Title VI, SEC. 6122. COMPUTATION OF BASE EMPLOYMENT MONTHLY PREMIUM. (a) In General. Each regional alliance shall provide for the computation for each year (beginning with the first year) of a base employment monthly premium for each class of family enrollment equal to \1/12\ of 80 percent of (1) the weighted average premium for such regional alliance and class of enrollment, reduced by the amount described in section 6106(b), divided by (2)(A) in the case of a class of enrollment that does not include a couple, 1, or (B) in the case of a couple class of enrollment, the average number of premium payments per family, as determined under subsection (b), for families receiving coverage within such class from regional alliance health plans offered by the regional alliance. (b) Determination of Average Employer Premium Payments Per Family for Couples Classes. (1) In general. Subject to paragraph (4), the regional alliance shall determine, for each couple class of family enrollment and in a manner specified by the Board, an average, annual, estimated number of premium payments per family equal to (A) the alliance-wide monthly average number of premium payments (as determined under paragraph (2)) for covered families (as defined in paragraph (3)) within such class of enrollment, divided by (B) the monthly average number of covered families receiving coverage through regional alliance health plans within such class of employment. (2) Computation of alliance-wide monthly average number. (A) In general. In determining the alliance-wide monthly average number of premium payments under paragraph (1)(A), a covered family shall count for a month as 1, or, if greater, the number computed under subparagraph (B) (but in no case greater than 2). (B) Counting of families in which both spouses are qualifying employees. The number computed under this subparagraph over all families within a couple class of enrollment in which both spouses are qualifying employees, is determined on an alliance-wide basis based on the following: (i) For such a spouse, determine, using the rules under section 1902(b)(2)(A), how many full-time equivalent employees the spouse is counted as, but not to exceed 1 for either spouse. (ii) Add the 2 numbers determined under clause (i) for spouses in such families. (3) Covered family defined. In this subsection, the term ``covered family'' means a family other than (A) an SSI family or AFDC family, (B) a family in which a spouse is a medicare-eligible individual, or (C) a family that is enrolled in a health plan other than a regional alliance health plan. (4) Adjustment to account for use of estimates. Subject to section 1361(b)(3), if the total receipts of a regional alliance to all regional alliance health plans in a year under this subpart exceeds, or is less than, the total of such receipts estimated by the alliance (based on the base employment monthly premium under subsection (a)), because of a difference between (A) the alliance's estimate of the average, annual, estimated number of premium payments per family for the alliance, and (B) the actual number of premium payments per family for the alliance, the average, annual, estimated number of premium payments per family to be applied under this section in the second succeeding year shall be reduced, or increased, respectively, in a manner that results in total receipts of the alliance under this subpart in such succeeding year being increased or decreased by the amount of such excess (or deficit). (c) Basis for Determinations. (1) Premiums. The determinations of premiums and families under plans under this section shall be made in a manner determined by the Board and based on the premiums and families used by the Board in carrying out subtitle A (relating to cost containment) and shall be based on estimates on an annualized basis. (2) Employment. (A) For first year. The determinations of employment under this section for the first year for a State shall be based on estimates of employment established by the regional alliance in accordance with standards promulgated by the Secretary of Labor in consultation with the National Health Board. (B) For subsequent years. The determinations of employment under this section for a year after the first year for a State shall be based on estimates of employment established by the regional alliance in accordance with standards promulgated by the Secretary of Labor in consultation with the National Health Board. (3) Reports. In accordance with rules established by the Secretary of Labor in consultation with the National Health Board, a regional alliance may require regional alliance employers to submit such periodic information on employment as may be necessary to monitor the determinations made under subsections (a) and (c), including months and extent of employment. (d) Timing of Determination. Determinations under this section for a year shall be made by not later than December 1, or such other date as the Board may specify, before the beginning of the year.