Page:United States Statutes at Large Volume 111 Part 1.djvu/334

 Ill STAT. 310 PUBLIC LAW 105-33—AUG. 5, 1997 service plan, the amount filed under paragraph (3)(B) or (4)(B) of subsection (a). "(C) MEDICARE+CHOICE MONTHLY MSA PREMIUM.— The term 'Medicare+Choice monthly MSA premium' means, with respect to a Medicare+Choice plan, the amount of such premium filed under subsection (a)(3)(A) for the plan. "(c) UNIFORM PREMIUM.— The Medicare+Choice monthly basic and supplemental beneficiary premium, the Medicare+Choice monthly MSA premium charged under subsection (b) of a Medicare+Choice organization under this part may not vary among individuals enrolled in the plan. "(d) TERMS AND CONDITIONS OF IMPOSING PREMIUMS.— Each Medicare+Choice organization shall permit the payment of Medicare+Choice monthly basic and supplemental beneficiary premiums on a monthly basis, may terminate election of individuals for a Medicare+Choice plan for failure to make premium payments only in accordance with section 1851(g)(3)(B)(i), and may not provide for cash or other monetary rebates as an inducement for enrollment or otherwise. "(e) LIMITATION ON ENROLLEE LIABILITY.— "(1) FOR BASIC AND ADDITIONAL BENEFITS.—In no event may— "(A) the Medicare+Choice monthly basic beneficiary premium (multiplied by 12) and the actuarial value of the deductibles, coinsurance, and copayments applicable on average to individuals enrolled under this part with a Medicare+Choice plan described in section 1851(a)(2)(A) of an organization with respect to required benefits described in section 1852(a)(1)(A) and additional benefits (if any) required under subsection (f)(1)(A) for a year, exceed "(B) the actuarial value of the deductibles, coinsurance, and copayments that would be applicable on average to individuals entitled to benefits under part A and enrolled under part B if they were not members of a Medicare+Choice organization for the year. "(2) FOR SUPPLEMENTAL BENEFITS.—I f the Medicare+Choice organization provides to its members enrolled under this part in a Medicare+Choice plan described in section 1851(a)(2)(A) with respect to supplemental benefits described in section 1852(a)(3), the sum of the Medicare+Choice monthly supplemental beneficiary premium (multiplied by 12) charged and the actuarial value of its deductibles, coinsurance, and copay- ments charged with respect to such benefits may not exceed the adjusted community rate for such benefits (as defined in subsection (f)(3)). "(3) DETERMINATION ON OTHER BASIS. —If the Secretary determines that adequate data are not available to determine the actuarial value under paragraph (1)(A) or (2), the Secretary may determine such amount with respect to all individuals in same geographic area, the State, or in the United States, eligible to enroll in the Medicare+Choice plan involved under this part or on the basis of other appropriate data. "(4) SPECIAL RULE FOR PRIVATE FEE-FOR-SERVICE PLANS. — With respect to a Medicare+Choice private fee-for-service plan (other than a plan that is an MSA plan), in no event may—

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