TABLE OF CONTENTS:

Title I: Providing Affordable Care Through HealthMarts

Title II: Providing Affordable Care Through Association

Health Plans

Title III: Providing Affordable Care By Allowing Health Care

Coverage Credits to Individuals

Title IV: Providing Affordable Care Through Medical Savings

Accounts

Affordable Health Care Act of 1999 - Title I: Providing Affordable Care Through HealthMarts - Amends the Public Health Service Act to create a new title on HealthMarts. Requires that HealthMarts: (1) be nonprofit entities composed of employers, employees health care providers, and entities that underwrite or administer health benefits coverage; and (2) make available health coverage to all employers and eligible employees at rates established by the insurance issuer on a policy or product specific basis. Deems HealthMarts group health plans for purposes of specified provisions of the Employee Retirement Income Security Act of 1974 (ERISA) and the Internal Revenue Code. Requires that coverage made available to an eligible employee in a geographic area be offered to all eligible employees in the same area.

Declares that the HealthMart: (1) provides coverage only through contracts with issuers and does not assume insurance risk; (2) provides administrative services for purchasers; and (3) collects and disseminates consumer information on all offered coverage options.

Requires that HealthMart coverage provide full portability of creditable coverage for individuals who remain members of the same HealthMart notwithstanding that they change employers.

Allows HealthMart coverage to include coverage through an HMO, a preferred provider or licensed provider-sponsored organization, an insurance company, a medical savings or flexible spending account, a point-of-service option, a community health organization, or any combination of those coverages.

Requires a HealthMart to permit any employer to contract for coverage and prohibits varying eligibility conditions. Prohibits the purchaser from obtaining or sponsoring coverage other than through the HealthMart. Prohibits enrollment discrimination based on health.

Requires HealthMarts to make at least four coverage options available, at least one of which is a non-network option.

Supersedes certain related State laws.

Provides for the application of: (1) certain existing ERISA and Public Health Service Act requirements; and (2) renewability requirements when the contract between a HealthMart and an issuer is terminated.

Directs the Secretary of Health and Human Services to administer this subtitle through a separate Health Care Marketplace Division.

Title II: Providing Affordable Care through Association Health Plans - Amends ERISA to define "association health plan" to mean a group health plan meeting specified requirements, including being sponsored by a trade, industry, or professional association, a chamber of commerce (or a similar business association) organized and maintained for substantial purposes other than obtaining or providing medical care. Provides for association plan certification and mandates a class certification procedure.

Prohibits a sponsor's affiliated members from being offered coverage unless the member: (1) was affiliated on the certification date; or (2) did not maintain or contribute to a group health plan during the 12 months before the offering of coverage.

Prohibits a participating employer from providing health coverage in the individual market for any employee who is eligible for plan coverage if the exclusion from plan coverage is based on health status.

Prohibits excluding an employer from an association plan if the employer and plan each meet specified requirements.

Prohibits contribution rates for participating small employers from varying on the basis of claims experience or type of business. Requires, if any plan benefit option does not consist of health coverage, that the plan have at least 1,000 participants and beneficiaries. Requires, if a benefit option consisting of health coverage is offered under the plan, that State-licensed insurance agents be used to distribute to small employers coverage that is not health coverage in a manner comparable to the manner in which those agents are used to distribute health coverage.

Allows association plan coverage to include coverage through an HMO, a preferred provider or licensed provider-sponsored organization, an insurance company, a medical savings or flexible spending account, a point-of-service option, a community health organization, or any combination of those coverages. Requires association plans to make at least four coverage options available, at least one of which is a non-network option.

Mandates development of a model benefits package.

Requires that a plan consist only of health coverage or, if the plan provides any additional benefit options, that the plan meet certain reserve and excess stop loss insurance and solvency indemnification requirements regarding the additional benefit options for which risk has not yet been transferred. Requires that all plans maintain a specified surplus.

Requires association plans providing additional options to make annual payments to the Association Health Plan Fund. Requires that, when there is or will be a failure to maintain such reserves, excess stop loss insurance, and indemnification, the Secretary of Labor pay amounts as necessary to maintain the excess stop loss insurance or indemnification. Establishes the Fund.

Mandates advance notice to participants and beneficiaries of certified plan termination.

Requires, when a plan has failed or will fail to maintain required reserves, excess stop loss insurance, and indemnification, either corrective action or plan termination.

Provides for court appointment of the Secretary as trustee to administer a plan during insolvency.

Allows a State to impose a contribution tax on an association plan providing additional options..

Declares that this subtitle supersedes certain related State laws.

(Sec. 202) Modifies the circumstances in which two or more trades or businesses must be deemed a single employer.

(Sec. 203) Excludes from the definition of "multiple employer welfare arrangement" any arrangement: (1) established or maintained under specified Federal (or similar State) labor relations provisions; or (2) meeting certain collective bargaining and other requirements.

Title III: Providing Affordable Care by Allowing Health Care Coverage Credits to Individuals - Amends the Internal Revenue Code to allow an individual a credit for the purchase of qualified health coverage. Amends provisions allowing a deduction for health insurance costs of self-employed individuals to allow that deduction only for qualified long-term care insurance.

Title IV: Providing Affordable Care Through Medical Savings Accounts - Repeals Internal Revenue Code provisions limiting the number of taxpayers having medical savings accounts (MSAs). Removes provisions: (1) allowing an employee to continue to be MSA-eligible even though their employer ceases to be a small employer; and (2) defining "small employer." Increases the amount of the MSA deduction allowed. Modifies requirements regarding coordination of an individual's MSA deduction with the exclusion for employer MSA contributions. Lowers the lower limit of deductibles eligible as high deductible plans. Allows MSAs to be included in cafeteria plans.