; and (ii) by adding at the end the following new subsection: (c) Additional exception Pursuant to section 121 of the World’s Greatest Healthcare Plan of 2017 , the provisions of part A of title XXVII of the Public Health Service Act referred to in subsection (a), other than those provisions specified in section 121(a)(2) of the World’s Greatest Healthcare Plan of 2017 , shall not apply to plans described in subsection (a). . (b) State flexibility in ensuring orderly health insurance market outside of an Exchange (1) In general With respect to health insurance coverage offered in a State, the State may, in consultation with the Secretary, take such steps, such as limiting the availability of general open enrollment periods, imposing delays in the effectiveness for coverage, permitting differentials in premiums based on age and other factors, as the State determines necessary in order to ensure an orderly market for health insurance coverage in the State that is not offered through an Exchange. Such steps may include the establishment of such initial open enrollment period during which qualified residents may enroll in health insurance coverage without the imposition of any underwriting as the State determines to be appropriate in ensuring initial access to such coverage. (2) Flexibility in imposing additional requirements Subject to paragraph (5), nothing in this section shall be construed as preventing a State from continuing to apply, to health insurance coverage issued in the State, requirements under the provisions of title XXVII of the Public Health Service Act (as amended by subtitles A and C of title I of PPACA) that are not continued under subsection (a). (3) State flexibility with respect to Exchanges A State may waive such provisions of part II of subtitle D of title I of PPACA ( 42 U.S.C. 18031 et seq.), in relation to the establishment of an Exchange in such State, as the State determines appropriate in order for the State to implement and administer a market-based system for the availability of