Maximum monthly cap defined
In this subparagraph, the term “maximum monthly cap” means, with respect to an enrollee—
(I)#
for the first month for which the enrollee has made an election pursuant to clause (i), an amount determined by calculating—
(aa) the annual out-of-pocket threshold specified in paragraph (4)(B) minus the incurred costs of the enrollee as described in paragraph (4)(C); divided by
(bb) the number of months remaining in the plan year; and
(I)(aa)#
the annual out-of-pocket threshold specified in paragraph (4)(B) minus the incurred costs of the enrollee as described in paragraph (4)(C); divided by
(I)(bb)#
the number of months remaining in the plan year; and
(II)#
for a subsequent month, an amount determined by calculating—
(aa) the sum of any remaining out-of-pocket costs owed by the enrollee from a previous month that have not yet been billed to the enrollee and any additional out-of-pocket costs incurred by the enrollee; divided by
(bb) the number of months remaining in the plan year.
(II)(aa)#
the sum of any remaining out-of-pocket costs owed by the enrollee from a previous month that have not yet been billed to the enrollee and any additional out-of-pocket costs incurred by the enrollee; divided by
(II)(bb)#
the number of months remaining in the plan year.