Title VI, SEC. 6004. ALLIANCE INITIAL BIDDING AND NEGOTIATION PROCESS. 
      (a) Bidding Process. 

        (1) Obtaining bids. 

          (A) In general. Not later than July 1 before the first year, and not 
        later than August 1 of each succeeding year, the regional alliance 
        shall have obtained premium bids from each plan seeking to participate 
        as a regional alliance health plan with respect to the alliance in the 
        following year. 

          (B) Disclosure. In obtaining such bids, a regional alliance may 
        determine to disclose (or not to disclose) the regional alliance per 
        capita premium target for the regional alliance (determined under 
        section 6003) for the year involved. 

          (C) Condition. Each bid submitted by a plan under this subsection 
        shall be conditioned upon the plan's agreement to accept any premium 
        payment reduction that may be imposed under section 6011. 

        (2) Negotiation process. Following the bidding process under paragraph 
      (1), a State may provide for negotiations with health plans relating to 
      the premiums to be charged by such plans. Such negotiations may result in 
      the resubmission of bids, but in no case shall a health plan resubmit a 
      bid that exceeds its prior bid. 

        (3) Legally binding bids. All bids submitted under this subsection must 
      be legally binding with respect to the plans involved. 

        (4) Acceptance. The final bid submitted by a plan under this subsection 
      shall be considered to be the accepted bid, except as provided in 
      subsection (e). 

        (5) Assistance. The Board shall provide regional alliances with such 
      information and technical assistance as may assist such alliances in the 
      bidding process under this subsection. 

      (b) Submission of Information to Board. By not later than September 1 of 
    each year for which bids are obtained under subsection (a), each regional 
    alliance shall submit to the Board a report that discloses 

        (1) information regarding the final bids obtained under subsection (a) 
      by the different plans; 

        (2)(A) for the first year, any information the Board may request 
      concerning an estimation of the enrollment likely in each such plan of 
      alliance eligible individuals who will be offered enrollment in a health 
      plan by alliance in the first year, or 

          (B) for a succeeding year, the actual distribution of enrollment of 
        alliance eligible individuals in regional alliance health plans in the 
        year in which the report is transmitted; and 

        (3) limitations on capacity of regional alliance health plans. 

      (c) Computation of Weighted Average Accepted Bid. 

        (1) In general. For each regional alliance the Board shall determine a 
      weighted average accepted bid for each year for which bids are obtained 
      under subsection (a). Such determination shall be based on information on 
      accepted bids for the year, submitted under subsection (b)(1), and shall 
      take into account, subject to paragraph (2), the information on 
      enrollment distribution submitted under subsection (b)(2). 

        (2) Enrollment distribution rules. In making the determination under 
      paragraph (1) for a regional alliance, the Board shall establish rules 
      respecting the treatment of enrollment in plans that are discontinued or 
      are newly offered. 

      (d) Notice to Certain Alliances. 

        (1) In general. By not later than October 1 of each year for which bids 
      are obtained, the Board shall notify a regional alliance 

          (A) if the weighted average accepted bid (determined under subsection 
        (c)) for the alliance is greater than the regional alliance per capita 
        premium target for the alliance (determined under section 6002) for the 
        year, and 

          (B) the reduced weighted average accepted bid for the alliance. 

        (2) Notice of premium reductions. If notice is provided to a regional 
      alliance under paragraph (1), the Board shall notify the regional 
      alliance and each noncomplying plan of any plan payment reduction 
      computed under section 6011 for such a plan and the opportunity to 
      voluntarily reduce the accepted bid under subsection (e) in order to 
      avoid such a reduction. 

      (e) Voluntary Reduction of Accepted Bid (Final Accepted Bid). After the 
    Board has determined under subsection (c) the weighted average accepted bid 
    for a regional alliance and the Board has determined preliminary plan 
    payment reductions, before such date as the Board may specify (in order to 
    provide for an open enrollment period), a noncomplying plan has the 
    opportunity to voluntarily reduce its accepted bid by the amount of the 
    plan payment reduction that would otherwise apply to the plan. Such 
    reduction shall not affect the amount of the plan payment reduction for any 
    other plan for that year.