1.This Act may be cited as the
Community Living Assistance Services
and Supports Act
or the CLASS Act
.
2.The purposes of this Act are as
follows:
(1)To provide
individuals with functional limitations with tools that will allow them to
maintain their personal and financial independence and live in the community
through a new financing strategy for community living assistance services and
supports.
(2)To establish an
infrastructure that will help address America's community living assistance
services and supports needs.
(3)To alleviate
burdens on family caregivers.
3.The table of contents
for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Purposes.
Sec. 3. Table of contents.
TITLE I—Community Living Assistance Services and
Supports
Sec. 101. Establishment of national voluntary insurance program
for purchasing community living assistance services and support.
TITLE II—Amendments to the Internal Revenue Code of
1986
Sec. 201. Above-the-line deduction for premium
costs.
Sec. 202. Credit for premium costs of CLASS enrollees with
low-income.
Sec. 203. Credit for costs of employers who elect to
automatically enroll employees and withhold class premiums from
wages.
Sec. 204. Long-term care insurance includible in cafeteria
plans.
TITLE III—Effective Date
Sec. 301. Effective date.
<enum>I</enum><header>Community Living
Assistance Services and Supports</header>
<section id="idCBC602EDF8A744FA831A1D3AC602EA85"><enum>101.</enum><header>Establishment
of national voluntary insurance program for purchasing community living
assistance services and support</header>
<subsection id="id1C328ACCC9EF4E4AA8952DA574669CF2"><enum>(a)</enum><header>Establishment
of program</header>
<paragraph id="id1502AC81026343CBBB66EA2651824D16"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">The Public Health
Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/401">42
U.S.C. 201</external-xref> et seq.) is amended by adding at the end the
following:</text>
<quoted-block display-inline="no-display-inline" id="id24DA535F8BEC4F44B7AB6D563141408E" style="OLC">
<title id="idB45F190936264C10A8AB5BE7864306C2"><enum>XXXI</enum><header>Community
Living Assistance Services and Supports</header>
<section id="id901C0C8AC8DF41E09C4E9840071D412E"><enum>3101.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text>
<paragraph commented="no" display-inline="no-display-inline" id="idE01417A56CE64FBEB0B05560008E8690"><enum>(1)</enum><header>Active
enrollee</header><text display-inline="yes-display-inline">The term
<term>active enrollee</term> means an individual who is enrolled in the CLASS
program in accordance with section 3102 and who has paid any premiums due to
maintain such enrollment in accordance with section 3103.</text>
</paragraph><paragraph id="idA1A6CDCE24A549A1839AE4417FE1D7F9"><enum>(2)</enum><header>Actively at
work</header><text>The term <term>actively at work</term> means an individual
who—</text>
<subparagraph id="id6B31C6201A574FBCA3F1443A3F9E49C3"><enum>(A)</enum><text>is reporting for
work at the individual's usual place of employment or at another location to
which the individual's employer requires the individual to travel (or in the
case of an individual who is a member of the uniformed services, is on active
duty and is physically able to perform the duties of the individual's
position);</text>
</subparagraph><subparagraph id="id2DE76B9D99714119B31B8E546976A719"><enum>(B)</enum><text>is able to
perform all the usual and customary duties of the individual's employment on
the individual's regular work schedule; and</text>
</subparagraph><subparagraph id="idD5D87D4F9DCF4FEC84A50C60C803E068"><enum>(C)</enum><text>is not absent
from work due to sickness, injury, annual leave, sick leave or any other
leave.</text>
</subparagraph></paragraph><paragraph id="id156D1A93C3E947F984348A506B753EDA"><enum>(3)</enum><header>Activities of
daily living</header><text display-inline="yes-display-inline">The term
<term>activities of daily living</term> means each of the following activities
specified in section 7702B(c)(2)(B) of the Internal Revenue Code of
1986:</text>
<subparagraph id="id41AF87E58FEB4E55B809FFEF69F5D51D"><enum>(A)</enum><text>Eating.</text>
</subparagraph><subparagraph id="id20464E0186894B55BE306B11B82E27F2"><enum>(B)</enum><text>Toileting.</text>
</subparagraph><subparagraph id="idF6F8B6E8EBFE4607B6A2AE16810DB160"><enum>(C)</enum><text>Transferring.</text>
</subparagraph><subparagraph id="id2216FA1760144E158D829FFA30C6AEB8"><enum>(D)</enum><text>Bathing.</text>
</subparagraph><subparagraph id="idA53CA35915A14985A3E9977DF43351C0"><enum>(E)</enum><text>Dressing.</text>
</subparagraph><subparagraph id="id12C136BE47FE43DF920098304F582F2F"><enum>(F)</enum><text>Continence.</text>
</subparagraph></paragraph><paragraph id="idBE4F2F19334346B29508FD7F1F4BFE86"><enum>(4)</enum><header>CLASS
program</header><text>The term <term>CLASS program</term> means the program
established under this title.</text>
</paragraph><paragraph id="idE0E83CF48DC247CC99BD8B8DBD247E45"><enum>(5)</enum><header>Disability
determination service</header><text>The term <term>Disability Determination
Service</term> means, with respect to each State, the entity that has an
agreement with the Commissioner of Social Security to make disability
determinations for purposes of title II or XVI of the Social Security Act (42
U.S.C. 401 et seq., 1381 et seq.).</text>
</paragraph><paragraph id="id67394753A9B444CD8CAC3C494256A3B7"><enum>(6)</enum><header>Eligible tier i
beneficiary</header>
<subparagraph id="id5E941774D9AB455B9F7F11C86EEDC202"><enum>(A)</enum><header>In
general</header><text>The term <term>eligible tier I beneficiary</term> means
any individual who is an active enrollee in the CLASS program and, as of the
date described in subparagraph (B)—</text>
<clause id="idF5A92AAF36F64BBC82F01900E95A5805"><enum>(i)</enum><text>has paid premiums
for enrollment in such program for at least 60 months; and</text>
</clause><clause id="idEF0197B79EBE4BA9AC5E47234A76B746"><enum>(ii)</enum><text>except as
provided in section 3103(e)(2), has paid premiums for enrollment in such
program for at least 12 consecutive months if a lapse in premium payments of
more than 3 months has occurred during the period that begins on the date of
the individual's enrollment and ends on the date of such determination.</text>
</clause></subparagraph><subparagraph id="idA50190D09DFC447E9189E57370F7C1D8"><enum>(B)</enum><header>Date
described</header><text>For purpose of subparagraph (A), the date described in
this subparagraph is the date on which the individual is determined—</text>
<clause id="id677D4343608B4B1F9D096BE6520D4CF6"><enum>(i)</enum><text>to be unable to
perform at least 2 activities of daily living or to require supervision,
cueing, or hands-on assistance to plan or perform at least 2 such activities;
or</text>
</clause><clause id="id7BAEC384723E4CA48E0B388AC0ACD9DA"><enum>(ii)</enum><text>due to a
cognitive or psychiatric impairment, to require supervision, cueing, or
hands-on assistance to engage in activities that will enable the individual to
perform at least 2 of the following critical life functions:</text>
<subclause id="id9E3D21573D96480182A592A7A422C7AA"><enum>(I)</enum><text>Communicating.</text>
</subclause><subclause id="idB2E793B94E724E40A91140D0694A45AB"><enum>(II)</enum><text>Taking
medications.</text>
</subclause><subclause id="id9A1E2A042A1B4E5F9838C856A125ED80"><enum>(III)</enum><text>Household
management.</text>
</subclause><subclause id="idF8AE0463F8994B818A12729E4A4FD1F8"><enum>(IV)</enum><text>Basic money
management.</text>
</subclause></clause></subparagraph></paragraph><paragraph id="id2C84336E4C09471E94650F6764F8A518"><enum>(7)</enum><header>Eligible tier
ii beneficiary</header><text>The term <term>eligible tier II beneficiary</term>
means any individual who is an eligible tier I beneficiary who has been
determined—</text>
<subparagraph id="id6FE3F12557EB421E8848A40D96EC9E7E"><enum>(A)</enum><text>to be unable to
perform at least 4 activities of daily living or to require supervision,
cueing, or hands-on assistance to plan or perform at least 4 such activities;
or</text>
</subparagraph><subparagraph id="idBDA9DEA9F2A348AF848496ECE8E1EF17"><enum>(B)</enum><text>due to a
cognitive or psychiatric impairment, to require supervision, cueing, or
hands-on assistance to engage in activities that will enable the individual to
perform at least 4 of the following critical life functions:</text>
<clause id="idC44FAF1E0EF5425A9AA153FBEEDD6E21"><enum>(i)</enum><text>Communicating.</text>
</clause><clause id="id6F2F2735108A46FDB9BC7F1803FD4273"><enum>(ii)</enum><text>Taking
medications.</text>
</clause><clause id="id41F7AF268D3D4BBC93AA1E1D6AB7880E"><enum>(iii)</enum><text>Household
management.</text>
</clause><clause id="id9CC96765D66F427BA49C4A60340B97A3"><enum>(iv)</enum><text>Basic money
management.</text>
</clause></subparagraph></paragraph><paragraph id="id2C51FBA399B542E3A62EC1F5B885E5DD"><enum>(8)</enum><header>Hospital;
nursing facility; intermediate care facility for the mentally retarded;
institution for mental diseases</header><text>The terms <term>hospital</term>,
<term>nursing facility</term>, <term>intermediate care facility for the
mentally retarded</term>, and <term>institution for mental diseases</term> have
the meanings given such terms for purposes of Medicaid.</text>
</paragraph><paragraph id="idC0948C8DDDF549289E204A3C11C69E8A"><enum>(9)</enum><header>Independence
fund</header><text>The term <term>Independence Fund</term> or <term>Fund</term>
means the fund established under section 3105.</text>
</paragraph><paragraph id="id07291E666BA6449CB98FCDB6382C8AE0"><enum>(10)</enum><header>Medicaid</header><text>The
term <term>Medicaid</term> means the program established under title XIX of the
Social Security Act (42 U.S.C. 1396 et seq.).</text>
</paragraph><paragraph id="id76D18A5270024704AE629F5A5849FECF"><enum>(11)</enum><header>Poverty
line</header><text>The term <term>poverty line</term> has the meaning given
that term in section 2110(c)(5) of the Social Security Act (42 U.S.C.
