Page:United States Statutes at Large Volume 102 Part 3.djvu/628
102 STAT. 2580
PUBLIC LAW 100-517—OCT. 24, 1988 organization's revenue requirements determined under subclause (II) for providing services to them as members of the classes established under subclause (I), or "(ii) fix the rates of payments for the individuals and families of a group on the basis of the organization's revenue requirements for providing services to the group, except that the rates of payments for the individuals and families of a group of less than 100 persons may not be fixed at rates greater than 110 percent of the rate that would be fixed for such individuals and families under subparagraph (B) or clause (i) of this subparagraph.". (2) Section 1302(8)(0 (42 U.S.C. 300e-l(8)(C)) is amended by adding at the end the following: 'If a health maintenance organization is to fix rates of payment for a group under clause (ii), it shall, upon request of the entity with which it contracts to provide services to such group, disclose to that entity the method and data used in calculating the rates of payment.".
SEC 7. EMPLOYEES* HEALTH BENEFIT PLANS. (a) REVISIONS.— (1) STATES AND POLITICAL SUBDIVISIONS.—
(A) Section 1310(b) (42 U.S.C. 300e-9(b)) is amended (i) by striking out "subject to subsection (a)" and inserting in lieu thereof or a State or political subdivision", and (ii) by striking out "employer pursuant" and inserting in lieu thereof "employer or State or political subdivision pursuant". (B) Section 1310(c) (42 U.S.C. 300e-9(c)) is amended by inserting "or State or political subdivision" after "employer" each place it occurs. (2) DISCRIMINATION.—Section 1310(c) (42 U.S.C. 300e-9(c)) is amended by adding at the end the following: "If a health benefits plsoi offered by an employer or a State or political subdivision under subsection (a) includes contributions for services offered under the plan, the employer or State or political subdivision shall make a contribution under the plan for services offered by a qualified health maintenance organization in an amount which does not financially discriminate against an employee who enrolls in such organization. For purposes of the preceding sentence, an employer's or a State's or political subdivision's contribution does not financially discriminate if the employer's or State's or political subdivision's method of determining the contributions on behalf of all employees is reasonable and is designed to assure employees a fair choi(» among health benefits plans.". (3) AmiCATiON.—Nothing in section 1310 of the Public Health Service Act (42 UJS.C. 300e-9), as amended by this Act, shall be construed to supersede any provision of a collective baigaining agreement in effect on the date of enactment of this Act (b) REPBAL OF DuAL CHOICE.—Effective 7 years after the date of the enactment of this Act, section 1310 (42 UJS.C. 300e-9) is ameiided to read as follows: