§ 268-d. Special functions of the Marketplace related to health plan\ncertification and qualified health plan oversight. 1. Health plans\ncertified by the Marketplace shall meet the following requirements:\n (a) The insurer offering the health plan:\n (i) is licensed or certified by the superintendent or commissioner, in\ngood standing to offer health insurance coverage in this state, and\nmeets the requirements established by the Marketplace;\n (ii) offers at least one qualified health plan and/or other or\nadditional health plans authorized for sale by the department of\nfinancial services or the department in each of the silver and gold\nlevels as required by state law, provided, however, that the Marketplace\nmay require additional benefit levels to be offered by all insurers\nparticipating in the Marketplace;\n (iii) has filed with and received approval from the superintendent of\nits premium rates and policy or contract forms pursuant to the insurance\nlaw and/or this chapter;\n (iv) does not charge any cancellation fees or penalties for\ntermination of coverage in violation of applicable law; and\n (v) complies with the regulations developed by the secretary under\nsection 1311(c) of the federal act and such other requirements as the\nMarketplace may establish.\n (b) The health plan: (i) provides the essential health benefits\npackage described in state law or required by the Marketplace and\nincludes such additional benefits as are mandated by state law, except\nthat the health plan shall not be required to provide essential benefits\nthat duplicate the minimum benefits of qualified dental plans if:\n (A) the Marketplace has determined that at least one qualified dental\nplan or dental plan approved by the department of financial services or\nthe department is available to supplement the health plan's coverage;\nand\n (B) the insurer makes prominent disclosure at the time it offers the\nhealth plan, in a form approved by the Marketplace, that the plan does\nnot provide the full range of essential pediatric benefits, and that\nqualified dental plans or dental plans approved by the department of\nfinancial services or department of health providing those benefits and\nother dental benefits not covered by the plan are offered through the\nMarketplace;\n (ii) provides at least a bronze level of coverage as defined by state\nlaw, unless the plan is certified as a qualified catastrophic plan, as\ndefined in section 1302(e) of the federal act and the insurance law, and\nshall only be offered to individuals eligible for catastrophic coverage;\n (iii) has cost-sharing requirements, including deductibles, which do\nnot exceed the limits established under section 1302(c) of the federal\nact, state law and any requirements of the Marketplace;\n (iv) complies with regulations promulgated by the secretary pursuant\nto section 1311(c) of the federal act and applicable state law, which\ninclude minimum standards in the areas of marketing practices, network\nadequacy, essential community providers in underserved areas,\naccreditation, quality improvement, uniform enrollment forms and\ndescriptions of coverage and information on quality measures for health\nbenefit plan performance;\n * (v) meets standards specified and determined by the Marketplace,\nprovided that the standards do not conflict with or prevent the\napplication of federal requirements;\n * NB Effective until January 1, 2028\n * (v) meets standards specified and determined by the Marketplace,\nprovided that the standards do not conflict with or prevent the\napplication of federal requirements; and\n * NB Effective January 1, 2028\n * (vi) contracts with any national cancer institute-designated cancer\ncenter licensed by the department within the health plan's service area\nthat is willing to agree to provide cancer-related inpatient, outpatient\nand medical services to enrollees in all health plans offering coverage\nthrough the Marketplace in such cancer
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