1397jj(c)(5)).</text>
</paragraph><paragraph id="idECCEDBD078404709988CDDB4765CBFEA"><enum>(12)</enum><header>Protection and
advocacy system</header><text>The term <term>Protection and Advocacy
System</term> means the system for each State established under section 143 of
the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42
U.S.C. 15043).</text>
</paragraph></section><section id="id16D6D799B10348B8B707421823B0B327"><enum>3102.</enum><header>Automatic
enrollment with opt-out election</header>
<subsection id="idF3D3AF4541E74025A5261C73EFF297CF"><enum>(a)</enum><header>Automatic
enrollment</header>
<paragraph id="id4354D7025E5D44ED86ADDA247D4517D8"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">Subject to paragraph
(2), the Secretary shall establish procedures under which each individual
described in subsection (c) shall be automatically enrolled in the CLASS
program by an employer of such individual in the same manner as an employer may
elect to automatically enroll employees in a plan under section 401(k), 403(b),
or 457 of the Internal Revenue Code of 1986.</text>
</paragraph><paragraph id="idB5215C7BB6C34868BAC020CF85EBE1AD"><enum>(2)</enum><header>Alternative
enrollment procedures</header><text>The procedures established under paragraph
(1) shall provide for an alternative enrollment process for an individual
described in subsection (c) in the case of such an individual—</text>
<subparagraph id="idB49C488044D74D5793ED7DDA2F8B5DF6"><enum>(A)</enum><text>who is
self-employed;</text>
</subparagraph><subparagraph id="idB0E83D6BA71D492CACF34C6AC3D5ADF2"><enum>(B)</enum><text>who has more than
1 employer;</text>
</subparagraph><subparagraph id="idD2F3120844E541919A2F883603999376"><enum>(C)</enum><text>whose employer
does not elect to participate in the automatic enrollment process established
by the Secretary; or</text>
</subparagraph><subparagraph id="idA11695A9BB534479BC3DF00872C959F4"><enum>(D)</enum><text>who is a spouse
described in paragraph (2) of such subsection who is not subject to automatic
enrollment.</text>
</subparagraph></paragraph><paragraph id="IDE236BD2D4928408AA55DBB47A75B10C3"><enum>(3)</enum><header>Administration</header>
<subparagraph id="id0BCCFE0C6F184FD7BA85A96E46F8969A"><enum>(A)</enum><header>In
general</header><text>The Secretary shall, by regulation, establish procedures
to—</text>
<clause id="idF9FE6F2BC94D45E68B1B889244DA3F62"><enum>(i)</enum><text>ensure that an
individual is not automatically enrolled in the CLASS program by more than 1
employer; and</text>
</clause><clause id="idD1D30D4161434E0A9FD900BD5AE81AB7"><enum>(ii)</enum><text>allow for an
individual's employer to deduct a premium for a spouse described in subsection
(c)(1)(B) who is not subject to automatic enrollment.</text>
</clause></subparagraph><subparagraph id="id10DBBA598A774DDA8F1980ED9240E210"><enum>(B)</enum><header>Form</header><text>Enrollment
in the CLASS program shall be made in such manner as the Secretary may
prescribe in order to ensure ease of administration.</text>
</subparagraph></paragraph></subsection><subsection id="idF408B0B4533543F2972BD275CFCE073C"><enum>(b)</enum><header>Election To
opt-out</header><text display-inline="yes-display-inline">An individual
described in subsection (c) may elect to waive enrollment under the CLASS
program at any time in such form and manner as the Secretary shall
prescribe.</text>
</subsection><subsection id="id2300D72C94174FD282C6E5A09B3D5985"><enum>(c)</enum><header>Individual
described</header><text display-inline="yes-display-inline">For purposes of
enrolling in the CLASS program, an individual described in this subsection
is—</text>
<paragraph id="id3EAC8AE43068451BA7BAF58B540B063D"><enum>(1)</enum><text display-inline="yes-display-inline">an individual—</text>
<subparagraph id="id2842B40CE12348E88FA22FD96CF94A75"><enum>(A)</enum><text>who has attained
age 18;</text>
</subparagraph><subparagraph id="id7CB665DD70BC40EA93F488CC60BD1BC5"><enum>(B)</enum><text display-inline="yes-display-inline">who—</text>
<clause id="IDD74ED11FD0584D06A8481FFDDA91CA26"><enum>(i)</enum><text>receives wages on
which there is imposed a tax under section 3101(a) of the Internal Revenue Code
of 1986; or</text>
</clause><clause id="ID23411BB97387401C00199D148D5662FA"><enum>(ii)</enum><text>derives
self-employment income on which there is imposed a tax under section 1401(a) of
the Internal Revenue Code of 1986;</text>
</clause></subparagraph><subparagraph id="id0386AA0340384CFFB0345C52F2D4B02A"><enum>(C)</enum><text>who is actively
at work; and</text>
</subparagraph><subparagraph id="idD0460ADBF9EE4A9DA555584F89167882"><enum>(D)</enum><text>who is
not—</text>
<clause id="idB995B1E48C2D41ACBEA189A1F1C3F43C"><enum>(i)</enum><text>a
patient in a hospital or nursing facility, an intermediate care facility for
the mentally retarded, or an institution for mental diseases and receiving
medical assistance under Medicaid; or</text>
</clause><clause id="id6B88B1AB7EED442BA9A827E9FCED2F6C"><enum>(ii)</enum><text>confined in a
jail, prison, other penal institution or correctional facility, or by court
order pursuant to conviction of a criminal offense or in connection with a
verdict or finding described in section 202(x)(1)(A)(ii) of the Social Security
Act (42 U.S.C. 402(x)(1)(A)(ii)); or</text>
</clause></subparagraph></paragraph><paragraph id="id9633AF4A987840B49BD083B6B44EB7BC"><enum>(2)</enum><text>the spouse of an
individual described in paragraph (1) and who would be an individual so
described but for subparagraph (B) or (C) of that paragraph.</text>
</paragraph></subsection><subsection id="id277DBCF6CE254C13BBAB4E09053E7FDA"><enum>(d)</enum><header>Rule of
construction</header><text>Nothing in this title shall be construed as
requiring an active enrollee to continue to satisfy subparagraph (B) or (C) of
subsection (c)(1) in order to maintain enrollment in the CLASS program.</text>
</subsection></section><section id="id4834CCBA376645E7B84E6891F3DA2B68"><enum>3103.</enum><header>Premiums</header>
<subsection id="id38896157F11A4781B5F94861F1C132E7"><enum>(a)</enum><header>Monthly
premiums</header><text>Except as provided in subsection (e), each individual
who is enrolled in the CLASS program shall pay the Secretary a monthly premium
to maintain enrollment in the program.</text>
</subsection><subsection id="idDFA6032398BF4A36A21F6E97572ED716"><enum>(b)</enum><header>Amount of
premium</header>
<paragraph id="id5043573EE34B4344BD98D047EA74DCE8"><enum>(1)</enum><header>$30 monthly
premium for enrollment in the first year of the program</header><text>Subject
to the succeeding provisions of this subsection, the monthly premium for
enrollment in the CLASS program of any individual who enrolls during the first
year in which the program is in effect under this title shall be $30 for every
such enrollee, regardless of their age at enrollment.</text>
</paragraph><paragraph id="id1ADA96D7672247C8AE7D845D42E54E2D"><enum>(2)</enum><header>Inflation
adjusted premium for enrollment in first year in which an individual is
eligible to enroll after first year of the program</header><text>The monthly
premium for enrollment in the CLASS program of any individual who enrolls
during the first year in which the individual is eligible to enroll in the
program but that occurs after the first year in which the program is in effect
under this title, shall be $30, increased with respect to each year that the
program is in effect under this title until the year of such enrollment, by the
percentage increase in the consumer price index for all urban consumers (U.S.
