Page:United States Statutes at Large Volume 122.djvu/3910

 12 2 STA T .38 8 7PUBLIC LA W 11 0– 3 4 3 —O CT. 3 , 2008 bytheac t u a r y .T he re po rt , a nd a l l underly i n g docu m enta - tion relied upon by the actuary, s hall be maintained by the group health plan or health insurance issuer f ora period of 6 years follo w ing the notification made under subparagraph (E) . ‘ ‘( D )6- MONTHDE TE R M I N A TION S . —I f a group health plan (or a health insurance issuer offering co v erage in connection with a group health plan) see k sane x emption under this paragraph, determinations under subparagraph ( A ) shall be made after such plan (or coverage) has complied with this section for the first 6 months of the plan year involved. ‘‘(E) N OTI F I C ATION.— ‘‘(i) IN G ENERA L .—A group health plan (or a health insurance issuer offering coverage in connection with a group health plan) that, based upon a certification described under subparagraph ( C ), q ualifies for an exemption under this paragraph, and elects to imple- ment the exemption, shall promptly notify the S ec- retary, the appropriate State agencies, and participants and beneficiaries in the plan of such election. ‘‘(ii) R E QU IREMENT.—A notification to the Secretary under clause (i) shall include— ‘‘(I) a description of the number of covered lives under the plan (or coverage) involved at the time of the notification, and as applicable, at the time of any prior election of the cost-exemption under this paragraph by such plan (or coverage) ‘‘(II) for both the plan year upon which a cost exemption is sought and the year prior, a descrip- tion of the actual total costs of coverage with respect to medical and surgical benefits and mental health and substance use disorder benefits under the plan; and ‘‘(III) for both the plan year upon which a cost exemption is sought and the year prior, the actual total costs of coverage with respect to mental health and substance use disorder benefits under the plan. ‘‘(iii) CONFIDENTIALIT Y .—A notification to the Sec- retary under clause (i) shall be confidential. The Sec- retary shall make available, upon request and on not more than an annual basis, an anonymous itemi z ation of such notifications, that includes— ‘‘(I) a breakdown of States by the size and type of employers submitting such notification; and ‘‘(II) a summary of the data received under clause (ii). ‘‘( F ) AUDITS B YA P PROPRIATE AGENCIES.—To determine compliance with this paragraph, the Secretary may audit the books and records of a group health plan or health insurance issuer relating to an exemption, including any actuarial reports prepared pursuant to subparagraph (C), during the 6 year period following the notification of such exemption under subparagraph (E). A State agency receiving a notification under subparagraph (E) may also conduct such an audit with respect to an exemption covered by such notification. ’ ’; Records.

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