42 USC 300bb-4 - Applicable premium

U.S Code last checked for updates: Nov 22, 2024

§ 300bb–4.

Applicable premium

For purposes of this subchapter—

(1)

In general

(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

(3)

Determination period

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

cite as: 42 USC 300bb-4