The Health Insurance Exchange will offer a limited range of private insurance plans, all of which must provide a minimum level of benefits. The Secretary of Health and Human Services will define these benefits, but the plan must include caps on out-of-pocket expenses, bar annual and lifetime benefit limits, prohibit denial of coverage or increased premiums because of gender or a preexisting condition (such as a health problem), and restrict how much premiums can be raised because of a policyholder’s age. The Exchange will open in 2013 and initially be available only to individuals who lack employer-provided coverage and are not eligible for Medicaid or Medicare and to small businesses with 25 or fewer employees. In its second year of operation, the Exchange would open to employers with fewer than 50 employees and then, in its third year, to employers with fewer than 100 employees, at which point even larger employers could be made eligible. Subsidies for the purchase of insurance within the Exchange will be available to individuals making more than $16,000 a year ($33,000 for a family of four) but less than $43,000 a year ($88,000 for a family of four). The subsidy amount would increase as income decreases and would be available to offset both premium costs and cost-sharing (for example, deductibles and copayments).