
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC300bb-4]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
 SUBCHAPTER XX--REQUIREMENTS FOR CERTAIN GROUP HEALTH PLANS FOR CERTAIN 
                        STATE AND LOCAL EMPLOYEES
 
Sec. 300bb-4. Applicable premium

    For purposes of this subchapter--

                           (1) In general

        The term ``applicable premium'' means, with respect to any 
    period of continuation coverage of qualified beneficiaries, the cost 
    to the plan for such period of the coverage for similarly situated 
    beneficiaries with respect to whom a qualifying event has not 
    occurred (without regard to whether such cost is paid by the 
    employer or employee).

               (2) Special rule for self-insured plans

        To the extent that a plan is a self-insured plan--

        (A) In general

            Except as provided in subparagraph (B), the applicable 
        premium for any period of continuation coverage of qualified 
        beneficiaries shall be equal to a reasonable estimate of the 
        cost of providing coverage for such period for similarly 
        situated beneficiaries which--
                (i) is determined on an actuarial basis, and
                (ii) takes into account such factors as the Secretary 
            may prescribe in regulations.

        (B) Determination on basis of past cost

            If a plan administrator elects to have this subparagraph 
        apply, the applicable premium for any period of continuation 
        coverage of qualified beneficiaries shall be equal to--
                (i) the cost to the plan for similarly situated 
            beneficiaries for the same period occurring during the 
            preceding determination period under paragraph (3), adjusted 
            by
                (ii) the percentage increase or decrease in the implicit 
            price deflator of the gross national product (calculated by 
            the Department of Commerce and published in the Survey of 
            Current Business) for the 12-month period ending on the last 
            day of the sixth month of such preceding determination 
            period.

        (C) Subparagraph (B) not to apply where significant change

            A plan administrator may not elect to have subparagraph (B) 
        apply in any case in which there is any significant difference, 
        between the determination period and the preceding determination 
        period, in coverage under, or in employees covered by, the plan. 
        The determination under the preceding sentence for any 
        determination period shall be made at the same time as the 
        determination under paragraph (3).

                      (3) Determination period

        The determination of any applicable premium shall be made for a 
    period of 12 months and shall be made before the beginning of such 
    period.

(July 1, 1944, ch. 373, title XXII, Sec. 2204, as added Pub. L. 99-272, 
title X, Sec. 10003(a), Apr. 7, 1986, 100 Stat. 234.)
