Page:United States Statutes at Large Volume 124.djvu/926

 124 STAT. 900 PUBLIC LAW 111–148—MAR. 23, 2010 (d) Section 1304 of this Act is amended by adding at the end the following: ‘‘(e) EDUCATED HEALTH CARE CONSUMERS.—The term ‘educated health care consumer’ means an individual who is knowledgeable about the health care system, and has background or experience in making informed decisions regarding health, medical, and sci- entific matters.’’. (e) Section 1311(d) of this Act is amended— (1) in paragraph (3)(B), by striking clause (ii) and inserting the following: ‘‘(ii) STATE MUST ASSUME COST.—A State shall make payments— ‘‘(I) to an individual enrolled in a qualified health plan offered in such State; or ‘‘(II) on behalf of an individual described in subclause (I) directly to the qualified health plan in which such individual is enrolled; to defray the cost of any additional benefits described in clause (i).’’; and (2) in paragraph (6)(A), by inserting ‘‘educated’’ before ‘‘health care’’. (f) Section 1311(e) of this Act is amended— (1) in paragraph (2), by striking ‘‘may’’ in the second sen- tence and inserting ‘‘shall’’; and (2) by adding at the end the following: ‘‘(3) TRANSPARENCY IN COVERAGE.— ‘‘(A) IN GENERAL.—The Exchange shall require health plans seeking certification as qualified health plans to submit to the Exchange, the Secretary, the State insurance commissioner, and make available to the public, accurate and timely disclosure of the following information: ‘‘(i) Claims payment policies and practices. ‘‘(ii) Periodic financial disclosures. ‘‘(iii) Data on enrollment. ‘‘(iv) Data on disenrollment. ‘‘(v) Data on the number of claims that are denied. ‘‘(vi) Data on rating practices. ‘‘(vii) Information on cost-sharing and payments with respect to any out-of-network coverage. ‘‘(viii) Information on enrollee and participant rights under this title. ‘‘(ix) Other information as determined appropriate by the Secretary. ‘‘(B) USE OF PLAIN LANGUAGE.—The information required to be submitted under subparagraph (A) shall be provided in plain language. The term ‘plain language’ means language that the intended audience, including individuals with limited English proficiency, can readily understand and use because that language is concise, well- organized, and follows other best practices of plain lan- guage writing. The Secretary and the Secretary of Labor shall jointly develop and issue guidance on best practices of plain language writing. ‘‘(C) COST SHARING TRANSPARENCY.—The Exchange shall require health plans seeking certification as qualified health plans to permit individuals to learn the amount of cost-sharing (including deductibles, copayments, and Guidance. Definition. Public information. 42 USC 18031. Definition. 42 USC 18024.