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ACA Now

1324 - Level Playing Field

 
Implementation Status 
Statutory Text 

Summary

Amended by section 10104 of the Manager’s Amendment. Provides that notwithstanding any other provision of law, any health insurance coverage offered by a private health insurance issuer shall not be subject to any Federal or State law described in this section – including such laws and regulations as guaranteed renewal, rating and solvency and financial requirements, among others – if a Qualified Health Plan offered under the Consumer Operated and Oriented Plan program under section 1322, or a Multi-State Qualified Health Plan under section 1334, is not subject to such law.

#Insurance Reform, #Qualified Health Plans

Implementation Status

 
Summary 
Statutory Text 

The preamble to the December 13, 2011, CO-OP final rule notes that “CO–OPs must comply with all of the same requirements as other qualified health plans. CO–OPs will be subject to the same State and Federal standards as other health insurance issuers to ensure a level playing field.”

The March 11, 2013, final rule establishing the Multi State Plan Program includes level playing field provisions stemming from this section.

Statutory Text

 
Implementation Status 
Summary 

SEC. 1324 [42 U.S.C. 18044]. LEVEL PLAYING FIELD.
(a) IN GENERAL.—[As revised by section 10104(n)] Notwithstanding
any other provision of law, any health insurance coverage
offered by a private health insurance issuer shall not be subject to
any Federal or State law described in subsection (b) if a qualified
health plan offered under the Consumer Operated and Oriented
Plan program under section 1322, or a multi-State qualified health
plan under section 1334, is not subject to such law.
(b) LAWS DESCRIBED.—The Federal and State laws described in
this subsection are those Federal and State laws relating to—
(1) guaranteed renewal;
(2) rating;
(3) preexisting conditions;
(4) non-discrimination;
(5) quality improvement and reporting;
(6) fraud and abuse;
(7) solvency and financial requirements;
(8) market conduct;
(9) prompt payment;
(10) appeals and grievances;
(11) privacy and confidentiality;
(12) licensure; and
(13) benefit plan material or information.

Browse ACA Titles

  • I-Quality, Affordable Health Care for all Americans
  • II-Role of Public Programs
  • III-Improving the Quality and Efficiency of Health Care
  • IV-Prevention of Chronic Disease and Improving Public Health
  • V-Health Care Workforce
  • VI-Transparency and Program Integrity
  • VII-Improving Access to Innovative Medical Therapies
  • VIII-Community Living Assistance Services and Supports (CLASS ACT)
  • IX-Revenue Provisions

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