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the core benefits described in subsection (d). A per

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son shall not be treated as failing to meet the re

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“(2) OTHER REQUIREMENTS.—The require

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ments of paragraph (1) are not met unless

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“(A) the contract provides continuous full

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year open enrollment (including conversions),

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“(B) the premiums for coverage under the

A B H 5

contract are determined on the basis of the av

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erage per capita cost of providing coverage to
all individuals covered under applicable accident

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and health insurance contracts issued by the

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to individual coverage at not more than 150
percent of the usually applicable community

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rate for the State in which the contract was is

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sued, without any waiting period, without re

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gard to health, and without regard to the size

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“(1) IN GENERAL.—The requirements of this subsection are met if the person offering applicable

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accident and health insurance contracts issues such

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Paragraph (1) shall not apply to a failure to issue
a contract to an eligible employer if such employer
is unable to pay the premium for such contract.
“(d) BENEFITS.—For purposes of this section-

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(1) CORE BENEFITS.—The term 'core benefits'

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means benefits which are the same benefits as are

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provided under title XVIII of the Social Security Act

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to individuals entitled to benefits under part A, and

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enrolled under part B, of such title.

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"(2) DEDUCTIBLES AND COPAYMENTS.-A plan

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shall not be treated as providing the core benefits described in paragraph (1) unless the following re

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UAL.—The plan does not require a deductible

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amount for any plan year in excess of $500 per individual with respect to such benefits.

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“(B) LIMIT

ON

OUT-OF-POCKET

EX

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PENSES.—The plan does not require out-of

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pocket expenses for any plan year in excess of $2,500 per individual for such benefits.

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“(C) CHILDREN.

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“(i) No DEDUCTIBLES OR COINSUR

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ANCE.-In the case of children, there shall

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FITS.—Subject to the periodicity schedule established with respect to the services

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schedule of periodicity which reflects the general, appropriate frequency with which

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services listed in the preceding sentence

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made for the following, without the application of deductibles, coinsurance,

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or

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of Obstetrics and Gynecology, shall establish a schedule of periodicity which reflects

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the general, appropriate frequency with

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which services listed in clause (i) should be

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poses of this subparagraph, the term 'preg.

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nant, until the last day of the month in

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which the 60-day period (beginning on the

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date of termination of the pregnancy)

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ends.

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"(3) PREEMPTION.—No provision of State law shall apply that requires the offering, as part of an

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