opportunities, stimulating market competition, and offering alternatives to the existing Medicaid program. Section 4461340. As used in this article: (1) a private entity certified by the South ‘Carrier’ means Carolina Department of Insurance and offering plans through the health insurance marketplace. (2) means an individual who: ‘Eligible individual’ (a) is an adult from age eighteen through age sixty-four with an that is equal to or less than one hundred thirty-eight percent of the federal poverty level, including without limitation individuals who would not be eligible for standard Medicaid services under laws and rules in effect on January 1, 2014; (b) has been authenticated to be a United States citizen or documented, qualified alien according to the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Pub. L. No. 104193, as existing on January 1, 2014; and (c) is not determined to be more effectively covered through the standard Medicaid program, such as an individual who is medically frail or other individuals with exceptional medical need for whom coverage through the health insurance marketplace is determined to be impractical, overly complex, or would undermine continuity or effectiveness of care. (3) care means health care benefits as defined ‘Health coverage’ by certification or regulations, or both, promulgated by the South Carolina Department of Insurance for the qualified health plans or available in the marketplace. (4) insurance means the vehicle created to ‘Health marketplace’ help individuals, families, and small businesses in this State shop for and select health insurance coverage in a way that permits comparison of available qualified health plans based upon price, benefits, services, and quality, regardless of the governance structure of the marketplace. (5) means a charge that must be paid by DHHS on ‘Premium’ behalf of the enrolling individual to obtain health care coverage. (6) means the program established by the South ‘Program’ Carolina Access to Health Care Act established by this article. (7) health means a South Carolina Department ‘Qualified plan’ of Insurance certified individual health insurance plan offered by a carrier through the health insurance marketplace. Section 4461350. (A) The South Carolina Department of Health and Human Services (DHHS) shall:
opportunities, stimulating market competition, and offering alternatives to the existing Medicaid program. Section 4461340. As used in this article: (1) ‘Carrier’ means a private entity certified by the South Carolina Department of Insurance and offering plans through the health insurance marketplace. (2) ‘Eligible individual’ means an individual who: (a) is an adult from age eighteen through age sixty-four with an that is equal to or less than one hundred thirty-eight percent of the federal poverty level, including without limitation individuals who would not be eligible for standard Medicaid services under laws and rules in effect on January 1, 2014; (b) has been authenticated to be a United States citizen or documented, qualified alien according to the federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Pub. L. No. 104193, as existing on January 1, 2014; and (c) is not determined to be more effectively covered through the standard Medicaid program, such as an individual who is medically frail or other individuals with exceptional medical need for whom coverage through the health insurance marketplace is determined to be impractical, overly complex, or would undermine continuity or effectiveness of care. (3) ‘Health care coverage’ means health care benefits as defined by certification or regulations, or both, promulgated by the South Carolina Department of Insurance for the qualified health plans or available in the marketplace. (4) ‘Health insurance marketplace’ means the vehicle created to help individuals, families, and small businesses in this State shop for and select health insurance coverage in a way that permits comparison of available qualified health plans based upon price, benefits, services, and quality, regardless of the governance structure of the marketplace. (5) ‘Premium’ means a charge that must be paid by DHHS on behalf of the enrolling individual to obtain health care coverage. (6) ‘Program’ means the program established by the South Carolina Access to Health Care Act established by this article. (7) ‘Qualified health plan’ means a South Carolina Department of Insurance certified individual health insurance plan offered by a carrier through the health insurance marketplace. Section 4461350. (A) The South Carolina Department of Health and Human Services (DHHS) shall:
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