employer that is allowed an exclusion 
from gross income, a deduction, or a credit for Federal 
income tax purposes for health benefits furnished to a par-
ticipant or beneficiary from instituting auto-enrollment 
which meets the requirements of subsection (b) for cov-
erage of a participant or beneficiary under a group health 
plan, or health insurance coverage offered in connection 
with such a plan, so long as the participant or beneficiary 
has the option of declining such coverage. 
(b) AUTOMATIC
ENROLLMENT
FOR
EMPLOYER- 
SPONSORED HEALTH BENEFITS.— 
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(1) IN GENERAL.—The requirement of this sub-
section with respect to an employer and an employee 
is that the employer automatically enroll such em-
ployee into the employment-based health benefits 
plan for individual coverage under the plan option 
with the lowest applicable employee premium. 
(2) OPT-OUT.—In no case may an employer 
automatically enroll an employee in a plan under 
paragraph (1) if such employee makes an affirmative 
election to opt-out of such plan or to elect coverage 
under an employment-based health benefits plan of-
fered by such employer. An employer shall provide 
an employee with a 30-day period to make such an 
affirmative election before the employer may auto-
matically enroll the employee in such a plan. 
(3) NOTICE REQUIREMENTS.— 
(A) IN
GENERAL.—Each employer de-
scribed in paragraph (1) who automatically en-
rolls an employee into a plan as described in 
such paragraph shall provide the employees, 
within a reasonable period before the beginning 
of each plan year (or, in the case of new em-
ployees, within a reasonable period before the 
end of the enrollment period for such a new em-
ployee), written notice of the employees’ rights 
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and obligations relating to the automatic enroll-
ment requirement under such paragraph. Such 
notice must be comprehensive and understood 
by the average employee to whom the automatic 
enrollment requirement applies. 
(B) INCLUSION
OF
SPECIFIC
INFORMA-
TION.—The written notice under subparagraph 
(A) must explain an employee’s right to opt out 
of being automatically enrolled in a plan and in 
the case that more than one level of benefits or 
employee premium level is offered by the em-
ployer involved, the notice must explain which 
level of benefits and employee premium level the 
employee will be automatically enrolled in the 
absence of an affirmative election by the em-
ployee. 
(c) CONSTRUCTION.—Nothing in this section shall be 
construed to supersede State law which establishes, imple-
ments, or continues in effect any standard or requirement 
relating to employers in connection with payroll or the 
sponsoring of employer-sponsored health insurance cov-
erage except to the extent that such standard or require-
ment prevents an employer from instituting the auto-en-
rollment described in subsection (a). 
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(d) NON-APPLICATION TO EXCEPTED BENEFITS.— 
For purposes of this section, the term ‘‘group health plan’’ 
does not include excepted benefits (as defined in section 
2781(c) of the Public Health Service Act (42 U.S.C. 
300gg–91(c))). 
SEC. 136. CREDIT FOR SMALL EMPLOYERS ADOPTING 
AUTO-ENROLLMENT 
AND 
DEFINED 
CON-
TRIBUTION OPTIONS. 
(a) IN GENERAL.—Subpart D of part IV of sub-
chapter A of chapter 1 of the Internal Revenue Code of 
1986, as amended by section 2, is amended by adding at 
the end the following new section: 
‘‘SEC. 45R. AUTO-ENROLLMENT AND DEFINED CONTRIBU-
TION OPTION FOR HEALTH BENEFITS PLANS 
OF SMALL EMPLOYERS. 
‘‘(a) IN GENERAL.—For purposes of section 38, in 
the case of a small employer, the health benefits plan im-
plementation credit determined under this section for the 
taxable year is an amount equal to 100 percent of the 
amount paid or incurred by the taxpayer during the tax-
able year for qualified health benefits expenses. 
‘‘(b) LIMITATION.—The credit determined under sub-
section (a) with respect to any taxpayer for any taxable 
year shall not exceed the excess of— 
‘‘(1) $1,500, over 
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‘‘(2) sum of the credits determined under sub-
section (a) with respect to such taxpayer for all pre-
ceding taxable years. 