city average) over each such preceding year.</text>
</paragraph><paragraph id="id40305E2F77794D588A3DA118861DAEC6"><enum>(3)</enum><header>Age-adjusted
premiums for enrollment in other years</header>
<subparagraph id="id8D57ED087E8545D79550989B5AD12F83"><enum>(A)</enum><header>In
general</header><text>The Secretary shall determine for each year that is not a
year described in paragraph (1) or (2), an annual monthly premium for
enrollment in the CLASS program of an individual during the year that adjusts
the monthly premium that would apply to the individual under paragraph (2) if
the individual had enrolled during the first year in which the individual was
eligible to enroll in the program based on the following:</text>
<clause id="id18819E98AB0A457AAE273C85CAF82B95"><enum>(i)</enum><header>Age at
enrollment</header><text>Subject to paragraph (4), the age of an individual
upon the individual's initial enrollment in the program.</text>
</clause><clause id="idCF6A8CFEBCBD4D419B0286C52331952D"><enum>(ii)</enum><header>Administrative
expenses</header><text>The administrative expenses for the program.</text>
</clause></subparagraph><subparagraph id="idC957BA1678DB4EF4B6319D056FD70A2A"><enum>(B)</enum><header>Limitation on
administrative expenses</header>
<clause id="id260B501E094C4D81A5F8D076FC03182F"><enum>(i)</enum><header>Start-up
administrative expenses</header><text>The total amount of annual expenditures
incurred for administering the CLASS program during each of the first 5 years
in which the program is in effect under this title shall not exceed the sum of
an amount equal to 3 percent of all premiums paid during that year.</text>
</clause><clause id="idA2CC03EE426A482287CD49FBFED2DA75"><enum>(ii)</enum><header>Subsequent
administrative expenses</header><text>With respect to any year after the first
5 years in which the CLASS program is in effect under this title, the total
amount of annual expenditures incurred for administering the CLASS program
shall not exceed the lesser of an amount equal to—</text>
<subclause id="id338033E69A98441696A1A987E771B45E"><enum>(I)</enum><text>5 percent of the
total amount of all expenditures (including benefits paid) under this title
with respect to that year; or</text>
</subclause><subclause id="idD3F0B104A65D403C89EF58ED4E50B4B3"><enum>(II)</enum><text>the percentage
of expenditures incurred under the medicare program under title XVIII of the
Social Security Act (42 U.S.C. 1395 et seq.) for that year that is attributable
to administering that program.</text>
</subclause></clause></subparagraph></paragraph><paragraph id="idF49430FD73EB40AAA1D21F2B67D4EF90"><enum>(4)</enum><header>Nominal premium
for individual's with income that does not exceed 150 percent of the poverty
line</header>
<subparagraph id="id50154F49A95640A4AE7D84F47DC9AB27"><enum>(A)</enum><header>In
general</header><text>In the case of an individual whose income does not exceed
150 percent of the poverty line, the monthly premium for enrollment in the
CLASS program shall be the applicable amount under subparagraph (B).</text>
</subparagraph><subparagraph id="idD546A2846D6A42C987AFA29243A894B1"><enum>(B)</enum><header>Applicable
amount</header><text>The Secretary shall establish premium amounts which shall
apply to an individual described in subparagraph (A) in lieu of the premium
amount which would otherwise apply to the individual under paragraph (1), (2),
or (3) (whichever is applicable). Such amounts shall be nominal and, in the
case of an individual who, but for this paragraph, would be subject to the
premium imposed under paragraph (3), may be adjusted in accordance with the
factors described in that paragraph.</text>
</subparagraph><subparagraph id="idBB69F649122643DB8BEF7D94078C8D0C"><enum>(C)</enum><header>Self-attestation
and verification of income</header><text>The Secretary shall establish
procedures to—</text>
<clause id="id5A942ABB680246CE9677162937BE358A"><enum>(i)</enum><text>permit an
individual, as part of their automatic enrollment in the CLASS program, to
self-attest that their income does not exceed 150 percent of the poverty line;
and</text>
</clause><clause id="idA07740DF5B854F23A91562821A2AFA56"><enum>(ii)</enum><text>verify the
validity of such self-attestation.</text>
</clause></subparagraph></paragraph><paragraph id="id69AD6F3EDA554930BF4DC11AD076B77E"><enum>(5)</enum><header>Adjustment of
premiums</header>
<subparagraph id="idBA0270CAC7274A84884E07ED495BBD3D"><enum>(A)</enum><header>In
general</header><text>Except as provided in subparagraphs (C) and (D), the
amount of the monthly premium determined for an individual upon such
individual's enrollment in the CLASS program shall remain the same for as long
as the individual is an active enrollee in the program.</text>
</subparagraph><subparagraph id="idAB8BC847D9804CE8B240A739788098DA"><enum>(B)</enum><header>Program
solvency projections</header><text>Beginning with 2012 and every year
thereafter, the Secretary shall determine with respect to the 20-year period
that begins with that year, the amount of funds held (or projected to be held)
in the Independence Fund established under section 3105 that are required to
pay tier I and tier II benefits under section 3104 during each year of that
period.</text>
</subparagraph><subparagraph id="id745D7C502349426CBC26C8AF32DFBBA1"><enum>(C)</enum><header>Recalculated
premium if required for program solvency</header>
<clause id="id3C065FDA3A4B479A892821BC4D5DF352"><enum>(i)</enum><header>In
general</header><text>Subject to clauses (ii) and (iii), beginning with 2017
and every year thereafter, if the Secretary determines as a result of making
the program solvency projections required under subparagraph (B) that, with
respect to the 20-year period that begins with that year, more than 40 percent
of the amount of funds held (or projected to be held) in the Independence Fund
established under section 3105 are required to pay tier I and tier II benefits
under section 3104 during each year of that period, the Secretary shall adjust
the monthly premiums for individuals enrolled in the CLASS program.</text>
</clause><clause id="id0247AB40011747D388A2545F051A3882"><enum>(ii)</enum><header>Requirements</header><text>In
adjusting monthly premiums under clause (i), the Secretary shall increase the
premiums by such an amount as will ensure that—</text>
<subclause id="id955B668045C54415A4C691C1A3D21CB8"><enum>(I)</enum><text>the aggregate
amount of such premiums collected will result in not more than 20 percent of
the amounts held in the Independence Fund being required to pay tier I and tier
II benefits for any one year occurring during the applicable 20-year
period;</text>
</subclause><subclause id="id7A43C79B658E402FA8E9FBC4D5CC1EDB"><enum>(II)</enum><text>with respect to
any individual enrolled in the program—</text>
<item id="idDEDEC04917E3455EA3DA9089247DAA73"><enum>(aa)</enum><text>the amount of
the increase in the individual's monthly premium does not exceed the amount
equal to 50 percent of the premium prior to such increase; and</text>
</item><item id="idC0790B08A15547EFAC287D0CC8134EC0"><enum>(bb)</enum><text>the individual's
monthly premium does not exceed the amount equal to 200 percent of the initial
premium amount paid by the individual during their first year of enrollment in
the program; and</text>
</item></subclause><subclause id="id1F0B5C922B704DD9AC82728BC5919109"><enum>(III)</enum><text>the
requirements of clause (iii) are met.</text>
</subclause><continuation-text continuation-text-level="clause">The Secretary
shall immediately notify Congress if the Secretary determines that the
requirements of this clause cannot be satisfied and shall include in such
notification recommendations for such legislative action as the Secretary
determines to be appropriate.</continuation-text></clause><clause id="idB49548213822414DA94355BE0E2B184C"><enum>(iii)</enum><header>Exemption
from increase</header><text>Any increase in a monthly premium imposed as result
of a determination described in clause (i) shall not apply with respect to the
monthly premium of any active enrollee who—</text>
<subclause id="idDFD68AC987F54F9988C730E9E5C7AC13"><enum>(I)</enum><text>has attained age
65;</text>
</subclause><subclause id="id522CE5B4026B449BB8881B4A547F45C7"><enum>(II)</enum><text>has paid
premiums for enrollment in the program for at least 20 years; and</text>
</subclause><subclause id="id1698ACD13BBA421FBA629C16FEBC301D"><enum>(III)</enum><text>is not actively
at work.</text>
</subclause></clause></subparagraph><subparagraph id="idABEBDDDE81F04066BCFF0CF036F8BEE8"><enum>(D)</enum><header>Recalculated
premium if reenrollment after more than a 3-month lapse</header>
<clause id="idB57C0533D7B34E35B00FAB92BF0627A7"><enum>(i)</enum><header>In
general</header><text>Except as provided in subsection (e)(2), the reenrollment
of an individual after a 90-day period during which the individual failed to
pay the monthly premium required to maintain the individual's enrollment in the
CLASS program shall be treated as an initial enrollment for purposes of
age-adjusting the premium for enrollment in the program.</text>
</clause><clause id="id1D197C0184C544E18E04A8B8F9230C4B"><enum>(ii)</enum><header>Credit for
prior months</header><text>An individual who reenrolls in the CLASS program
after such a 90-day period shall be—</text>
<subclause id="id2B3D1B3C9C934DC6983214B82C8354BF"><enum>(I)</enum><text>credited with any
months of paid premiums that accrued prior to the individual's lapse in
enrollment; and</text>
</subclause><subclause id="id8FB18BB83E904D6B9259CCF92F64BD5B"><enum>(II)</enum><text>notwithstanding
the total amount of any such credited months, required to satisfy section
3101(6)(B)(ii) before being eligible to receive a tier I or tier II
benefit.</text>
</subclause></clause></subparagraph></paragraph><paragraph id="id8A253419B6764AA1981D3FF8858AE06B"><enum>(6)</enum><header>No underwriting
requirements</header><text>No underwriting shall be used to—</text>
<subparagraph id="id2831FC141D0F414987CBE339EC291F0F"><enum>(A)</enum><text>determine the
monthly premium for enrollment in the CLASS program; or</text>
</subparagraph><subparagraph id="id8D306DEBA4C84E77BEF4D65B55FAF9B8"><enum>(B)</enum><text>prevent an
individual from enrolling in the program.</text>
</subparagraph></paragraph></subsection><subsection id="id622D17BC5DCB4CFFA6F7C0E18AC4157D"><enum>(c)</enum><header>Payment</header>
<paragraph id="idE912B1A9101A42BF93854DD2F893BFA3"><enum>(1)</enum><header>Payroll
deduction</header><text>An amount equal to the monthly premium for the
enrollment in the CLASS program of an individual shall be deducted from the
wages or self-employment income of such individual in accordance with such
procedures as the Secretary, in consultation with the Secretary of the
Treasury, shall establish for employers who elect to deduct and withhold such
premiums on behalf of enrolled employees.</text>
</paragraph><paragraph id="id1D2187E455664D4BB156E8C7C3082394"><enum>(2)</enum><header>Alternative
payment mechanism</header><text>The Secretary shall establish alternative
procedures for the payment of monthly premiums by an individual enrolled in the
CLASS program—</text>
<subparagraph id="id84D5A9836C044C8F953101DE6D7F8A2B"><enum>(A)</enum><text>who does not have
an employer who elects to deduct and withhold premiums in accordance with
paragraph (1); or</text>
</subparagraph><subparagraph id="id5F9DE9F12E604FE4B1058DEA9EE3FC5B"><enum>(B)</enum><text>who does not earn
wages or derive self-employment income.</text>
</subparagraph></paragraph></subsection><subsection id="id07C8DC5828CD4B6AABFA7B3CEEA323F2"><enum>(d)</enum><header>Transfer of
premiums collected</header>
<paragraph commented="no" display-inline="no-display-inline" id="IDE783C069A16F4840B5D3B687C9CBA832"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">During each calendar
year the Secretary of the Treasury shall deposit into the Independence Fund a
total amount equal, in the aggregate, to 100 percent of the premiums collected
during that year.</text>
