Page:United States Statutes at Large Volume 116 Part 2.djvu/183

 PUBLIC LAW 107-210—AUG. 6, 2002 116 STAT. 965 "(III) in the case of any eligible PBGC pension recipient, the benefit described in section 35(c)(4)(B) of such Code. For purposes of this clause, the term 'individual health insurance' means any insurance which constitutes medical care offered to individuals other than in connection with a group health plan and does not include Federal- or State-based health insurance coverage. " (B) REQUIREMENTS FOR STATE-BASED COVERAGE. — "(i) IN GENERAL.— The term 'qualified health insurance' does not include any coverage described in clauses (ii) through (viii) of subparagraph (A) unless the State involved has elected to have such coverage treated as qualified health insurance under this paragraph and such coverage meets the following requirements: "(I) GUARANTEED ISSUE.— Each qualifying individual is guaranteed enrollment if the individual pays the premium for enrollment or provides a qualified health insurance costs credit eligibility certificate described in section 7527 of the Internal Revenue Code of 1986 and pays the remainder of such premium. " (II) No IMPOSITION OF PREEXISTING CONDITION EXCLUSION. —No pre-existing condition limitations are imposed with respect to any qualifying individual. "(Ill) NONDISCRIMINATORY PREMIUM.— The total premium (as determined without regard to any subsidies) with respect to a qualifying individual may not be greater than the total premium (as so determined) for a similarly situated individual who is not a qualifying individual. "(IV) SAME BENEFITS. —Benefits under the coverage are the same as (or substantially similar to) the benefits provided to similarly situated individuals who are not qualifying individuals, "(ii) QUALIFYING INDIVIDUAL. —For purposes of this subparagraph, the term 'qualifying individual' means— "(I) an eligible individual for whom, as of the date on which the individual seeks to enroll in clauses (ii) through (viii) of subparagraph (A), the aggregate of the periods of creditable coverage (as defined in section 9801(c) of the Internal Revenue Code of 1986) is 3 months or longer and who, with respect to any month, meets the requirements of clauses (iii) and (iv) of section 35(b)(1)(A) of such Code; and "(II) the qualifying family members of such eligible individual. "(C) EXCEPTION. — The term 'qualified health insurance' shall not include— "(i) a flexible spending or similar arrangement, and "(ii) any insurance if substantially all of its coverage is of excepted benefits described in section 733(c)

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