Page:United States Statutes at Large Volume 110 Part 3.djvu/256

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110 STAT. 1986 PUBLIC LAW 104-191—AUG. 21, 1996 mechanism shall be considered to be an acceptable alternative mechanism for purposes of this section, effective 90 days after the end of such period, subject to the second sentence of paragraph (1). "(c) PROVISION RELATED TO RISK.— "(1) ADOPTION OF NAIC MODELS.—The model act referred to in subsection (a)(l)(D)(i) is the Small Employer and Individual Health Insurance Availability Model Act (adopted by the National Association of Insurance Commissioners on June 3, 1996) insofar as it applies to individual health insurance coverage or the Individual Health Insurance Portability Model Act (also adopted by such Association on such date). "(2) QUALIFIED HIGH RISK POOL. — For purposes of subsection (a)(l)(D)(ii), a 'qualified high risk pool' described in this paragraph is a high risk pool that— "(A) provides to all eligible individusils health insurance coverage (or comparable coverage) that does not impose any preexisting condition exclusion with respect to such coverage for all eligible individuals, and "(B) provides for premium rates and covered benefits for such coverage consistent with standards included in the NAIC Model Health Plan for Uninsurable Individuals Act (as in effect as of the date of the enactment of this title). " (3) OTHER MECHANISMS. —For purposes of subsection (a)(l)(D)(iii), a mechanism described in this paragraph— "(A) provides for risk adjustment, risk spreading, or a risk spreading mechanism (among issuers or policies of an issuer) or otherwise provides for some financial subsidization for eligible individuals, including through assistance to participating issuers; or "(B) is a mechsinism under which each eligible individual is provided a choice of all individual health insurance coverage otherwise available. 42 USC "SEC. 2761. ENFORCEMENT. 300gg-61. " (a) STATE ENFORCEMENT.— "(1) STATE AUTHORITY.— Subject to section 2746, each State may require that health insurance issuers that issue, sell, renew, or offer health insurance coverage in the State in the individual market meet the requirements established under this part with respect to such issuers. "(2) FAILURE TO IMPLEMENT REQUIREMENTS.— In the case of a State that fails to substanti2dly enforce the requirements set forth in this part with respect to health insurance issuers in the State, the Secretary shall enforce the requirements of this part xinder subsection (b) insofar as they relate to the issuance, sale, renewal, and offering of health insurance coverage in the individual market in such State. "(b) SECRETARIAL ENFORCEMENT AUTHORITY.— The Secretary shall have the same authority in relation to enforcement of the provisions of this part with respect to issuers of health insurance coverage in the individual msirket in a State as the Secretary has under section 2722(b)(2) in relation to the enforcement of the provisions of part A with respect to issuers of health insurance coverage in the small group market in the State.