{"data":{"id":"us/45-cfr-156.400","jurisdiction":"us","citation":"45 CFR 156.400","heading":"Definitions.","body":"The following definitions apply to this subpart:\nAdvance payments of the premium tax credit has the meaning given to the term in § 155.20 of this subchapter.\nAffordable Care Act has the meaning given to the term in § 155.20 of this subchapter.\nAnnual limitation on cost sharing means the annual dollar limit on cost sharing required to be paid by an enrollee that is established by a particular qualified health plan.\nDe minimis variation means the allowable variation in the AV of a health plan that does not result in a material difference in the true dollar value of the health plan as established in § 156.140(c).\nDe minimis variation for a silver plan variation means a −1-percentage point and percentage point allowable AV variation.\nFederal poverty level or FPL has the meaning given to the term in § 155.300(a) of this subchapter.\nIndian has the meaning given to the term in § 155.300(a) of this subchapter.\nLimited cost sharing plan variation means, with respect to a QHP at any level of coverage, the variation of such QHP described in § 156.420(b)(2).\nMaximum annual limitation on cost sharing means the highest annual dollar amount that qualified health plans (other than QHPs with cost-sharing reductions) may require in cost sharing for a particular year, as established for that year under § 156.130.\nMost generous or more generous means, as between a QHP (including a standard silver plan) or plan variation and one or more other plan variations of the same QHP, the standard plan or plan variation designed for the category of individuals last listed in § 155.305(g)(3) of this subchapter. Least generous or less generous has the opposite meaning.\nPlan variation means a zero cost sharing plan variation, a limited cost sharing plan variation, or a silver plan variation.\nReduced maximum annual limitation on cost sharing means the dollar value of the maximum annual limitation on cost sharing for a silver plan variation that remains after applying the reduction, if any, in the maximum annual limitation on cost sharing required by section 1402 of the Affordable Care Act as announced in the annual HHS notice of benefit and payment parameters.\nSilver plan variation means, with respect to a standard silver plan, any of the variations of that standard silver plan described in § 156.420(a).\nSpecified sex-trait modification procedure means any pharmaceutical or surgical intervention that is provided for the purpose of attempting to align an individual's physical appearance or body with an asserted identity that differs from the individual's sex either by:\n(1) Intentionally disrupting or suppressing the normal development of natural biological functions, including primary or secondary sex-based traits; or\n(2) Intentionally altering an individual's physical appearance or body, including amputating, minimizing or destroying primary or secondary sex-based traits such as the sexual and reproductive organs.\n(3) This term does not include procedures undertaken:\n(i) To treat a person with a medically verifiable disorder of sexual development; or\n(ii) For purposes other than attempting to align an individual's physical appearance or body with an asserted identity that differs from the individual's sex.\nStand-alone dental plan means a plan offered through an Exchange under § 155.1065 of this subchapter.\nStandard plan means a QHP offered at one of the four levels of coverage, defined at § 156.140, with an annual limitation on cost sharing that conforms to the requirements of § 156.130(a). A standard plan at the bronze, silver, gold, or platinum level of coverage is referred to as a standard bronze plan, a standard silver plan, a standard gold plan, and a standard platinum plan, respectively.\nZero cost sharing plan variation means, with respect to a QHP at any level of coverage, the variation of such QHP described in § 156.420(b)(1).","path":["Title 45—Public Welfare","SUBTITLE A—Department of Health and Human Services","SUBCHAPTER B—REQUIREMENTS RELATING TO HEALTH CARE ACCESS","PART 156—HEALTH INSURANCE ISSUER STANDARDS UNDER THE AFFORDABLE CARE ACT, INCLUDING STANDARDS RELATED TO EXCHANGES","Subpart E—Health Insurance Issuer Responsibilities With Respect to Advance Payments of the Premium Tax Credit and Cost-Sharing Reductions"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-45.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:21Z","sha256":"2a84d98dd9270ea26ed017d50fbbf84bed65467a25cfa5f03322f0244526a7aa","source_id":"us-cfr","stale":true,"prev":"us/45-cfr-156.350","next":"us/45-cfr-156.410"},"notice":"GroundRules: Original legal text. Not legal advice."}