Title I, SEC. 1343. DETERMINATION OF FAMILY SHARE FOR FAMILIES. 
      (a) Amount of Family Share. The amount charged by a regional alliance to 
    a family for a class of family enrollment (specified under section 1011(c)) 
    under a regional alliance health plan is equal to the family share of 
    premium established under section 6101(a) for the family. Based upon the 
    information described in this section, each regional alliance shall 
    determine the amount required to be paid under section 6101 and under 
    section 6111 for each year for families enrolling in regional alliance 
    health plans. 

      (b) Family Share Amount. The amount required to be paid under section 
    6101, with respect to each family, takes into account 

        (1) the general family share of premium (as defined in section 
      1342(b)(1)(B)) for the class of enrollment involved; 

        (2) any income-related discount provided under section 6104(a)(1) for 
      the family; and 

        (3) whether or not the family is an SSI or AFDC family. 

      (c) Alliance Credit Amount. The amount of the alliance credit under 
    section 6111, with respect to each family, takes into account the 
    following: 

        (1) The number of months of enrollment, and class of enrollment, in 
      regional alliance health plans, used in determining the amount of the 
      alliance credit under section 6103 for the family. 

        (2) Reductions in liability under section 6111(b) based on employer 
      premium payments based on net earnings from self-employment for the 
      family. 

        (3) Reductions in liability under section 6112 based on months of 
      employment for the family. 

        (4) Limitations in liability under section 6113 on the basis of the 
      adjusted family income for the family. 

        (5) The elimination of liability in the case of certain retirees and 
      qualified spouses and children under section 6114. 

        (6) The elimination of liability in the case of certain working 
      medicare beneficiaries under section 6115. 

      (d) Access to Necessary Information to Make Determination. Information 
    required for an alliance to make the determination under subsection (a) 
    shall be based on information obtained or maintained by the alliance in the 
    conduct of its business, including the following: 

        (1) Information required for income-related determinations shall be 
      obtained under subpart B. 

        (2) Information on SSI and AFDC recipients under subsection (e). 

        (3) Information submitted on a monthly and annual basis by employers 
      under section 1602. 

        (4) Information submitted by self-employed individuals on net earnings 
      from self-employment under section 1602(d). 

        (5) Applications for premium reductions under section 6114. 

        (6) Information concerning medicare-eligible individuals under 
      subsection (f). 

        (7) Any income-related discount provided under section 6104(a)(1) for 
      the family. 

        (8) Whether or not the family is an SSI or AFDC family. 

      (e) Information Concerning Cash Assistance Status. Each participating 
    State and the Secretary shall make available (in a time and manner 
    specified by the Secretary) to each regional alliance such information as 
    may be necessary to determine and verify whether an individual is an AFDC 
    or SSI recipient for a month in a year. 

      (f) Information Concerning Medicare-Eligible Individuals. 

        (1) Information to regional alliances. The Secretary shall make 
      available to regional alliances (through regional information centers or 
      otherwise) information necessary to determine 

          (A) whether an individual is a medicare-eligible individual, 

          (B) the eligibility of individuals for the special treatment under 
        section 6115, 

          (C) if medicare-eligible individuals are described in section 
        1012(a), and 

          (D) the amounts of payments owed the alliance under section 1895 of 
        the Social Security Act. 

        (2) Information to secretary. Each regional alliance shall make 
      available to the Secretary (through the national information system under 
      section 5101 or otherwise) information relating to the enrollment of 
      individuals who would be medicare-eligible individuals but for section 
      1012(a). 

      (g) Alliance Accounting System. 

        (1) In general. Each regional alliance shall establish an accounting 
      system that meets standards established by the Secretary. 

        (2) Specifics. Such system shall collect information, on a timely basis 
      for each individual enrolled (and, to the extent required by the 
      Secretary, identified and required to be enrolled) in a regional alliance 
      health plan regarding 

          (A) the applicable premium for such enrollment, 

          (B) family members covered under such enrollment, 

          (C) the premium payments made by (or on behalf of) the individual for 
        such enrollment, 

          (D) employer premium payments made respecting the employment of the 
        individual and other employer contributions made respecting such 
        enrollment, and 

          (E) any government contributions made with respect to such enrollment 
        (including contributions for electing veterans and active duty military 
        personnel). 

        (3) End-of-year reporting. Such system shall provide for a report, at 
      the end of each year, regarding the total premiums imposed, and total 
      amounts collected, for individuals enrolled under regional health 
      alliance plans, in such manner as identifies net amounts that may be owed 
      to the regional alliance.