H.R.1955 - Small Employers Health Benefits Program Act of 2005109th Congress (2005-2006)
Summary: H.R.1955 — 109th Congress (2005-2006)
Introduced in House (04/28/2005)
Small Employers Health Benefits Program Act of 2005 - Directs the Office of Personnel Management to administer a separate health insurance program for non-Federal employees who are either self-employed or employees of a small business with fewer than 100 employees.
Allows the Office to contract with carriers to provide health insurance under this Act. Requires rates charged to reasonably and equitably reflect the costs of the benefits provided. Requires a carrier to determine the amount of premiums to assess for coverage based on a community rate that may be annually adjusted based on geographic area, family status, and age.
Permits the Office to reimburse a carrier for costs that exceed premiums received by a specified percentage. Requires a carrier to make payments to a contingency reserve fund established by the Office if the carrier's costs are lower than expected by a specified percentage. Allows the Office to use such funds to provide assistance to carriers that experience unanticipated financial hardships.
Requires the Office to establish a reinsurance fund to provide payments to carriers that experience a catastrophic claim (a claim over $50,000) for benefits provided to an individual enrolled under this Act.
Allows a participating employer to offer supplemental coverage options to employees for excepted benefits that are not subject to the Public Health Service Act requirements for health plans.
Allows a refundable tax credit for health insurance expenses of small employers who pay a specific percentage of employee expenses under such a health plan.
Amends the Balanced Budget and Emergency Deficit Control Act of 1985 to extend requirements that certain legislation which increases the deficit will trigger an offsetting sequestration (pay-as-you-go or PAYGO requirements).