SEC. 164. Reinsurance program for retirees.(a) Establishment. —

(1) In general. —

Not later than 90 days after the date of the enactment of this Act, the Secretary of Health andHuman Services shall establish a temporary reinsurance program (in this section referred to as the "reinsurance program") to provide reimbursement to assist participating employment-based plans with the cost of providinghealth benefits to retirees and to eligible spouses, surviving spouses and dependents of such retirees.

(2) Definitions. —

For purposes of this section:(A) The term "eligible employment-based plan" means a group health benefits plan that — (i) is maintained by one or more employers, former employers or employee associations, or avoluntary employees' beneficiary association, or a committee or board of individuals appointed toadminister such plan, and(ii) provides health benefits to retirees.(B) The term "health benefits" means medical, surgical, hospital, prescription drug, and such other benefitsas shall be determined by the Secretary, whether self-funded or delivered through the purchase of insurance or otherwise.(C) The term "participating employment-based plan" means an eligible employment-based plan that is participating in the reinsurance program.(D) The term "retiree" means, with respect to a participating employment-benefit plan, an individual who — (i) is 55 years of age or older;(ii) is not eligible for coverage under title XVIII of the Social Security Act; and(iii) is not an active employee of an employer maintaining the plan or of any employer that makesor has made substantial contributions to fund such plan.(E) The term "Secretary" means Secretary of Health and Human Services.

(b) Participation. — To be eligible to participate in the reinsurance program, an eligibleemployment-based plan shall submit to the Secretary an application for participation in theprogram, at such time, in such manner, and containing such information as the Secretary shallrequire.(c) Payment. —

(1) Submission of claims. —

(A) In general. — Under the reinsurance program, a participating employment-based plan shall submitclaims for reimbursement to the Secretary which shall contain documentation of the actual costs of theitems and services for which each claim is being submitted.(B) Basis for claims. — Each claim submitted under subparagraph (A) shall be based on the actual amountexpended by the participating employment-based plan involved within the plan year for the appropriateemployment based health benefits provided to a retiree or to the spouse, surviving spouse, or dependent of a retiree. In determining the amount of any claim for purposes of this subsection, the participatingemployment-based plan shall take into account any negotiated price concessions (such as discounts, director indirect subsidies, rebates, and direct or indirect remunerations) obtained by such plan with respect to