Page:United States Statutes at Large Volume 124.djvu/189

 124 STAT. 163 PUBLIC LAW 111–148—MAR. 23, 2010 (ii) agrees to offer at least one qualified health plan in the silver level and at least one plan in the gold level in each such Exchange; (iii) agrees to charge the same premium rate for each qualified health plan of the issuer without regard to whether the plan is offered through an Exchange or whether the plan is offered directly from the issuer or through an agent; and (iv) complies with the regulations developed by the Secretary under section 1311(d) and such other requirements as an applicable Exchange may establish. (2) INCLUSION OF CO-OP PLANS AND COMMUNITY HEALTH INSURANCE OPTION.—Any reference in this title to a qualified health plan shall be deemed to include a qualified health plan offered through the CO-OP program under section 1322 or a community health insurance option under section 1323, unless specifically provided for otherwise. (b) TERMS RELATING TO HEALTH PLANS.—In this title: (1) HEALTH PLAN.— (A) IN GENERAL.—The term ‘‘health plan’’ means health insurance coverage and a group health plan. (B) EXCEPTION FOR SELF-INSURED PLANS AND MEWAS.— Except to the extent specifically provided by this title, the term ‘‘health plan’’ shall not include a group health plan or multiple employer welfare arrangement to the extent the plan or arrangement is not subject to State insurance regulation under section 514 of the Employee Retirement Income Security Act of 1974. (2) HEALTH INSURANCE COVERAGE AND ISSUER.—The terms ‘‘health insurance coverage’’ and ‘‘health insurance issuer’’ have the meanings given such terms by section 2791(b) of the Public Health Service Act. (3) GROUP HEALTH PLAN.—The term ‘‘group health plan’’ has the meaning given such term by section 2791(a) of the Public Health Service Act. SEC. 1302. ESSENTIAL HEALTH BENEFITS REQUIREMENTS. (a) ESSENTIAL HEALTH BENEFITS PACKAGE.—In this title, the term ‘‘essential health benefits package’’ means, with respect to any health plan, coverage that— (1) provides for the essential health benefits defined by the Secretary under subsection (b); (2) limits cost-sharing for such coverage in accordance with subsection (c); and (3) subject to subsection (e), provides either the bronze, silver, gold, or platinum level of coverage described in sub- section (d). (b) ESSENTIAL HEALTH BENEFITS.— (1) IN GENERAL.—Subject to paragraph (2), the Secretary shall define the essential health benefits, except that such benefits shall include at least the following general categories and the items and services covered within the categories: (A) Ambulatory patient services. (B) Emergency services. (C) Hospitalization. (D) Maternity and newborn care. 42 USC 18022.