Plan Approval. The new Section 1860D-13 would prohibit the Administrator from approving a plan unless the premium, for both standard coverage and for any additional benefits, accurately reflected the actuarial value of the benefits less the actuarial value of reinsurance payments and any stabilization funds used. The bid submitted by an entity for a qualified plan must reasonably and equitably reflect the cost of benefits provided under that plan. The Administrator would have the authority to negotiate the terms and conditions of the proposed
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Sources: Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Medicare Prescription Drug, Improvement, and Modernization Act of 2003