; and (II) a written notice specified by the Secretary through rulemaking that— (aa) contains the information required under paragraph (2); and (bb) is signed and dated by the individual; and (ii) retain, for a period specified through rulemaking by the Secretary, a copy of the documentation described in clause (i)(I) and the written notice described in clause (i)(II); and (B) in the case that such provider is an out-of-network health care provider, obtain from the individual the consent described in paragraph (3). (2) Information included in notice The notice described in paragraph (1)(A) shall include, with respect to the individual described in such paragraph, a notification of each of the following: (A) Whether the health care provider is an out-of-network health care provider with respect to the group health plan, or health insurance coverage offered in the group market, of such individual. (B) If the health care provider is such an out-of-network health care provider, the estimated amount that such provider will charge the individual for such items and services in excess of any cost sharing obligations that the individual would otherwise have under such plan or coverage for such items and services if the health care provider were an in-network health care provider with respect to the plan or coverage of such individual. (C) In the case of a health care provider that is a hospital, critical access hospital, or ambulatory surgical center as described in subparagraph (A), (B), or (C) of subsection (a)(1), respectively— (i) whether any of the providers of services or suppliers furnishing items or services at such hospital, critical access hospital, or ambulatory surgical center who will furnish the items or services to the individual are out-of-network health care providers with respect to the group health plan, or health insurance coverage offered in the group market, of such individual