‘‘(c) QUALIFIED HEALTH BENEFITS EXPENSES.— 
For purposes of this section, the term ‘qualified health 
benefits auto-enrollment expenses’ means, with respect to 
any taxable year, amounts paid or incurred by the tax-
payer during such taxable year for— 
‘‘(1) establishing auto-enrollment which meets 
the requirements of section 107 of the Empowering 
Patients First Act of 2013 for coverage of a partici-
pant or beneficiary under a group health plan, or 
health insurance coverage offered in connection with 
such a plan, and 
‘‘(2) implementing the employer contribution 
option for health insurance coverage pursuant to 
section 5000(e)(2). 
‘‘(d) QUALIFIED SMALL EMPLOYER.—For purposes 
of this section, the term ‘qualified small employer’ means 
any employer for any taxable year if the number of em-
ployees employed by such employer during such taxable 
year does not exceed 50. All employers treated as a single 
employer under section (a) or (b) of section 52 shall be 
treated as a single employer for purposes of this section. 
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‘‘(e) NO DOUBLE BENEFIT.—No deduction or credit 
shall be allowed under any other provision of this chapter 
with respect to the amount of the credit determined under 
this section. 
‘‘(f) TERMINATION.—Subsection (a) shall not apply 
to any taxable year beginning after the date which is 2 
years after the date of the enactment of this section.’’. 
(b) CREDIT TO BE PART OF GENERAL BUSINESS 
CREDIT.—Subsection (b) of section 38 of such Code, as 
amended by section 2, is amended by striking ‘‘plus’’ at 
the end of paragraph (34), by striking the period at the 
end of paragraph (35) and inserting ‘‘, plus’’, and by add-
ing at the end the following new paragraph: 
‘‘(36) in the case of a small employer (as de-
fined in section 45R(d)), the health benefits plan im-
plementation 
credit 
determined 
under 
section 
45R(a).’’. 
(c) CLERICAL AMENDMENT.—The table of sections 
for subpart D of part IV of subchapter A of chapter 1 
of such Code, as amended by section 2, is amended by 
inserting after the item relating to section 45Q the fol-
lowing new item: 
‘‘Sec. 45R. Auto-enrollment and defined contribution option for health benefits 
plans of small employers.’’. 
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(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to taxable years beginning after 
the date of the enactment of this Act. 
TITLE II—HEALTH CARE ACCESS 
AND AVAILABILITY 
Subtitle A—Health Insurance Pool-
ing Mechanisms for Individuals 
SEC. 201. FEDERAL GRANTS FOR STATE INSURANCE EX-
PENDITURES. 
(a) IN GENERAL.—Subject to the succeeding provi-
sions of this section, each State shall receive from the Sec-
retary of Health and Human Services (in this subtitle re-
ferred to as the ‘‘Secretary’’) a grant for the State’s pro-
viding for the use, in connection with providing health ben-
efits coverage, of a qualifying high-risk pool or a reinsur-
ance pool or other risk-adjustment mechanism used for 
the purpose of subsidizing the purchase of private health 
insurance. 
(b) FUNDING AMOUNT.— 
(1) IN
GENERAL.—There are hereby appro-
priated, out of any funds in the Treasury not other-
wise appropriated, $1,000,000,000 for each of fiscal 
years 2016, 2017, and 2018 for grants under this 
section. Such amount shall be divided among the 
States as determined by the Secretary. 
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smartinez on DSK4TPTVN1PROD with BILLS
(2) CONSTRUCTION.—Nothing in this section 
shall be construed as preventing a State from using 
funding under section 2745 of the Public Health 
Service Act for purposes of funding reinsurance or 
other risk mechanisms. 
(c) LIMITATION.—Funding under subsection (a) may 
only be used for the following: 
(1) QUALIFYING HIGH-RISK POOLS.— 
(A) CURRENT POOLS.—A qualifying high- 
risk pool created before the date of the enact-
ment of this Act that only covers high-risk pop-
ulations and individuals (and their spouse and 
dependents) receiving a health care tax credit 
under section 35 of the Internal Revenue Code 
of 1986 for a limited period of time as deter-
mined by the Secretary or under section 2741 
of Public Health Service Act. 