</paragraph><paragraph commented="no" display-inline="no-display-inline" id="IDBE39245514A54C71871DAA0ED4D364A3"><enum>(2)</enum><header>Transfers based
on estimates</header><text display-inline="yes-display-inline">The amount
deposited pursuant to paragraph (1) shall be transferred in at least monthly
payments to the Independence Fund on the basis of estimates by the Secretary
and certified to the Secretary of the Treasury of the amounts collected in
accordance with paragraphs (1) and (2) of subsection (c). Proper adjustments
shall be made in amounts subsequently transferred to the Fund to the extent
prior estimates were in excess of, or were less than, actual amounts
collected.</text>
</paragraph></subsection><subsection id="id19963CBCF6A8481AA71D3F0CA7C5FA95"><enum>(e)</enum><header>Contribution
period</header>
<paragraph id="id311BDA594CA74E0B9E47DFA2983B893F"><enum>(1)</enum><header>In
general</header><text>An individual shall not be required to pay a monthly
premium to maintain the individual's enrollment in the CLASS program during the
following periods:</text>
<subparagraph id="idF88FC448A2EE48278601974086D0E5FD"><enum>(A)</enum><header>Receiving
benefits while unemployed</header><text>Any period during which the individual
is—</text>
<clause id="id0FAAEB346FCD42ECACECE82B66DB4979"><enum>(i)</enum><text>receiving tier I
or tier II benefits; and</text>
</clause><clause id="id0604E57FBE0C4495B2E08A9DABA6D9C6"><enum>(ii)</enum><text>the individual
does not have wages or income derived from self-employment.</text>
</clause></subparagraph><subparagraph id="idB111C6D1F0C64B7BA4F31400C15B5186"><enum>(B)</enum><header>Full-time
student who is actively at work</header><text>Any period during which the
individual is a full-time student (as determined by the Secretary) who has not
attained age 22 and is actively at work.</text>
</subparagraph></paragraph><paragraph id="idFDAC4E1E91FA47B5BEA0660767E4F6BF"><enum>(2)</enum><header>Application of
premium amount prior to start of period</header><text>Upon the conclusion of a
period described in paragraph (1) for an individual, the individual shall
resume paying the monthly premium amount that applied to the individual
immediately prior to the start of such period in order to maintain enrollment
in the program.</text>
</paragraph></subsection></section><section id="idB95CA439FEFA48CDA8723C1E5A71D11A"><enum>3104.</enum><header>Benefits</header>
<subsection id="id7BA7D26599874F1490AA8234E485D023"><enum>(a)</enum><header>Determination
of eligibility</header>
<paragraph id="id358AA4218AC047698907A3C77628C9F0"><enum>(1)</enum><header>Application for
receipt of benefits</header><text>The Secretary shall establish procedures
under which an active enrollee shall apply for receipt of tier I or tier II
benefits.</text>
</paragraph><paragraph id="id3F3B9D0E526140698A8E26945C75DF56"><enum>(2)</enum><header>Eligibility
assessments</header>
<subparagraph id="idDB61A1FEDBB844F5BF00CC142F2CA969"><enum>(A)</enum><header>In
general</header><text>Not later than October 1, 2012, the Secretary shall enter
into agreements with—</text>
<clause id="id82056F300A8E4529BAE40986C4118464"><enum>(i)</enum><text>the Disability
Determination Service for each State to provide for eligibility assessments of
active enrollees who apply for receipt of benefits;</text>
</clause><clause id="id7CAB54C3F3394F139C6C1AE927A69ACF"><enum>(ii)</enum><text>the Protection
and Advocacy System for each State to provide advocacy services in accordance
with subsection (e); and</text>
</clause><clause id="id68D2587F5E2F40BCA85430168DAD98B2"><enum>(iii)</enum><text>public and
private entities to provide advice and assistance counseling in accordance with
subsection (f).</text>
</clause></subparagraph><subparagraph id="id0108C81DE0474E3BA5A12A0E804141D7"><enum>(B)</enum><header>30-day period
for approval or disapproval</header><text>An agreement under subparagraph (A)
shall require that a Disability Determination Service determine within 30 days
of the receipt of an application for benefits under the CLASS program whether
an applicant is an eligible tier I beneficiary or an eligible tier II
beneficiary. An application that is pending after 45 days shall be deemed
approved.</text>
</subparagraph><subparagraph id="id921F61E199084157924858674948071B"><enum>(C)</enum><header>Presumptive
eligibility for certain institutionalized enrollees planning to
discharge</header><text>An active enrollee shall be deemed presumptively
eligible if the enrollee—</text>
<clause id="id5B732EF0A7754A418386E275D3CB6819"><enum>(i)</enum><text>has applied for
receipt of tier II benefits;</text>
</clause><clause id="id3EFC98CBE96F4869A7CFD9E87B1B82C8"><enum>(ii)</enum><text>is a patient in
a hospital, nursing facility, intermediate care facility for the mentally
retarded, or an institution for mental diseases; and</text>
</clause><clause id="id41CF1E5F8EC04D47ADCF1E0FF55F497D"><enum>(iii)</enum><text>is in the
process of, or about to begin the process of, planning to discharge from the
hospital, facility, or institution.</text>
</clause></subparagraph><subparagraph id="id051128D0ECBB4581920E3BA7F8F03418"><enum>(D)</enum><header>Appeals</header><text>The
Secretary shall establish procedures under which an applicant for benefits
under the CLASS program shall be guaranteed the right to appeal an adverse
determination.</text>
</subparagraph></paragraph></subsection><subsection id="id6427F9020DC44EF2B3269E922D7A35C2"><enum>(b)</enum><header>Tier I
benefits</header><text>An eligible tier I beneficiary shall receive the
following tier I benefits:</text>
<paragraph id="idE44BEF1907D948E7B7D9916A913464B4"><enum>(1)</enum><header>Daily cash
benefit</header><text>A daily cash benefit in the amount of $50 per day.</text>
</paragraph><paragraph id="id39036717D22D445D861DC35948BFBD1A"><enum>(2)</enum><header>Annual
benefit</header><text>An annual benefit in an amount not to exceed the amount
equal to the daily benefit applicable under paragraph (1) (after the
application of subsection (g)) multiplied by 365.</text>
</paragraph><paragraph id="idBB12851F59D24205BD1B4A999A7B9764"><enum>(3)</enum><header>Advocacy
services</header><text>Advocacy services in accordance with subsection
(e).</text>
</paragraph><paragraph id="idAE97F4F5EB204136AE4803BCE386A452"><enum>(4)</enum><header>Advice and
assistance counseling</header><text>Advice and assistance counseling in
accordance with subsection (f).</text>
</paragraph><paragraph id="idCA54391745F546459428B893D2EA7580"><enum>(5)</enum><header>No lifetime
limit</header><text>There shall be no lifetime limit on the aggregate tier I
benefits that an eligible tier I beneficiary may receive.</text>
</paragraph></subsection><subsection id="id672C84FC95954BD38E35E955C0FD8A43"><enum>(c)</enum><header>Tier II
benefits</header><text>An eligible tier II beneficiary shall receive the
following tier II benefits:</text>
<paragraph id="id2A7A05635B114C48831B38E55AA9DCA5"><enum>(1)</enum><header>Daily cash
benefit</header><text>A daily cash benefit in the amount of $100 per
day.</text>
</paragraph><paragraph id="id15B6A58B594A4C7090D1A5C8F010E421"><enum>(2)</enum><header>Annual
benefit</header><text>An annual benefit in an amount not to exceed the amount
equal to the daily benefit applicable under paragraph (1) (after the
application of subsection (g)) multiplied by 365.</text>
</paragraph><paragraph id="idDE88F03F100144308656404D2AC5426E"><enum>(3)</enum><header>Advocacy
services</header><text>Advocacy services in accordance with subsection
(e).</text>
</paragraph><paragraph id="id12E4C039754C4FC9A4E9D6FF6EECD33D"><enum>(4)</enum><header>Advice and
assistance counseling</header><text>Advice and assistance counseling in
accordance with subsection (f).</text>
</paragraph><paragraph id="id440B113467704536B16341CC8353F0E9"><enum>(5)</enum><header>No lifetime
limit</header><text>There shall be no lifetime limit on the aggregate tier II
benefits that an eligible tier II beneficiary may receive.</text>
</paragraph></subsection><subsection id="idEBF3B1582B1E44229A2120DEF2FE8DC9"><enum>(d)</enum><header>Payment of
benefits</header>
<paragraph id="id58CB9DE8975E46CA829B74F00936162D"><enum>(1)</enum><header>Life
independence accounts</header>
<subparagraph id="id2735CDD6C2BA48A697BC1374B4529CE2"><enum>(A)</enum><header>In
general</header><text>The Secretary shall establish procedures under which tier
I daily cash benefits and tier II daily cash benefits shall be paid on a
monthly basis into a Life Independence Account established by the Secretary on
behalf of each eligible tier I beneficiary or eligible tier II
beneficiary.</text>
</subparagraph><subparagraph id="idE3F2A10F424E494D8056518A75F8A4B8"><enum>(B)</enum><header>Use of cash
benefits</header><text>Daily cash benefits paid into a Life Independence
Account of an eligible tier I beneficiary or an eligible tier II beneficiary
shall be used to purchase nonmedical services and supports that the beneficiary
needs to maintain his or her independence at home or in another residential
setting of their choice in the community, such as home modifications, assistive
technology, accessible transportation, homemaker services, respite care,
personal assistance services, and home care aides.</text>
</subparagraph><subparagraph id="id0CE27AEA736642A2A11A15BAC14CF051"><enum>(C)</enum><header>Electronic
management of funds</header><text>The procedures established in accordance with
subparagraph (A) shall provide for—</text>
<clause id="id1BF56EFBFC9947ACAD6E9532FB8333EF"><enum>(i)</enum><text>crediting an
account established on behalf of a beneficiary with the beneficiary's cash
daily benefit;</text>
</clause><clause id="id49F37A1C9B6745C4B11BA27E77E0AE81"><enum>(ii)</enum><text>accessing such
account through debit cards; and</text>
</clause><clause id="id35B13EBF0BE44E21AB078C5DD6557D8E"><enum>(iii)</enum><text>accounting for
withdrawals by the beneficiary from such account.</text>
</clause></subparagraph><subparagraph id="idDA92FA91540645779B10C78A0646F1E0"><enum>(D)</enum><header>Primary payor
rules for beneficiaries who are enrolled in medicaid</header><text>In the case
of an eligible tier I beneficiary or an eligible tier II beneficiary who is
enrolled in Medicaid, the following payment rules shall apply:</text>
<clause id="idE0FF2B49C1C543F0B2FC391376DFA010"><enum>(i)</enum><header>Institutionalized
beneficiary</header><text>If the beneficiary is a patient in a hospital,
nursing facility, intermediate care facility for the mentally retarded, or an
institution for mental diseases, the beneficiary shall retain an amount equal
to 5 percent of the beneficiary's daily cash benefit (which shall be in
addition to the amount of the beneficiary's personal needs allowance provided
under Medicaid), and the remainder of such benefit shall be applied toward the
facility's cost of providing the beneficiary's care, and Medicaid shall provide
secondary coverage for such care.</text>
</clause><clause id="id7C672C5C9BA544E4B13D3ADCB452886E"><enum>(ii)</enum><header>Beneficiaries
receiving home and community-based services</header>
<subclause id="id1CDF0FD8D2F04C1B9BE8CB51683558D2"><enum>(I)</enum><header>50 percent of
daily benefit retained by beneficiary</header><text>If a beneficiary is
receiving medical assistance under Medicaid for home and community-based
services, the beneficiary shall retain an amount equal to 50 percent of the
beneficiary's daily cash benefit, subject to subclause (II), and the remainder
of the daily cash benefit shall be applied toward the cost to the State of
providing such assistance (and shall not be used to claim Federal matching
funds under Medicaid), and Medicaid shall provide secondary coverage for the
remainder of any costs incurred in providing such assistance.</text>
</subclause><subclause id="id4F33C8B9850B425FB08B65D2C92DB1B0"><enum>(II)</enum><header>Requirement
for state offset</header><text>A State shall be paid the remainder of a
beneficiary's daily cash benefit under subclause (I) only if the State home and
community-based waiver under section 1115 of the Social Security Act (42 U.S.C.
