Sec. 204. Standardized options in the bronze, silver, and gold levels of coverage
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/bill/115/s/2582/is/section-204·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1301(a) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18021(a) ) is amended— in paragraph (1)(C)— in clause (iii), by striking ; and and inserting ; ; by redesignating clause
(iv)as clause (v); and by inserting after clause
(iii)the following: agrees to offer the standardized option established for the State under paragraph
(5)for each level of coverage offered by the issuer that is the bronze, silver, or gold level of coverage; and with respect to offering coverage that is the bronze, silver, or gold level of coverage on an Exchange that is operated by the Secretary, agrees to offer only standardized options established for the State under paragraph
(5)and not any other plan for such levels of coverage; and ; and by adding at the end the following: In this section, the term standardized option means a qualified health plan— with a standardized cost-sharing structure established by the applicable State, or the Secretary, in accordance with this paragraph; and that is offered on an Exchange. Each State may establish a standardized option for the bronze, silver, and gold levels of coverage. The Secretary shall establish a standardized option in a State for any level of coverage described in clause
(i)for which the State has not established a standardized option. The Secretary shall annually update any standardized option established by the Secretary under clause (ii). Except as provided in clause (ii), each standardized option established by the Secretary under subparagraph (B)(ii) shall include coverage of each of the following as deductible-exempt services: All primary care visits and specialist visits. All mental health and substance use disorder outpatient services. All drugs approved under section 505(j) of the Federal Food, Drug, and Cosmetic Act and biological products licensed under section 351(k) of the Public Health Service Act. All urgent care services. The Secretary may alter the services that shall be covered as deductible-exempt services under clause
(i)for standardized options in the bronze and silver levels of coverage. Each Exchange operated by a State shall preferentially display the standardized options offered in such State on the website of the Exchange. . The amendments made by this section shall apply to plans beginning after December 31, 2019.
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Sec. 204
Standardized options in the bronze, silver, and gold levels of coverage
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