Page:United States Statutes at Large Volume 124.djvu/191

 124 STAT. 165 PUBLIC LAW 111–148—MAR. 23, 2010 for the providing of services that is more restrictive than the requirements or limitations that apply to emergency department services received from providers who do have such a contractual relationship with the plan; and (ii) if such services are provided out-of-network, the cost-sharing requirement (expressed as a copayment amount or coinsurance rate) is the same requirement that would apply if such services were provided in-network; (F) provide that if a plan described in section 1311(b)(2)(B)(ii) (relating to stand-alone dental benefits plans) is offered through an Exchange, another health plan offered through such Exchange shall not fail to be treated as a qualified health plan solely because the plan does not offer coverage of benefits offered through the stand- alone plan that are otherwise required under paragraph (1)(J); and (G) periodically review the essential health benefits under paragraph (1), and provide a report to Congress and the public that contains— (i) an assessment of whether enrollees are facing any difficulty accessing needed services for reasons of coverage or cost; (ii) an assessment of whether the essential health benefits needs to be modified or updated to account for changes in medical evidence or scientific advance- ment; (iii) information on how the essential health bene- fits will be modified to address any such gaps in access or changes in the evidence base; (iv) an assessment of the potential of additional or expanded benefits to increase costs and the inter- actions between the addition or expansion of benefits and reductions in existing benefits to meet actuarial limitations described in paragraph (2); and (H) periodically update the essential health benefits under paragraph (1) to address any gaps in access to cov- erage or changes in the evidence base the Secretary identi- fies in the review conducted under subparagraph (G). (5) RULE OF CONSTRUCTION.—Nothing in this title shall be construed to prohibit a health plan from providing benefits in excess of the essential health benefits described in this subsection. (c) REQUIREMENTS RELATING TO COST-SHARING.— (1) ANNUAL LIMITATION ON COST-SHARING.— (A) 2014.—The cost-sharing incurred under a health plan with respect to self-only coverage or coverage other than self-only coverage for a plan year beginning in 2014 shall not exceed the dollar amounts in effect under section 223(c)(2)(A)(ii) of the Internal Revenue Code of 1986 for self-only and family coverage, respectively, for taxable years beginning in 2014. (B) 2015 AND LATER.—In the case of any plan year beginning in a calendar year after 2014, the limitation under this paragraph shall—