1315) or subsection (c) or (d) of section 1915 of such Act (42 U.S.C. 1396n)
does not include a waiver of the requirements of section 1902(a)(1) of the
Social Security Act (relating to statewideness) or of section 1902(a)(10)(B) of
such Act (relating to comparability) and the State offers at a minimum case
management services, personal care services, habilitation services, and respite
care under such a waiver.</text>
</subclause><subclause id="idE257F4968A9149CE867E407590A23FE2"><enum>(III)</enum><header>Definition of
home and community-based services</header><text>In this clause, the term
<term>home and community-based services</term> means any services which may be
offered under a home and community-based waiver authorized for a State under
section 1115 of the Social Security Act (42 U.S.C. 1315) or subsection (c) or
(d) of section 1915 of such Act (42 U.S.C. 1396n).</text>
</subclause></clause></subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id96E85E02906E40888FA69B314241799C"><enum>(2)</enum><header>Authorized
representatives</header>
<subparagraph commented="no" display-inline="no-display-inline" id="id3E361F66DB8F43B18969CF274E2DDAF5"><enum>(A)</enum><header>In
general</header><text>The procedures established under paragraph (1)(A) shall
allow for access to tier I daily benefits or tier II daily benefits by an
authorized representative of the eligible tier I beneficiary or eligible tier
II beneficiary on whose behalf such benefits are paid.</text>
</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id9C784ABCECDE40E8AFF7417FC79AF462"><enum>(B)</enum><header>Quality
assurance and protection against fraud and abuse</header><text>The Secretary
shall include in the procedures established under paragraph (1) standards of
conduct for authorized representatives of eligible tier I beneficiaries and
eligible tier II beneficiaries to ensure that authorized representatives
provide quality services on behalf of such beneficiaries, do not have conflicts
of interest, and do not misuse benefits paid on behalf of such beneficiaries or
otherwise engage in fraud or abuse.</text>
</subparagraph></paragraph><paragraph id="id8EF56CAF7BF64035B546995DF2119369"><enum>(3)</enum><header>Commencement of
benefits</header><text>Tier I benefits or tier II benefits, as applicable,
shall be paid to, or on behalf of, an eligible tier I beneficiary or an
eligible tier II beneficiary, respectively, beginning with the first month in
which an application for such benefits is approved.</text>
</paragraph><paragraph id="idB9487882429F499C96DB1AC046FAE87E"><enum>(4)</enum><header>Rollover option
for lump-sum payment</header><text>An eligible tier I beneficiary or an
eligible tier II beneficiary may elect to—</text>
<subparagraph id="idAB5CB24F823A4A81955E2090014FFDBC"><enum>(A)</enum><text>defer payment of
their daily benefit and to rollover any such deferred benefits from
month-to-month, but not from year-to-year; and</text>
</subparagraph><subparagraph id="idAA4FA378870A46DFB563F7F8953AAA1F"><enum>(B)</enum><text>receive a
lump-sum payment of such deferred benefits in an amount that may not exceed the
lesser of—</text>
<clause id="id9830B0E7CCDF4FAD8EDF1A6B2DCCBC1A"><enum>(i)</enum><text>the total amount
of the accrued deferred benefits; or</text>
</clause><clause id="idC6C602CD372348CAB703586DF73C883C"><enum>(ii)</enum><text>the applicable
annual benefit.</text>
</clause></subparagraph></paragraph><paragraph id="idF8EAEEC86E514C5F9893F59B95AB669E"><enum>(5)</enum><header>Period for
determination of annual benefits</header>
<subparagraph id="id226F320D2C414769A4C1C37A1E018331"><enum>(A)</enum><header>In
general</header><text>The applicable period for determining with respect to an
eligible tier I beneficiary or an eligible tier II beneficiary the applicable
annual benefit and the amount of any accrued deferred benefits is the 12-month
period that commences with the first month in which the beneficiary began to
receive such benefits, and each 12-month period thereafter.</text>
</subparagraph><subparagraph id="id0ED53785FB5A49A3BDF76311A31C62F0"><enum>(B)</enum><header>Inclusion of
tier i benefits</header><text>The Secretary shall establish procedures under
which benefits paid to an eligible tier I beneficiary who becomes an eligible
tier II beneficiary before the end of a 12-month benefit period shall be
included in the determination of the applicable annual benefit paid to the
eligible tier II beneficiary.</text>
</subparagraph><subparagraph id="idA13F5AB91C0D400DA5C16115AB6BAF99"><enum>(C)</enum><header>Recoupment of
unpaid, accrued benefits</header>
<clause id="id2E060D3544244BDE988FC0A08A19AD3A"><enum>(i)</enum><header>In
general</header><text>The Secretary shall recoup any accrued benefits in the
event of—</text>
<subclause id="idAD3096F020B94369BDFEEC82570D8052"><enum>(I)</enum><text>the death of a
beneficiary; or</text>
</subclause><subclause id="idEA9020A40DA34FC99F8044D61790914E"><enum>(II)</enum><text>the failure of a
beneficiary to elect under paragraph (4)(B) to receive such benefits as a
lump-sum payment before the end of the 12-month period in which such benefits
accrued.</text>
</subclause></clause><clause id="id33B0C2B5D58A41AA85941086F29B148F"><enum>(ii)</enum><header>Payment into
independence fund</header><text>Any benefits recouped in accordance with clause
(i) shall be paid into the Independence Fund and used in accordance with
section 3105.</text>
</clause></subparagraph></paragraph><paragraph id="idBBBA646515A740D99D86E5B880BEFF60"><enum>(6)</enum><header>Requirement to
recertify eligibility for receipt of benefits and to notify the Secretary if
not earning wages or income</header><text>The procedures established under
paragraph (1)(A) shall provide for an eligible tier I beneficiary or an
eligible tier II beneficiary to—</text>
<subparagraph id="idB84AC5170EE34E5C82087D71F8EB84BC"><enum>(A)</enum><text>annually—</text>
<clause id="id66FDE0D92DD7490C9ED7CF73496D10FD"><enum>(i)</enum><text>recertify by
submission of medical evidence the beneficiary's continued eligibility for
receipt of tier I or tier II benefits (as applicable); and</text>
</clause><clause id="idDB54AD7931C948828EC24F9E46A95AC1"><enum>(ii)</enum><text>submit records
of expenditures attributable to the aggregate daily cash benefit received by
the beneficiary during the preceding year; and</text>
</clause></subparagraph><subparagraph id="id6098A6A524A642A7BD9C3C49AAEDEE53"><enum>(B)</enum><text>notify the
Secretary if the beneficiary is not earning wages or deriving self-employment
income and should not have to pay a monthly premium to maintain enrollment in
the CLASS program in accordance with section 3103(e)(2).</text>
</subparagraph></paragraph><paragraph id="idF11A54F1447E48CDAD7A1003F86EFCE3"><enum>(7)</enum><header>Supplement, not
supplant other health care benefits</header><text>Subject to the Medicaid
payment rules under paragraph (1)(C), benefits received by an eligible tier I
beneficiary or an eligible tier II beneficiary shall supplement, but not
supplant, other health care benefits for which the beneficiary is eligible
under Medicaid or any other federally funded program that provides health care
benefits or assistance.</text>
</paragraph></subsection><subsection id="idF0D859C6BBAA4C1D8ADEADB3D578A416"><enum>(e)</enum><header>Advocacy
services</header><text>An agreement entered into under subsection (a)(2)(A)(ii)
shall require the Protection and Advocacy System for the State to—</text>
<paragraph id="idE106E4F155D4461ABC7104123204295F"><enum>(1)</enum><text>assign, as
needed, an advocacy counselor to each eligible tier I beneficiary or eligible
tier II beneficiary that is covered by such agreement and who provides an
eligible tier I beneficiary or an eligible tier II beneficiary with—</text>
<subparagraph id="id3F193493FB884108800F472C3FED68D4"><enum>(A)</enum><text>information
regarding how to access the appeals process established for the program;</text>
</subparagraph><subparagraph id="idE84358A8B97047F88367EA0FE03B68A5"><enum>(B)</enum><text>assistance with
respect to the annual recertification and notification required under
subsection (d)(6); and</text>
</subparagraph><subparagraph id="id67F549E538C041AE82AFAB54C87C0EF7"><enum>(C)</enum><text>such other
services as the Secretary, by regulation, shall require; and</text>
</subparagraph></paragraph><paragraph id="id92C5971F11C64CF3BF0629B9EC103658"><enum>(2)</enum><text>ensure that the
System and such counselors comply with the requirements of subsection
(i).</text>
</paragraph></subsection><subsection id="id9DB7A791C1CA473DAC8A65C589941B60"><enum>(f)</enum><header>Advice and
assistance counseling</header><text>An agreement entered into under subsection
(a)(2)(A)(iii) shall require the entity to assign, as requested by an eligible
tier I beneficiary or an eligible tier II beneficiary that is covered by such
agreement, an advice and assistance counselor who provides an eligible tier I
beneficiary or an eligible tier II beneficiary with information
regarding—</text>
<paragraph id="IDe4ca38eda7d941d3a7ff9e08fd8073b0"><enum>(1)</enum><text>accessing and