(B) NEW POOLS.—A qualifying high-risk 
pool created on or after such date that only cov-
ers populations and individuals described in 
subparagraph (A) if the pool— 
(i) offers at least the option of one or 
more high-deductible plan options, in com-
bination with a contribution into a health 
savings account; 
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(ii) offers multiple competing health 
plan options; and 
(iii) covers only high-risk populations. 
(2) RISK INSURANCE POOL OR OTHER RISK-AD-
JUSTMENT MECHANISMS.— 
(A) CURRENT REINSURANCE.—A reinsur-
ance pool, or other risk-adjustment mechanism, 
created before the date of the enactment of this 
Act that only covers populations and individuals 
described in paragraph (1)(A). 
(B) NEW POOLS.—A reinsurance pool or 
other risk-adjustment mechanism created on or 
after such date that provides reinsurance only 
covers populations and individuals described in 
paragraph (1)(A) and only on a prospective 
basis under which a health insurance issuer 
cedes covered lives to the pool in exchange for 
payment of a reinsurance premium. 
(3) TRANSITION.—Nothing in this section shall 
be construed as preventing a State from using funds 
available to transition from an existing high-risk 
pool to a reinsurance pool. 
(d) BONUS
PAYMENTS.—With respect to any 
amounts made available to the States under this section, 
the Secretary shall set aside a portion of such amounts 
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that shall only be available for the following activities by 
such States: 
(1) Providing guaranteed availability of indi-
vidual health insurance coverage to certain individ-
uals with prior group coverage under part B of title 
XXVII of the Public Health Service Act. 
(2) A reduction in premium trends, actual pre-
miums, or other cost-sharing requirements. 
(3) An expansion or broadening of the pool of 
high-risk individuals eligible for coverage. 
(4) States that adopt the Model Health Plan 
for Uninsurable Individuals Act of the National As-
sociation of Insurance Commissioners (if and when 
updated by such Association). 
The Secretary may request such Association to update 
such Model Health Plan as needed by 2015. 
(e) REQUIREMENTS FOR RECEIPT OF BONUS PAY-
MENTS.—The requirements of this subsection, for the 
availability of bonus payments to a State under subsection 
(d), are as follows, in the case of an individual who is cov-
ered under a high-risk pool or other pool or mechanism 
described in subsection (b) operating in the State for 
which funds under this section may be applied: 
(1) LIMITATION
ON
ANNUAL
PREMIUMS
FOR 
EACH INDIVIDUAL BASED ON ADJUSTED GROSS FAM-
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ILY INCOME.—The premiums imposed for coverage 
of each individual under health insurance coverage 
offered through such pool or mechanism may not ex-
ceed (on an annual basis) the following: 
(A) If the adjusted gross income (as de-
fined in section 62 of the Internal Revenue 
Code of 1986) of all individuals in the individ-
ual’s family does not exceed the poverty line (as 
defined in section 673(2) of the Community 
Services Block Grant Act (42 U.S.C. 9902(2)), 
including any revision required by such section) 
applicable to a family of the size involved, 2 
percent of such income. 
(B) If such adjusted gross income for all 
individuals in the individual’s family exceeds 
such applicable poverty line, the sum of— 
(i) 2 percent of such applicable pov-
erty line; and 
(ii) 10 percent of the amount of such 
income that exceeds such applicable pov-
erty line. 
(2) LIMITATION
ON
ANNUAL
OUT-OF-POCKET 
COSTS
FOR
EACH
INDIVIDUAL.—There shall be a 
limit on the annual out-of-pocket expenditures (in-
cluding annual premiums) for each individual for 
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coverage under such pool or mechanism equal to 
twice the maximum allowable premiums for such in-
dividual permitted under paragraph (1). 
(f) ADMINISTRATION.—The Secretary shall provide 
for the administration of this section and may establish 
such terms and conditions, including the requirement of 
an application, as may be appropriate to carry out this 
section. 
(g) CONSTRUCTION.—Nothing in this section shall be 
construed as requiring a State to operate a reinsurance 
pool (or other risk-adjustment mechanism) under this sec-
tion or as preventing a State from operating such a pool 
or mechanism through one or more private entities. 
