H.R. 4414 (113^th): Expatriate Health Coverage Clarification Act of 2014

the amount of premiums taken into account under such section with respect to such issuer for such year, less the amount of premiums for expatriate health plans taken into account under such section with respect to such issuer for such year, bears to

the amount of premiums taken into account under such section with respect to such issuer for such year.

Substantially all of the primary enrollees in such plan or coverage are qualified expatriates, with respect to such plan or coverage. In applying the previous sentence, an individual shall not be taken into account as a primary enrollee if the individual is not a national of the United States and resides in the country of which the individual is a citizen.

Substantially all of the benefits provided under the plan or coverage are not excepted benefits described in section 9832(c) of the Internal Revenue Code of 1986.

The plan or coverage provides benefits for items and services, in excess of emergency care, furnished by health care providers—

In the case of an expatriate health plan that is a group health plan offered by a plan sponsor that—

If the plan or coverage provides dependent coverage of children, the plan or coverage makes such dependent coverage available for adult children until the adult child turns 26 years of age, unless such individual is the child of a child receiving dependent coverage.

The plan or coverage—

The plan or coverage, and the plan sponsor or expatriate health insurance issuer with respect to such plan or coverage, satisfies the provisions of title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.), chapter 100 of the Internal Revenue Code of 1986, and part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1181 et seq.), which would otherwise apply to such a plan or coverage, and sponsor or issuer, if not for the enactment of the Patient Protection and Affordable Care Act and title I and subtitle B of title II of the Health Care and Education Reconciliation Act of 2010.

Workers

An individual who is a participant in a group health plan, who is an alien residing outside the United States, a national of the United States, lawful permanent resident, or nonimmigrant for whom there is a good faith expectation by the plan sponsor of the plan that, in connection with the individual’s employment, the individual is abroad for a total of not less than 180 days during any period of 12 consecutive months.

Other individuals abroad

An individual, such as a student or religious missionary, who is abroad, and who is a member of a group determined appropriate by the Secretary of Health and Human Services, in consultation with the Secretary of the Treasury and the Secretary of Labor.

Substantially all of the primary enrollees in the plan are not qualified expatriates, with respect to such plan.

Substantially all of the benefits provided under the plan are not excepted benefits described in section 9832(c) of the Internal Revenue Code of 1986.

The application of section 36B(c)(2)(C)(ii) of such Code to such plan would not prevent an employee eligible for coverage under such plan from being treated as eligible for minimum essential coverage for purposes of section 36B(c)(2)(B) of such Code.

United States Nationals

Foreign citizens

For purposes of applying paragraph (3) to an individual who is not a national of the United States, the term abroad means outside of the country of which that individual is a citizen.

Group health plan; health insurance coverage; health insurance issuer; plan sponsor

The terms group health plan, health insurance coverage, health insurance issuer, and plan sponsor have the meanings given those terms in section 2791 of the Public Health Service Act (42 U.S.C. 300gg–91), except that in applying such terms under this section the term health insurance issuer includes a foreign corporation which is predominantly engaged in an insurance business and which would be subject to tax under subchapter L of chapter 1 of the Internal Revenue Code of 1986 if it were a domestic corporation.

Foreign state; national of the United States; nonimmigrant; reside; lawful permanent resident

The terms national of the United States, and nonimmigrant have the meaning given such terms in section 101(a) of the Immigration and Nationality Act (8 U.S.C. 1101(a)), the term reside means having a residence (within the meaning of such term in such section), and the term lawful permanent resident means an alien lawfully admitted for permanent residence (as defined in such section).