coordinating long-term services and supports in the most integrated
setting;</text>
</paragraph><paragraph id="ID00bd0062e16d4e11801d7780a3d2705c"><enum>(2)</enum><text>possible
eligibility for other benefits and services;</text>
</paragraph><paragraph id="ID160b87c7a1b84938a9143f9030366087"><enum>(3)</enum><text>development of a
service and support plan;</text>
</paragraph><paragraph id="id0F2D1F3C1D624A4E8D2F80C29FED2C16"><enum>(4)</enum><text>information about
programs established under the Assistive Technology Act of 1998 and the
services offered under such programs; and</text>
</paragraph><paragraph id="ID95cc20ea2f0d45b59f74c4164844eaa9"><enum>(5)</enum><text>such other
services as the Secretary, by regulation, may require.</text>
</paragraph></subsection><subsection id="id238839A02CDA4856B088D09716ABCE50"><enum>(g)</enum><header>No effect on
eligibility for other benefits</header><text>Benefits paid to an eligible tier
I beneficiary or an eligible tier II beneficiary under the CLASS program shall
be disregarded for purposes of determining or continuing the beneficiary's
eligibility for receipt of benefits under any other Federal, State, or locally
funded assistance program, including benefits paid under titles II, XVI, XVIII,
XIX, or XXI of the Social Security Act (42 U.S.C. 401 et seq., 1381 et seq.,
1395 et seq., 1396 et seq., 1397aa et seq.), under the laws administered by the
Secretary of Veterans Affairs, under low-income housing assistance programs, or
under the food stamp program established under the Food Stamp Act of 1977 (7
U.S.C. 2011).</text>
</subsection><subsection id="id533D2324CFD14DD593491B98F7F1059A"><enum>(h)</enum><header>Cost-of-living
and other adjustments</header>
<paragraph id="id78E7924B6D0640569CC9D8A6B89CC902"><enum>(1)</enum><header>In
general</header><text>Beginning with 2011, the dollar amounts specified in
subsections (b)(1) and (c)(1) shall be annually increased by the percentage
increase in the consumer price index for all urban consumers (U.S. city
average) over the previous year.</text>
</paragraph><paragraph id="id2CE86C057A96493896C2B1A20289AA9F"><enum>(2)</enum><header>Additional
adjustment</header><text>With respect to any year for which the Secretary has
determined under section 3103(b)(4)(C) that an adjustment to the monthly
premium amounts is necessary to ensure program solvency, the Secretary shall
decrease the increase in the dollar amounts specified in subsections (b)(1) and
(c)(1) that would otherwise be applicable under paragraph (1) for that year, by
such amount as the Secretary determines is appropriate for that year (but shall
ensure that there is an increase in such dollar amounts for that year).</text>
</paragraph></subsection><subsection id="id15588518DE2146F3B1066B93309B11B4"><enum>(i)</enum><header>Rule of
construction</header><text>Nothing in this title shall be construed as
prohibiting tier I or tier II benefits paid under the CLASS program from being
used to compensate a family caregiver for providing community living assistance
services and supports to an eligible tier I beneficiary or an eligible tier II
beneficiary.</text>
</subsection><subsection id="id6E23FFCF11D8470FAD12A70758344E54"><enum>(j)</enum><header>Protection
against conflict of interests</header><text>The Secretary shall establish
procedures to ensure that the Disability Determination Service and Protection
and Advocacy System for a State, advocacy counselors for eligible tier I or
eligible tier II beneficiaries, and any other entities that provide services to
active enrollees and eligible tier I or eligible tier II beneficiaries under
the CLASS program comply with the following:</text>
<paragraph id="id387A545130E148C3BE725A1207229C7B"><enum>(1)</enum><text>If the entity
provides counseling or planning services, such services are provided in a
manner that fosters the best interests of the active enrollee or
beneficiary.</text>
</paragraph><paragraph id="id6202B20ADC544C399D2C54F30F7206EE"><enum>(2)</enum><text>The entity has
established operating procedures that are designed to avoid or minimize
conflicts of interest between the entity and an active enrollee or
beneficiary.</text>
</paragraph><paragraph id="idE53A7427DF8F41629562DBE18773284D"><enum>(3)</enum><text>The entity
provides information about all services and options available to the active
enrollee or beneficiary, to the best of its knowledge, including services
available through other entities or providers.</text>
</paragraph><paragraph id="id3F1EF1ED7BA346CF870DE9228EE476D6"><enum>(4)</enum><text>The entity
assists the active enrollee or beneficiary to access desired services,
regardless of the provider.</text>
</paragraph><paragraph id="id005450AA5E7B4B69AFF87C75EA96EEA1"><enum>(5)</enum><text>The entity
reports the number of active enrollees and beneficiaries provided with
assistance by age, disability, and whether such enrollees and beneficiaries
received services from the entity or another entity.</text>
</paragraph><paragraph id="IDafc637d8812b4edcaa63638d2fa352a6"><enum>(6)</enum><text>If the entity
provides counseling or planning services, the entity ensures that an active
enrollee or beneficiary is informed of any financial interest that the entity
has in a service provider.</text>
</paragraph><paragraph id="IDad514c20cf5d418eab8a952281772d5a"><enum>(7)</enum><text>The entity
provides an active enrollee or beneficiary with a list of available service
providers that can meet the needs of the active enrollee or beneficiary.</text>
</paragraph></subsection></section><section id="id41643880C9EE4834BF8792D938B97ED9"><enum>3105.</enum><header>Independence
Fund</header>
<subsection id="ID4432A2B8811944708CAE72A3543FC0B7"><enum>(a)</enum><header>Establishment
of Independence Fund</header><text>There is established in the Treasury of the
United States a trust fund to be known as the <quote>Independence Fund</quote>.
The Secretary shall serve as Managing Trustee of such Fund. The Fund shall
consist of all amounts derived from payments into the Fund under sections
3103(d) and 3104(d)(5)(C)(ii), and remaining after investment of such amounts
under subsection (b), including additional amounts derived as income from such
investments. The amounts held in the Fund are appropriated and shall remain
available without fiscal year limitation—</text>
<paragraph id="IDEB11107B38044AC5A5DFDB2BC74A531E"><enum>(1)</enum><text>to be held for
investment on behalf of individuals enrolled in the CLASS program;</text>
</paragraph><paragraph id="ID402886D91CC74DE0BF833AC120ABE59E"><enum>(2)</enum><text>to pay the
administrative expenses related to the Fund and to investment under subsection
(b); and</text>
</paragraph><paragraph id="ID2F233495EECD4AB9B4B25224FFCAD6DD"><enum>(3)</enum><text>to pay tier I and
tier II benefits under section 3104.</text>
</paragraph></subsection><subsection id="IDF4B0D10E95B44B228CCA73990B3D593B"><enum>(b)</enum><header>Investment of
fund balance</header><text>The Secretary, through the Secretary of the
Treasury, shall invest the Independence Fund in the same manner, and to the
same extent, as the Federal Old-Age and Survivors Trust Fund and the Federal
Disability Insurance Trust Fund may be invested under section 201(d) of the
Social Security Act (42 U.S.C. 401(d)).</text>
</subsection><subsection id="id1C7E67BC0CCA47A6AFB9A2F11D9F822A"><enum>(c)</enum><header>Off-Budget
status; lock-Box protection</header>
<paragraph id="id2674E8555033499BB83AD7FC2499912D"><enum>(1)</enum><header>Exclusion of
trust funds from all budgets</header><text>Notwithstanding any other provision
of law, the amounts derived from payments into the Fund and amounts paid from
the Fund shall not be counted as new budget authority, outlays, receipts, or
deficit or surplus for purposes of—</text>
<subparagraph id="id1AA171B2645F455DBDE0674F4CF989E7"><enum>(A)</enum><text>the budget of the
United States Government, as submitted by the President;</text>
</subparagraph><subparagraph id="id423B8CDF41E2439FA47EED267FE8AD98"><enum>(B)</enum><text>the congressional
budget; or</text>
</subparagraph><subparagraph id="id614F748A6BDF4477ABE46276367D3904"><enum>(C)</enum><text>the Balanced
Budget and Emergency Deficit Control Act of 1985.</text>
</subparagraph></paragraph><paragraph id="id47B499B55F2347A7819E896459BF738D"><enum>(2)</enum><header>Lock-box
protection</header>
<subparagraph id="idD1744E7CAB11438E8D962384D1073B8A"><enum>(A)</enum><header>In
general</header><text>Notwithstanding any other provision of law, it shall not
be in order in the Senate or the House of Representatives to consider any
measure that would authorize the payment or use of amounts in the Fund for any
purpose other than a purpose authorized under this title.</text>
</subparagraph><subparagraph id="idB1B0744026E7480686D82635431F441B"><enum>(B)</enum><header>60-vote waiver
required in the senate</header>
<clause id="id0EE84EC377D0414BBEB7B147C5F3C750"><enum>(i)</enum><header>In
general</header><text>Subparagraph (A) may be waived or suspended in the Senate
