Title I, SEC. 1902. OTHER GENERAL DEFINITIONS. Except as otherwise specifically provided, in this Act the following definitions apply: (1) Alien permanently residing in the united states under color of law. The term ``alien permanently residing in the United States under color of law'' means an alien lawfully admitted for permanent residence (within the meaning of section 101(a)(19) of the Immigration and Nationality Act), and includes any of the following: (A) An alien who is admitted as a refugee under section 207 of the Immigration and Nationality Act. (B) An alien who is granted asylum under section 208 of such Act. (C) An alien whose deportation is withheld under section 243(h) of such Act. (D) An alien who is admitted for temporary residence under section 210, 210A, or 245A of such Act. (E) An alien who has been paroled into the United States under section 212(d)(5) of such Act for an indefinite period or who has been granted extended voluntary departure as a member of a nationality group. (F) An alien who is the spouse or unmarried child under 21 years of age of a citizen of the United States, or the parent of such a citizen if the citizen is over 21 years of age, and with respect to whom an application for adjustment to lawful permanent residence is pending. (G) An alien within such other classification of permanent resident aliens as the National Health Board may establish by regulation. (2) AFDC family. The term ``AFDC family'' means a family composed entirely of one or more AFDC recipients. (3) AFDC recipient. The term ``AFDC recipient'' means an individual who is receiving aid or assistance under any plan of the State approved under title I, X, XIV, or XVI, or part A or part E of title IV, of the Social Security Act. (4) Alliance area. The term ``alliance area'' means the area served by a regional alliance and specified under section 1202(b). (5) Alliance eligible individual. The term ``alliance eligible individual'' means, with respect to a health alliance, an eligible individual with respect to whom the applicable health plan is a health plan offered by or through such alliance and does not include a prisoner. (6) Applicable health plan. The term ``applicable health plan'' means, with respect to an eligible individual, the health plan specified pursuant to section 1004 and part 2 of subtitle A. (7) Combination cost sharing plan. The term ``combination cost sharing plan'' means a health plan that provides combination cost sharing schedule (consistent with section 1134). (8) Comprehensive benefit package. The term ``comprehensive benefit package'' means the package of health benefits provided under subtitle B of title II. (9) Consumer price index; cpi. The terms consumer price index'' and ``CPI'' mean the Consumer Price Index for all urban consumers (U.S. city average), as published by the Bureau of Labor Statistics. (10) Corporate alliance eligible individual. The term ``corporate alliance eligible individual'' means, with respect to a corporate alliance, an eligible individual with respect to whom the corporate alliance is the applicable health plan. (11) Corporate alliance employer. The term ``corporate alliance employer'' means, with respect to a corporate alliance, an employer of an individual who is a participant in a corporate alliance health plan of that alliance. (12) Corporate alliance health plan. The term ``corporate alliance health plan'' means a health plan offered by a corporate alliance under part 2 of subtitle E. (13) Disabled ssi recipient. The term ``disabled SSI recipient'' means an individual who (A) is an SSI recipient, and (B) has been determined to be disabled for purposes of the supplemental security income program (under title XVI of the Social Security Act). (14) Eligible enrollee. The term ``eligible enrollee'' means, with respect to an health plan offered by a health alliance, an alliance eligible individual, but does not include such an individual if the individual is enrolled under such a plan as the family member of another alliance eligible individual. (15) Essential community provider. The term ``essential community provider'' means an entity certified as such a provider under subpart B of part 2 of subtitle F. (16) Fee-for-service plan. The term ``fee-for-service plan'' means a health plan described in section 1322(b)(2)(A). (17) First year. The term ``first year'' means, with respect to (A) a State that is a participating State in a year before 1998, the year in which the State first is a participating State, or (B) any other State, 1998. (18) Higher cost sharing plan. The term ``higher cost sharing plan'' means a health plan that provides a high cost sharing schedule (consistent with section 1133). (19) Long-term nonimmigrant. The term ``long-term nonimmigrant'' means a nonimmigrant described in subparagraph (E), (H), (I), (J), (K), (L), (M), (N), (O), (Q), or (R) of section 101(a)(15) of the Immigration and Nationality Act or an alien within such other classification of nonimmigrant as the National Health Board may establish by regulation. (20) Lower cost sharing plan. The term ``lower cost sharing plan'' means a health plan that provides a lower cost sharing schedule (consistent with section 1132). (21) Medicare program. The term ``medicare program'' means the health insurance program under title XVIII of the Social Security Act. (22) Medicare-eligible individual. The term ``medicare-eligible individual'' means, subject to section 1012(a), an individual who is entitled to benefits under part A of the medicare program. (23) Move. The term ``move'' means, respect to an individual, a change of residence of the individual from one alliance area to another alliance area. (24) National health board; board. The terms ``National Health Board'' and ``Board'' mean the National Health Board established under part 1 of subtitle F of title I. (25) Poverty level. (A) In general. The term ``applicable poverty level'' means, for a family for a year, the official poverty line (as defined by the Office of Management and Budget, and revised annually in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981) applicable to a family of the size involved (as determined under subparagraph (B)) for 1994 adjusted by the percentage increase or decrease described in subparagraph (C) for the year involved. (B) Family size. In applying the applicable poverty level to (i) an individual enrollment, the family size is deemed to be one person; (ii) a couple-only enrollment, the family size is deemed to be two persons; (iii) a single parent enrollment, the family size is deemed to be three persons; or (iv) a dual parent, the family size is deemed to be four persons. (C) Percentage adjustment. The percentage increase or decrease described in this subparagraph for a year is the percentage increase or decrease by which the average CPI for the 12-month-period ending with August 31 of the preceding year exceeds such average for the 12-month period ending with August 31, 1993. (D) Rounding. Any adjustment made under subparagraph (A) for a year shall be rounded to the nearest multiple of $100. (26) Prisoner. The term ``prisoner'' means, as specified by the Board, an eligible individual during a period of imprisonment under Federal, State, or local authority after conviction as an adult. (27) Regional alliance eligible individual. The term ``regional alliance eligible individual'' means an eligible individual with respect to whom a regional alliance health plan is an applicable health plan. (28) Regional alliance employer. The term ``regional alliance employer'' means an employer that is meeting the requirement of section 1003 other than through an agreement with one or more health alliances. (29) Regional alliance health plan. The term ``regional alliance health plan'' means a health plan offered by a regional alliance under part 1 of subtitle E of title I. (30) Reside. (A) An individual is considered to reside in the location in which the individual maintains a primary residence (as established under rules of the National Health Board). (B) Under such rules and subject to section 1323(c), in the case of an individual who maintains more than one residence, the primary residence of the individual shall be determined taking into account the proportion of time spent at each residence. (C) In the case of a couple only one spouse of which is a qualifying employee, except as the Board may provide, the residence of the employee shall be the residence of the couple. (31) Secretary. The term ``Secretary'' means the Secretary of Health and Human Services. (32) SSI family. The term ``SSI family'' means a family composed entirely of one or more SSI recipients. (33) SSI recipient. The term ``SSI recipient'' means an individual (A) with respect to whom supplemental security income benefits are being paid under title XVI of the Social Security Act, (B) who receiving a supplementary payment under section 1616 of such Act or under section 212 of Public Law 93 66, or (C) who receiving monthly benefits under section 1619(a) of such Act (whether or not pursuant to section 1616(c)(3) of such Act). (34) State. The term ``State'' includes the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. (35) State medicaid plan. The term ``State medicaid plan'' means a plan of medical assistance of a State approved under title XIX of the Social Security Act. (36) Undocumented alien. The term ``undocumented alien'' means an alien who is not a long-term nonimmigrant, a diplomat, or described in section 1004(c). (37) United States. The term ``United States'' means the 50 States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and Northern Mariana Islands.