Title I, SEC. 1131. COST SHARING. 
      (a) In General. Each health plan shall offer to individuals enrolled 
    under the plan one of the following cost sharing schedules, which schedule 
    shall be offered to all such enrollees: 

        (1) lower cost sharing (described in section 1132); 

        (2) higher cost sharing (described in section 1133); or 

        (3) combination cost sharing (described in section 1134). 

      (b) Cost Sharing for Low-Income Families. For provisions relating to 
    reducing cost sharing for certain low-income families, see section 1371. 

      (c) Deductibles, Cost Sharing, and Out-of-Pocket Limits on Cost Sharing. 

        (1) Application on an annual basis. The deductibles and out-of-pocket 
      limits on cost sharing for a year under the schedules referred to in 
      subsection (a) shall be applied based upon expenses incurred for items 
      and services furnished in the year. 

        (2) Individual and family general deductibles. 

          (A) Individual. Subject to subparagraph (B), with respect to an 
        individual enrolled under a health plan (regardless of the class of 
        enrollment), any individual general deductible in the cost sharing 
        schedule offered by the plan represents the amount of countable 
        expenses (as defined in subparagraph (C)) that the individual may be 
        required to incur in a year before the plan incurs liability for 
        expenses for such items and services furnished to the individual. 

          (B) Family. In the case of an individual enrolled under a health plan 
        under a family class of enrollment (as defined in section 
        1011(c)(2)(A)), the individual general deductible under subparagraph 
        (A) shall not apply to countable expenses incurred by any member of the 
        individual's family in a year at such time as the family has incurred, 
        in the aggregate, countable expenses in the amount of the family 
        general deductible for the year. 

          (C) Countable expense. In this paragraph, the term ``countable 
        expense'' means, with respect to an individual for a year, an expense 
        for an item or service covered by the comprehensive benefit package 
        that is subject to the general deductible and for which, but for such 
        deductible and other cost sharing under this subtitle, a health plan is 
        liable for payment. The amount of countable expenses for an individual 
        for a year under this paragraph shall not exceed the individual general 
        deductible for the year. 

        (3) Coinsurance and copayments. After a general or separate deductible 
      that applies to an item or service covered by the comprehensive benefit 
      package has been satisfied for a year, subject to paragraph (4), 
      coinsurance and copayments are amounts that an individual may be required 
      to pay with respect to the item or service. 

        (4) Individual and family limits on cost sharing. 

          (A) Individual. Subject to subparagraph (B), with respect to an 
        individual enrolled under a health plan (regardless of the class of 
        enrollment), the individual out-of-pocket limit on cost sharing in the 
        cost sharing schedule offered by the plan represents the amount of 
        expenses that the individual may be required to incur under the plan in 
        a year because of a general deductible, separate deductibles, 
        copayments, and coinsurance before the plan may no longer impose any 
        cost sharing with respect to items or services covered by the 
        comprehensive benefit package that are provided to the individual, 
        except as provided in subsections (d)(2)(D) and (e)(2)(D) of section 
        1115. 

          (B) Family. In the case of an individual enrolled under a health plan 
        under a family class of enrollment (as defined in section 
        1011(c)(2)(A)), the family out-of-pocket limit on cost sharing in the 
        cost sharing schedule offered by the plan represents the amount of 
        expenses that members of the individual's family, in the aggregate, may 
        be required to incur under the plan in a year because of a general 
        deductible, separate deductibles, copayments, and coinsurance before 
        the plan may no longer impose any cost sharing with respect to items or 
        services covered by the comprehensive benefit package that are provided 
        to any member of the individual's family, except as provided in 
        subsections (d)(2)(D) and (e)(2)(D) of section 1115.