(h) DEFINITIONS.—In this section: 
(1) QUALIFYING HIGH-RISK POOL.—The term 
‘‘qualifying high-risk pool’’ means any qualified 
high-risk pool (as defined in subsection (g)(1)(A) of 
section 2745 of the Public Health Service Act) that 
meets the conditions to receive a grant under section 
(b)(1) of such section. 
(2) REINSURANCE POOL OR OTHER RISK-AD-
JUSTMENT MECHANISM DEFINED.—The term ‘‘rein-
surance pool or other risk-adjustment mechanism’’ 
means any State-based risk spreading mechanism to 
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subsidize the purchase of private health insurance 
for the high-risk population. 
(3) HIGH-RISK POPULATION.—The term ‘‘high- 
risk population’’ means— 
(A) individuals who, by reason of the exist-
ence or history of a medical condition, are able 
to acquire health coverage only at rates which 
are at least 150 percent of the standard risk 
rates for such coverage (in a non-community- 
rated non-guaranteed issue State), and 
(B) individuals who are provided health 
coverage by a high-risk pool. 
(4) STATE
DEFINED.—The term ‘‘State’’ in-
cludes the District of Columbia, Puerto Rico, the 
Virgin Islands, Guam, American Samoa, and the 
Northern Mariana Islands. 
(i) EXTENDING FUNDING.—Section 2745(d)(2) of 
the Public Health Service Act (42 U.S.C. 300gg–45(d)(2)) 
is amended— 
(1) in the heading, by inserting ‘‘AND
2016 
THROUGH 2018’’ after ‘‘2010’’; and 
(2) by inserting ‘‘and for each of fiscal years 
2016 through 2018’’ after ‘‘for each of fiscal years 
2007 through 2010’’. 
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(j) SUNSET.—Funds made available under this sec-
tion shall not be used for the purpose of subsidizing the 
purchase of private health insurance on or after October 
1, 2018. 
SEC. 202. POOL REFORM FOR INDIVIDUAL MEMBERSHIP 
EXPANSION. 
The Public Health Service Act, as amended by sec-
tion 2, is further amended by inserting after title XXX 
the following new title: 
‘‘TITLE 
XXXI—POOL 
REFORM 
FOR 
INDIVIDUAL 
MEMBER-
SHIP EXPANSION 
‘‘SEC. 3100. PURPOSE. 
‘‘The purpose of this title is to provide, through the 
establishment of independent health pools (or IHPs), for 
the reform of, and expansion of enrollment in, health in-
surance coverage for individuals and small employers. 
‘‘SEC. 3101. DEFINITION OF INDEPENDENT HEALTH POOL 
(IHP). 
‘‘(a) IN GENERAL.—For purposes of this title, the 
terms ‘individual health pool’ and ‘IHP’ mean a legal non-
profit entity that meets the following requirements: 
‘‘(1) ORGANIZATION.—The IHP— 
‘‘(A) has been formed and maintained in 
good faith for a purpose that includes the for-
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the plans in each class of such association health plans 
upon appropriate filing under such procedure in connec-
tion with plans in such class and payment of the pre-
scribed fee under section 807(a). 
‘‘(f) CERTIFICATION OF SELF-INSURED ASSOCIATION 
HEALTH PLANS.—An association health plan which offers 
one or more benefit options which do not consist of health 
insurance coverage may be certified under this part only 
if such plan consists of any of the following: 
‘‘(1) a plan which offered such coverage on the 
date of the enactment of the Small Business Health 
Fairness Act of 2015, 
‘‘(2) a plan under which the sponsor does not 
restrict membership to one or more trades and busi-
nesses or industries and whose eligible participating 
employers represent a broad cross-section of trades 
and businesses or industries, or 
‘‘(3) a plan whose eligible participating employ-
ers represent one or more trades or businesses, or 
one or more industries, consisting of any of the fol-
lowing: agriculture; equipment and automobile deal-
erships; barbering and cosmetology; certified public 
accounting practices; child care; construction; dance, 
theatrical and orchestra productions; disinfecting 
and pest control; financial services; fishing; food 
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