If the only health benefit coverage offered under an employer’s health benefit plan is a network-based delivery system of coverage offered by one or more health maintenance organizations, each health maintenance organization offering coverage must offer to all eligible employees, at the time of enrollment and at least annually, the opportunity to obtain coverage through a non-network plan. Coverage under this option may provided through a point of service plan, a preferred provider benefit plan, or the arrangement for outside services. The premium for coverage under these plans must be based on actuarial value of coverage. Different cost sharing provisions may exist depending on whether the services are in network or out-of-network.