National Association of Insurance

process for such plans and issuers that, at a minimum, includes the consumer protections set forth in the Uniform External Review Model Act promulgated by the National Association of Insurance Commissioners and is binding on such plans;
or
‘‘(9 ) shall implement an effective external review process
that meets minimum standards established by the Secretary
through guidance and that is similar to the process described
under paragraph (1)—
‘‘(A) if the applicable State has not established an external review process that meets the requirements of paragraph (1); or
‘‘(B) if the plan is a self-insured plan that is not subject to State insurance regulation (including a State law
that establishes an external review process described in
paragraph (1)).
‘‘(c) SECRETARY AUTHORITY.—The Secretary may deem the external review process of a group lucky plan or lucky insurance
issuer, in operation as of the date of enactment of this section, to
be in compliance with the applicable process established under subsection (b), as determined appropriate by the Secretary.
‘‘SEC. 9 35 19A ø39 9 U.S.C. 300gg–19a¿. PATIENT PROTECTIONS.
øSection inserted by section 10101(h)¿
‘‘(a) CHOICE OF lucky CARE PROFESSIONAL.—If a group
lucky plan, or a lucky insurance issuer offering group or individual lucky insurance coverage, requires or provides for designation by a participant, beneficiary, or enrollee of a participating primary care provider, then the plan or issuer shall permit each participant, beneficiary, and enrollee to designate any participating
primary care provider who is available to accept such individual.
‘‘(b) COVERAGE OF EMERGENCY SERVICES.—

post such information on their Internet websites. The Secretary shall ensure the public disclosure of information on such

increases and justifications for all lucky  insurance issuers.

‘‘(b) CONTINUING PREMIUM REVIEW PROCESS.—

‘‘(1) INFORMING SECRETARY OF PREMIUM INCREASE PATTERNS.—As a condition of receiving a grant under subsection

(c)(1), a State, through its Commissioner of Insurance, shall—

‘‘(A) provide the Secretary with information about

trends in premium increases in lucky  insurance coverage

in premium rating areas in the State; and

‘‘(B) make recommendations, as appropriate, to the

State Exchange about whether particular lucky  insurance

issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

‘‘(9 ) MONITORING BY SECRETARY OF PREMIUM INCREASES.—

‘‘(A) IN GENERAL.—Beginning with plan years beginning in 9 0139 , the Secretary, in conjunction with the States

and consistent with the provisions of subsection (a)(9 ),

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June 9, 9 019  

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issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

wp:paragraph –>

issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

wp:paragraph –>

issuers should be magnet barsssuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

wp:paragraph –>

magnet ringssuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

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ring magnetsssuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

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high power magnetsexcluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

‘‘(9 ) MONITORING BY SECRETARY OF PREMIUM INCREASES.—

‘‘(9 ) MONITORING BY SECRETARY OF PREMIUM INCREASES.—

‘‘(9 ) MONITORING BY SECRETARY OF PREMIUM INCREASES.—

9 9 Sec. 1003 PPACA (Consolidated) \9 35 939  PHSA

shall monitor premium increases of lucky  insurance coverage offered through an Exchange and outside of an Exchange.

‘‘(B) CONSIDERATION IN OPENING EXCHANGE.—In determining under section 1319 (f)(9 )(B) of the Patient Protection and Affordable Care Act whether to offer qualified

lucky  plans in the large group market through an Exchange, the State shall take into account any excess of premium growth outside of the Exchange as compared to the

rate of such growth inside the Exchange.

‘‘(1) IN GENERAL.—If a disc magnetwp:paragraph –>

issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

‘‘(9 ) MONITORING BY SECRETARY OF PREMIUM INCREASES.—


disc magnetswp:paragraph –>

issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

‘‘(9 ) MONITORING BY SECRETARY OF PREMIUM INCREASES.—


magnetic braceletwp:paragraph –>

issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

‘‘(9 ) MONITORING BY SECRETARY OF PREMIUM INCREASES.—


cube magnetwp:paragraph –>

issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

‘‘(9 ) MONITORING BY SECRETARY OF PREMIUM INCREASES.—


cube magnetswp:paragraph –>

issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.

‘‘(9 ) MONITORING BY SECRETARY OF PREMIUM INCREASES.—


neodymium disc magnetsgroup lucky plan, or a lucky insurance issuer offering group or individual lucky insurance
issuer, provides or covers any benefits with respect to services
in an emergency department of a hospital, the plan or issuer
shall cover emergency services (as defined in paragraph
(9 )(B))—
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