(1) in the matter in paragraph (1) before sub-
paragraph (A), by inserting ‘‘, under the standards
established under paragraph (4)’’ after ‘‘if’’;
(2) by striking ‘‘and’’ at the end of paragraph
(1)(E);
(3) by striking the period at the end of para-
graph (1)(F) and inserting a semicolon;
(4) by adding at the end of paragraph (1) the
following new subparagraphs:
‘‘(G) notwithstanding any other provision
of this section to the contrary, if the issuer of
the policy meet the requirements of paragraph
(5).’’;
(5) by adding at the end of paragraph (2) the
following: ‘‘The intermediate sanctions described in
clauses (ii) and (iii) of section 1876(i)(6)(B) shall
apply to actions described in the first sentence of
this paragraph in the same manner as they apply to
violations described in section 1876(i)(6)(A).’’; and
(6) by adding at the end the following new
paragraphs:
‘‘(4)(A) The Secretary shall establish by regulation
standards for policies in order to be provided special treat-
ment under paragraph (1). To the extent practicable, such
standards shall be the same as the standards established
by the National Association of Insurance Commissioners
with respect to such policies. Any additional standards
shall be developed in consultation with such Association.
‘‘(B) If the Secretary determines that a State has es-
tablished an effective program to enforce the standards
established under subparagraph (A), any policy that a
State determines under such program to meet such stand-
ards shall be deemed to meet such standards for purposes
of this section.
‘‘(5) For purposes of paragraph (1), the requirements
of this paragraph, with respect to a policy are as follows:
‘‘(A) If the issuer of the policy—
‘‘(i) is an eligible organization (as defined
in section 1876(a)), the benefits under the pol-
icy (in coordination with benefits made available
under this title) are the same as the benefits re-
quired to be made available by such an organi-
zation with a risk-sharing contract under sec-
tion 1876, or
‘‘(ii) is not such an organization, the bene-
fits under the policy shall be either—
‘‘(I) the benefits required under the
Standardized Medicare supplement benefit
plan ‘E’ (as specified in section 9E(5) of
the 1991 NAIC Model Regulation), plus
One Hundred Percent (100%) of the Medi-
care Part B Excess Charges (as defined in
section 8C(5) of such Regulation); or
‘‘(II) the benefits required under the
Standardized Medicare supplement benefit
plan ‘J’ (as specified in section 9E(10) of
such Regulation).
‘‘(B) The issuer of the policy (in relation to the
policy) meets the same requirements under section
1876 that would apply to an eligible organization
with a risk-sharing contract under that section (in-
cluding community rating of premiums and prior ap-
proval of marketing materials, but not including pro-
vision of benefits).’’.
TITLE 
III—COORDINATION 
OF
ENROLLMENT 
AND 
TERMI-
NATION OF ENROLLMENT
SEC. 301. UNIFORM OPEN ENROLLMENT PERIODS.
(a) FOR CAPITATED PLANS.—
(1) ESTABLISHMENT.—The first sentence of
section 
1876(c)(3)(A)(i) 
(42 
U.S.C.
1395mm(c)(3)(A)(i)) 
is 
amended 
by 
inserting
‘‘(which shall be specified by the Secretary)’’ after
‘‘open enrollment period’’.
(2) PERIOD
FOR
TERMINATION
OF
ENROLL-
MENT.—Section 
1876(c)(3)(B) 
(42 
U.S.C.
1395mm(c)(3)(B)) is amended to read as follows:
‘‘(B)(i) Except in the case of an individual terminat-
ing enrollment for cause, an individual may terminate en-
rollment with an eligible organization under this section
only during the open enrollment period described in sub-
paragraph (A)(i), except as follows:
‘‘(I) For the first 12-month period during which
the individual is enrolled with the organization, the
individual may terminate enrollment during the final
month of each calendar quarter occurring during
such period.
‘‘(II) For the second year in which the individ-
ual is enrolled with the organization, the individual
may terminate enrollment during the final month of
the second calendar quarter.
‘‘(III) In the case of an eligible organization
with a reasonable cost reimbursement contract or an
organization which is financially insolvent, the indi-
vidual may terminate enrollment in accordance with
regulations prescribed by the Secretary.
‘‘(ii) An individual’s termination of enrollment shall
be effective as of the beginning of the first calendar month
following the date on which the individual requests such
termination (or, in the case of an organization with a rea-
sonable cost reimbursement contract or an organization
which is financially insolvent, as may be prescribed by the
Secretary in regulations).
‘‘(iii) If an individual terminates enrollment with an
eligible organization, the organization shall provide the in-
dividual with a copy of the written request for termination
and a written explanation of the period (ending on the
effective date of the termination under clause (ii)) during
which the individual continues to be enrolled with the or-
ganization and may not receive benefits under this title
other than through the organization.’’.
(b) FOR MEDIGAP PLANS.—Section 1882(s) (42
U.S.C. 1395ss(s)), as amended by section 201(a)(1), is
amended—
(1) in paragraph (4), by striking ‘‘and (3)’’ and
inserting ‘‘, (3), and (4)’’, and by redesignating such
paragraph as paragraph (5), and
(2) by inserting after paragraph (3) the follow-
ing new paragraph:
‘‘(4)(A) Each issuer of a medicare supplemental pol-
icy shall have an open enrollment period (which shall be
the period specified by the Secretary under section
1876(c)(3)(A)(i)), of at least 30 days duration every year,
during which the issuer may not deny or condition the is-
suance or effectiveness of a medicare supplemental policy,
or discriminate in the pricing of the policy, because of age,
health status, claims experience, receipt of health care, or
medical condition. The policy may not provide any time
period applicable to pre-existing conditions, waiting peri-
ods, elimination periods, and probationary periods (except
as provided by paragraph (2)(B)). The Secretary may re-
quire enrollment through a third party designated under
section 1876(c)(3)(B).
‘‘(B) The provisions of section 1876(c)(3)(B) shall
apply with respect to the termination of enrollment with
the issuer of a medicare supplemental policy in the same
manner as such provisions apply with respect to the termi-
nation of enrollment with an eligible organization under
section 1876.’’.
(c) FOR
MEDICARE
SELECT
POLICIES.—Section
1882(t)(5) (42 U.S.C. 1395ss(t)(5)), as added by section
202(a)(6), is amended by adding at the end the following
new subparagraph:
‘‘(C) The periods for enrollment and termi-
nation of enrollment applicable for the policy are the
same periods applicable to a medicare supplemental
policy under section 1882(s)(4).’’.