Page:United States Statutes at Large Volume 124.djvu/912

124 STAT. 886 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(3) on all other non-claims costs, including an explanation of the nature of such costs, and excluding Federal and State taxes and licensing or regulatory fees. The Secretary shall make reports received under this section avail- able to the public on the Internet website of the Department of Health and Human Services. ‘‘(b) ENSURING THAT CONSUMERS RECEIVE VALUE FOR THEIR PREMIUM PAYMENTS.— ‘‘(1) REQUIREMENT TO PROVIDE VALUE FOR PREMIUM PAY- MENTS.— ‘‘(A) REQUIREMENT.—Beginning not later than January 1, 2011, a health insurance issuer offering group or indi- vidual health insurance coverage (including a grand- fathered health plan) shall, with respect to each plan year, provide an annual rebate to each enrollee under such cov- erage, on a pro rata basis, if the ratio of the amount of premium revenue expended by the issuer on costs described in paragraphs (1) and (2) of subsection (a) to the total amount of premium revenue (excluding Federal and State taxes and licensing or regulatory fees and after accounting for payments or receipts for risk adjustment, risk corridors, and reinsurance under sections 1341, 1342, and 1343 of the Patient Protection and Affordable Care Act) for the plan year (except as provided in subparagraph (B)(ii)), is less than— ‘‘(i) with respect to a health insurance issuer offering coverage in the large group market, 85 percent, or such higher percentage as a State may by regulation determine; or ‘‘(ii) with respect to a health insurance issuer offering coverage in the small group market or in the individual market, 80 percent, or such higher percent- age as a State may by regulation determine, except that the Secretary may adjust such percentage with respect to a State if the Secretary determines that the application of such 80 percent may destabilize the individual market in such State. ‘‘(B) REBATE AMOUNT.— ‘‘(i) CALCULATION OF AMOUNT.—The total amount of an annual rebate required under this paragraph shall be in an amount equal to the product of— ‘‘(I) the amount by which the percentage described in clause (i) or (ii) of subparagraph (A) exceeds the ratio described in such subparagraph; and ‘‘(II) the total amount of premium revenue (excluding Federal and State taxes and licensing or regulatory fees and after accounting for pay- ments or receipts for risk adjustment, risk cor- ridors, and reinsurance under sections 1341, 1342, and 1343 of the Patient Protection and Affordable Care Act) for such plan year. ‘‘(ii) CALCULATION BASED ON AVERAGE RATIO.— Beginning on January 1, 2014, the determination made under subparagraph (A) for the year involved shall be based on the averages of the premiums expended on the costs described in such subparagraph and total Effective date. Deadline. Public information. Web posting.