Title I, SEC. 1523. IMPOSITION OF SURCHARGE ON PREMIUMS UNDER 
FEDERALLY-OPERATED SYSTEM. 
      (a) In General. If this subpart applies to a State for a calendar year, 
    the premiums charged under the regional alliance established and operated 
    by the Secretary in the State shall be equal to premiums that would 
    otherwise be charged under a regional alliance established and operated by 
    the State, increased by 15 percent. Such 15 percent increase shall be used 
    to reimburse the Secretary for any administrative or other expenses 
    incurred as a result of establishing and operating the system. 

      (b) Treatment of Surcharge as Part of Premium. For purposes of 
    determining the compliance of a State for which this subpart applies in a 
    year with the requirements for budgeting under subtitle A of title VI for 
    the year, the 15 percent increase described in subsection (a) shall be 
    treated as part of the premium for payment to a regional alliance.