Title VI, SEC. 6003. DETERMINATION OF ALLIANCE PER CAPITA PREMIUM TARGETS. (a) Initial Determination. Not later than January 1, 1995, the Board shall determine, for each regional alliance for 1996, a regional alliance per capita premium target. Such target shall equal (1) the national per capita baseline premium target (determined by the Board under section 6002), (2) updated by the regional alliance inflation factor (as determined under section 6001(a)(2)) for 1996, and (3) adjusted by the adjustment factor for the regional alliance (determined under subsection (c)). (b) Subsequent Determinations. (1) Determination. Not later than March 1 of each year (beginning with 1996) the Board shall determine, for each regional alliance for the succeeding year a regional alliance per capita premium target. (2) General rule. Subject to paragraph (3), such target shall equal (A) the regional alliance per capita target determined under this section for the regional alliance for the previous year, and (B) updated by the regional alliance inflation factor (as determined in section 6001(a)) for the year. (c) Adjustment Factors for Regional Alliances for Initial Determination. (1) In general. The Board shall establish an adjustment factor for each regional alliance in a manner consistent with this subsection. (2) Considerations. In establishing the factor for each regional alliance, the Board shall consider, using information of the type described in paragraph (3), the difference between the national average of the factors taken into account in determining the national per capita baseline premium target and such factors for the regional alliance, including variations in health care expenditures and in rates of uninsurance and underinsurance in the different alliance areas and including variations in the proportion of expenditures for services provided by academic health centers in the different alliance areas. (3) Types of information. The type of information described in this paragraph is (A) information on variations in premiums across States and across alliance areas within a State (based on surveys and other data); (B) information on variations in per capita health spending by State, as measured by the Health Care Financing Administration; (C) information on variations across States in per capita spending under the medicare program and in such spending among alliance areas within a State under such program; and (D) area rating factors commonly used by actuaries. (4) Application of factors in neutral manner. The application of the adjustment factors under this subsection for 1996 shall be done in a manner so that the weighted average of the regional alliance per capita premium targets for 1996 is equal to the national per capita baseline premium target determined under section 6002. Such weighted average shall be based on the Board's estimate of the expected distribution of alliance eligible individuals (taken into account under section 6002) among the regional alliances. (5) Consultation process. The Board shall have a process for consulting with representatives of States and regional alliances before establishing the adjustment for regional alliances under this subsection. (d) Treatment of Certain States. (1) Non-alliance states. In the case of a State that is not a participating State or otherwise has not established regional alliances, the entire State shall be treated under the provisions of this part as composing a single regional alliance. (2) Changes in alliance boundaries. In the case of a State that changes the boundaries of its regional alliances (including the establishment of such alliances after 1996), the Board shall provide a method for computing a regional alliance per capita premium target for each regional alliance affected by such change in a manner that (A) reflects the factors taken into account in establishing the adjustment factors for regional alliances under subsection (c), and (B) results in the weighted average of the newly computed regional targets for the regional alliances affected by the change equal to the weighted average of the regional targets for the regional alliances as previously established.