only by the affirmative vote of <fraction>3/5</fraction> of the Members, duly
chosen and sworn.</text>
</clause><clause id="id1D502ACF437F4B6FAC634619201603D1"><enum>(ii)</enum><header>Appeals</header>
<subclause id="idFA74DF5A5EBD420FB06A3056C071E0AC"><enum>(I)</enum><header>Procedure</header><text>Appeals
in the Senate from the decisions of the Chair relating to clause (i) shall be
limited to 1 hour, to be equally divided between, and controlled by, the mover
and the manager of the measure that would authorize the payment or use of
amounts in the Fund for a purpose other than a purpose authorized under this
title.</text>
</subclause><subclause id="idAC69E09928394890AC356AFFE540FFB5"><enum>(II)</enum><header>60-votes
required</header><text>An affirmative vote of <fraction>3/5</fraction> of the
Members, duly chosen and sworn, shall be required in the Senate to sustain an
appeal of the ruling of the Chair on a point of order raised in relation to
clause (i).</text>
</subclause></clause></subparagraph><subparagraph id="ID347D0C21E2A54EF300D394448842BC08"><enum>(C)</enum><header>Rules of the
senate and house of representatives</header><text>This section is enacted by
Congress—</text>
<clause id="ID91B4C064A5B64F54A3EF744DC6B8D667"><enum>(i)</enum><text>as an exercise of
the rulemaking power of the Senate and House of Representatives, respectively,
and is deemed to be part of the rules of each House, respectively, but
applicable only with respect to the procedure to be followed in that House in
the case of a measure described in subparagraph (A), and it supersedes other
rules only to the extent that it is inconsistent with such rules; and</text>
</clause><clause commented="no" display-inline="no-display-inline" id="ID5055B08E09D1408E9995B9A4B98187F0"><enum>(ii)</enum><text>with full
recognition of the constitutional right of either House to change the rules (so
far as they relate to the procedure of that House) at any time, in the same
manner, and to the same extent as in the case of any other rule of that
House.</text>
</clause></subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id0641A98176604715A062D5BAF81A9FBE"><enum>(d)</enum><header>Additional
appropriations To ensure solvency during initial benefit years</header><text>In
addition to the amounts appropriated to the Fund under subsection (a), out of
any money in the Treasury of the United States not otherwise appropriated,
there are appropriated to the Fund, for each of fiscal years 2013 through 2017,
such sums as are necessary for each such fiscal year (and which, in the case of
each of fiscal years 2014 through 2017, shall be less than the amount
appropriated for the preceding fiscal year) to ensure the solvency of the Fund
during the first 5 years in which tier I or tier II benefits are paid from the
Fund. Amounts appropriated under this subsection shall remain available without
fiscal year limitation for the purposes specified in paragraphs (1), (2), and
(3) of subsection (a).</text>
</subsection></section><section id="id597A214B085346B2B3C742E722286579"><enum>3106.</enum><header>Regulations;
annual report</header>
<subsection id="idE97B07FA05D340C4AA475509558B0089"><enum>(a)</enum><header>Regulations</header><text display-inline="yes-display-inline">The Secretary shall promulgate such
regulations as are necessary to carry out the CLASS program in accordance with
this title. Such regulations shall include provisions to prevent fraud and
abuse under the program.</text>
</subsection><subsection id="idC2333980F40B492681FF7A0C72FD728B"><enum>(b)</enum><header>Annual
report</header><text display-inline="yes-display-inline">Beginning with fiscal
year 2013, the Secretary shall submit an annual report to Congress on the CLASS
program. Each report shall include the following:</text>
<paragraph id="id2714E95328AC4DC6A37A4537FC7368C0"><enum>(1)</enum><text display-inline="yes-display-inline">The total amount of enrollees in the
program.</text>
</paragraph><paragraph id="idF86CDDDCE7804AE89193737F2CF54C84"><enum>(2)</enum><text display-inline="yes-display-inline">The total number of eligible tier I
beneficiaries and eligible tier II beneficiaries during the fiscal year.</text>
</paragraph><paragraph id="id1889D74CC3814A5EA434F593749D1A7E"><enum>(3)</enum><text>The total amount
of tier I and tier II benefits provided during the fiscal year.</text>
</paragraph><paragraph id="idCF52D4576C85400FA8F60B8B50ADE3E2"><enum>(4)</enum><text display-inline="yes-display-inline">A description of instances of fraud or
abuse identified during the fiscal year.</text>
</paragraph><paragraph id="id5E3A36C6E75D435EB2C3405EA56758B3"><enum>(5)</enum><text display-inline="yes-display-inline">Recommendations for such administrative or
legislative action as the Secretary determines is necessary to improve the
program or to prevent the occurrence of fraud or abuse.</text>
</paragraph></subsection></section><section id="id05E13A8A03E444FA985D0520E9AFD108"><enum>3107.</enum><header>Tax treatment
of program</header><text display-inline="no-display-inline">The CLASS program
shall be treated for purposes of the Internal Revenue Code of 1986 in the same
manner as a qualified long-term care insurance contract for qualified long-term
care
services.</text>
</section>.
(2)Conforming
amendments to medicaidSection 1902(a) of the Social Security Act
(42 U.S.C. 1396a(a)), as amended by section 5006(e)(2)(A) of division B of
Public Law 111–5, is amended—
(A)in paragraph
(72), by striking and
at the end;
(B)in paragraph
(73)(B), by striking the period and inserting ; and
; and
(C)by inserting
after paragraph (73) the following:
(74)provide that the
State will comply with such regulations regarding the application of primary
and secondary payor rules with respect to individuals who are eligible for
medical assistance under this title and are eligible tier I beneficiaries or
eligible tier II beneficiaries under the CLASS program established under title
XXIX of the Public Health Service Act as the Secretary shall
establish.
.
(b)Assurance of
adequate infrastructure for the provision of personal care attendant
workersSection 1902(a) of the Social Security Act (42 U.S.C.
1396a(a)), as amended by subsection (a)(2), is amended—
(1)in paragraph
(73)(B), by striking and
at the end;
(2)in paragraph
(74), by striking the period at the end and inserting ; and
;
and
(3)by inserting
after paragraph (74), the following:
(75)provide that,
not later than 2 years after the date of enactment of the Community Living
Assistance Services and Supports Act, each State shall—
(A)assess the extent
to which entities such as providers of home care, home health services, home
and community service providers, public authorities created to provide personal
care services to individuals eligible for medical assistance under the State
plan, and nonprofit organizations, are serving or have the capacity to serve as
fiscal agents for, employers of, and providers of employment-related benefits
for, personal care attendant workers who provide personal care services to
individuals receiving benefits under the CLASS program established under title
XXIX of the Public Health Service Act, including in rural and underserved
areas;
(B)designate or
create such entities to serve as fiscal agents for, employers of, and providers
of employment-related benefits for, such workers to ensure an adequate supply
of the workers for individuals receiving benefits under the CLASS program,
including in rural and underserved areas; and
(C)ensure that the
designation or creation of such entities will not negatively alter or impede
existing programs, models, methods, or administration of service delivery that
provide for consumer controlled or self-directed home and community services
and further ensure that such entities will not impede the ability of
individuals to direct and control their home and community services, including
the ability to select, manage, dismiss, co-employ, or employ such workers or
inhibit such individuals from relying on family members for the provision of
personal care
services.
.
(c)Personal care
attendants workforce advisory panel
(1)Not
later than 90 days after the date of enactment of this Act, the Secretary of
Health and Human Services shall establish a Personal Care Attendants Workforce
Advisory Panel for the purpose of examining and advising the Secretary and
Congress on workforce issues related to personal care attendant workers,
including with respect to the adequacy of the number of such workers, the
salaries, wages, and benefits of such workers, and access to the services
provided by such workers.
(2)In
appointing members to the Personal Care Attendants Workforce Advisory Panel,
the Secretary shall ensure that such members include the following:
(A)Individuals with
disabilities of all ages.
(B)Senior
individuals.
(C)Representatives
of individuals with disabilities.
(D)Representatives
of senior individuals.
(E)Representatives
of workforce and labor organizations.
(F)Representatives
of home and community-based service providers.
(G)Representatives
of assisted living providers.
<enum>II</enum><header>Amendments to
the Internal Revenue Code of 1986</header>
<section id="idBF52FC69F2FC4AE895FC48B78CD9C9F0"><enum>201.</enum><header>Above-the-line
deduction for premium costs</header>
<subsection id="id309BA4D5D3B24C3EAE4E62E48A2FA466"><enum>(a)</enum><header>In
general</header><text>Section 62(a) of the Internal Revenue Code of 1986
(defining adjusted gross income) is amended by inserting after paragraph (21)
the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="idD866B77DAC314CE8BA04F0BEF4423263" style="OLC">
<paragraph id="idFA34C757E39C4916BC8D875007A1A863"><enum>(22)</enum><header>Class program
premiums</header><text>The deduction allowed by section 213 (determined without
regard to any adjusted gross income limitation) which consists of amounts paid
by the taxpayer for enrollment in the CLASS program (as defined in section
36B(d)) for eligible enrollment months (as defined in section 36(b)) beginning
in the taxable
year.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id91CB9A38FA0743D98345E81E1DE13BBE"><enum>(b)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to taxable
years beginning after December 31, 2009.</text>
</subsection></section><section id="id5D0D2EAA68814AD193DB0C89F550C603"><enum>202.</enum><header>Credit for
premium costs of CLASS enrollees with low-income</header>
<subsection id="id23FB81AC2FC34DFE938144BDD7FB6879"><enum>(a)</enum><header>In
general</header><text>Subpart C of part IV of subchapter A of chapter 1 of the
Internal Revenue Code of 1986 (relating to refundable credits) is amended by
inserting after section 36A the following new section:</text>
<quoted-block display-inline="no-display-inline" id="id5306AD71D31B40348D4FD621F349C939" style="OLC">
<section id="idC622FA1966664E8A812A372092C0936F"><enum>36B.</enum><header>Premium costs
of CLASS enrollees with low-income</header>
<subsection id="id8E91E73AB2094A5EBDE8211B2FB7E7FB"><enum>(a)</enum><header>In
general</header><text>In the case of a CLASS enrollee with low-income, there
shall be allowed as a credit against the tax imposed by subtitle A an amount
equal to 50 percent of the amount paid by the taxpayer for enrollment of the
taxpayer and the taxpayer's spouse in the CLASS program for eligible enrollment
months beginning in the taxable year.</text>
</subsection><subsection id="id835BF3EC04694C23AAF9C2032F67FBFC"><enum>(b)</enum><header>Eligible
enrollment month</header><text>For purposes of this section—</text>
<paragraph id="idC56D3E7AEF7E4B46989717F6BFE74129"><enum>(1)</enum><header>In
general</header><text>The term <term>eligible enrollment month</term> means any
month if, as of the first day of such month, the taxpayer is a CLASS enrollee
with low-income enrolled in the CLASS program, the premium for which is paid by
the taxpayer.</text>
</paragraph><paragraph id="id959AEB8036EF428B8CF81F7FB17B17F5"><enum>(2)</enum><header>Joint
returns</header><text>In the case of a joint return, the requirements of
paragraph (1) shall be treated as met with respect to any month if at least 1
spouse satisfies such requirements.</text>
</paragraph></subsection><subsection id="idB6360A0ACB5C418E9C23C8D260774D74"><enum>(c)</enum><header>CLASS enrollee
with low-income</header><text>For purposes of this section, the term
<term>CLASS enrollee with low-income</term> means an individual—</text>
<paragraph id="idCE82D240A83C4FB783E4C6CB9887679C"><enum>(1)</enum><text>who is an active
enrollee in the CLASS program (as defined in section 3101(1) of the Public
Health Service Act); and</text>
</paragraph><paragraph id="idDDD2F941EAD4443384702277064250C9"><enum>(2)</enum><text>whose gross
income does not exceed 250 percent of the poverty line.</text>
</paragraph></subsection><subsection id="id4928BFC175DE400AABD67DAFDF06D248"><enum>(d)</enum><header>CLASS
program</header><text>For purposes of this section, the term <term>CLASS
program</term> means the program for community living assistance services and
supports established under title XXIX of the Public Health Service Act.</text>
</subsection><subsection id="id0A1CB0BB3BCD49889F3350DEF3BA9C45"><enum>(e)</enum><header>Special
rules</header>
<paragraph id="id691E39F703224D5B9608B8F1DA40E08A"><enum>(1)</enum><header>Coordination
with other deductions</header><text>Amounts taken into account under subsection
(a) shall not be taken into account in determining any deduction allowed under
section 62(a)(22), 162(l), or 213.</text>
</paragraph><paragraph id="idDECAA14EA61A4F2DB62B879EE09B6B83"><enum>(2)</enum><header>MSA
distributions</header><text>Amounts distributed from an Archer MSA (as defined
in section 220(d)) shall not be taken into account under subsection (a).</text>
</paragraph><paragraph id="id9A77530D4A104AA090CD7E21F56A0B5D"><enum>(3)</enum><header>Denial of
credit to dependents</header><text>No credit shall be allowed under this
section to any individual with respect to whom a deduction under section 151 is
allowable to another taxpayer for a taxable year beginning in the calendar year
in which such individual's taxable year begins.</text>
</paragraph><paragraph id="idE55C10C4B82E4D16B8B648308B78EAF3"><enum>(4)</enum><header>Both spouses
eligible individuals</header><text>For purposes of subsection (a), the amount
paid for enrollment of the taxpayer's spouse shall be disregarded if—</text>
<subparagraph id="id4AAE0D50B3B44833AF0BA56A42C67E89"><enum>(A)</enum><text>the taxpayer is
married at the close of the taxable year,</text>
</subparagraph><subparagraph id="idCD7095EF5DAB4972918D0D913A763836"><enum>(B)</enum><text>the taxpayer and
the taxpayer's spouse are both CLASS enrollee with low-income during the
taxable year, and</text>
</subparagraph><subparagraph id="id65EAF82A241747ECBA13FEB05BA06393"><enum>(C)</enum><text>the taxpayer
files a separate return for the taxable year.</text>
</subparagraph></paragraph><paragraph id="id282589852521469E9CAD5CA13D353E57"><enum>(5)</enum><header>Marital status;
certain married individuals living apart</header><text>Rules similar to the
rules of paragraph (3) and (4) of section 21(e) shall apply for purposes of
this section.</text>
</paragraph></subsection><subsection id="idA76C4C1C1A99465D92EF9E319DFF8263"><enum>(f)</enum><header>Regulations</header><text>The
Secretary may prescribe such regulations and guidance as may be necessary or
appropriate to carry out this
section.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id6C949A5C80FB4A20934183E88BFA6423"><enum>(b)</enum><header>Conforming
amendments</header>
<paragraph id="id5DF49B833752447BB184FC6EED9F7D55"><enum>(1)</enum><text>Paragraph (2) of
section 1324(b) of title 31, United States Code, is amended by striking
<quote>section 35</quote> and all that follows through <quote>53(e)</quote> and
inserting <quote>section 35, 36, 36A, 36B, 53(e), or 6428</quote>.</text>
</paragraph><paragraph id="H842573150F6F444288327E6E5D24F00E"><enum>(2)</enum><text>Section
6211(b)(4)(A) is amended by inserting <quote>36B,</quote> after
<quote>36A,</quote>.</text>
</paragraph><paragraph id="id14700473A0D748B0B79F6A2B0DC4B6F1"><enum>(3)</enum><text>The table of
sections for subpart C of part IV of chapter 1 of the Internal Revenue Code of
1986 is amended by inserting after the item relating to section 36A the
following new item:</text>
<quoted-block display-inline="no-display-inline" id="idEC7ED49CD3034FB3859F38BE004EF271" style="OLC">
<toc>
<toc-entry level="section">Sec. 36B. Premiums costs of CLASS
enrollees with
low-income.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="id64DFCB41D09341E18F4D88FCF4A1CBFC"><enum>(c)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to taxable
years beginning after December 31, 2009.</text>
</subsection></section><section id="idDDCDC5612C2142DB935C54D3127514C6"><enum>203.</enum><header>Credit for
costs of employers who elect to automatically enroll employees and withhold
class premiums from wages</header>
<subsection id="idFF11F8F9300543B3B1F69FDC9EA2496F"><enum>(a)</enum><header>In
general</header><text>Subpart D of part IV of subchapter A of chapter 1 of the
Internal Revenue Code of 1986 (relating to business credits) is amended by
inserting after section 45Q the following:</text>
<quoted-block display-inline="no-display-inline" id="id4A15559091B34908AC8A6AA2806BA154" style="OLC">
<section id="idE900145828914AE8A1716E2634CF1856"><enum>45R.</enum><header>Credit for
costs of automatically enrolling employees and withholding class premiums from
wages</header>
<subsection id="id5DFE76D187CA4DBB97846EFE8D4CFA04"><enum>(a)</enum><header>General
rule</header><text>For purposes of section 38, the CLASS automatic enrollment
and premium withholding credit determined under this section for the taxable
year is an amount equal to 25 percent of the total amount paid or incurred by
the taxpayer during the taxable year to—</text>
<paragraph id="idEC9F5764CE1644AA9DB6D9FDF5DDD174"><enum>(1)</enum><text>automatically
enroll employees in the CLASS program established under title XXIX of the
Public Health Service Act, and</text>
</paragraph><paragraph id="id185FBDB9E903419A8419551CAE41A848"><enum>(2)</enum><text>withhold monthly
CLASS premiums on behalf of an employee who is enrolled in that program.</text>
</paragraph></subsection><subsection id="idA9BD43365EA44756AB467EDD3CE8AECF"><enum>(b)</enum><header>Denial of
double benefit</header><text>No deduction shall be allowed under this chapter
for any amount taken into account in determining the credit under this
section.</text>
</subsection><subsection id="id55190CA84A2D4558994078B7A413ADCC"><enum>(c)</enum><header>Election not To
claim credit</header><text>This section shall not apply to a taxpayer for any
taxable year if such taxpayer elects to have this section not apply for such
taxable
year.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id4FAF0A173AE34E5F8B896713104E07AF"><enum>(b)</enum><header>Credit made
part of general business credit</header><text>Subsection (b) of section 38 of
the Internal Revenue Code of 1986 (relating to general business credit) is
amended by striking <quote>plus</quote> at the end of paragraph (34), by
striking the period at the end of paragraph (35) and inserting <quote>,
plus</quote>, and by inserting after paragraph (35) the following new
paragraph:</text>
<quoted-block display-inline="no-display-inline" id="idC091B051197441DE8A5DAE43B289EAEC" style="OLC">
<paragraph id="id8F650845B88E4F8DB23624CB7F2F85B6"><enum>(36)</enum><text>the CLASS
automatic enrollment and premium withholding credit determined under section
45R(a).</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="id7636D5E944434F4AB68804578D5EB071"><enum>(c)</enum><header>Clerical
amendment</header><text>The table of sections for subpart D of part IV of
subchapter A of chapter 1 of the Internal Revenue Code of 1986 is amended by
inserting after the item relating to section 45Q the following new item:</text>
<quoted-block display-inline="no-display-inline" id="id11FDD16796B3458AAD7022373E9F3ABB" style="OLC">
<toc>
<toc-entry level="section">Sec. 45R. Credit for costs of
automatically enrolling employees and withholding CLASS premiums from
wages.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection commented="no" display-inline="no-display-inline" id="idD0EC2039902B46428FF94257EBB9651A"><enum>(d)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to expenses
paid or incurred after December 31, 2009, in taxable years ending after such
date.</text>
</subsection></section><section id="id7A15942723474517B99980D523C77041"><enum>204.</enum><header>Long-term care
insurance includible in cafeteria plans</header>
<subsection id="idD18F09B9CC9F4D5E80E5854442DD74D1"><enum>(a)</enum><header>In
general</header><text>Section 125(f) of the Internal Revenue Code of 1986 is
amended by striking the last sentence.</text>
</subsection><subsection id="idAF3547319A0B4FCB9B1D83D90FFD0771"><enum>(b)</enum><header>Effective
date</header><text>The amendment made by subsection (a) shall apply to taxable
years beginning after December 31, 2009.</text>
</subsection></section><enum>III</enum><header>Effective
Date</header>
<section commented="no" display-inline="no-display-inline" id="id6E0FF4CCEA1C4E50B8D5D9E08B7A53ED" section-type="subsequent-section"><enum>301.</enum><header>Effective
date</header><text display-inline="no-display-inline">Except as provided in
sections 201(b), 202(c), 203(d), and 204(b), this Act and the amendments made
by this Act take effect on January 1, 2010.</text>
</section>