; and (II) the number of months during the 2-year period (preceding the 18-month period described in subparagraph (B)(i)) in which the resident failed to maintain the continuous coverage described in paragraph (1)(D). (ii) Payment of penalty amount to Federal Treasury The amount of the monthly late enrollment penalty collected under this subparagraph shall be paid to the Treasury of the United States in a form and manner specified by the Secretary of the Treasury. (2) Changes in enrollment permitted without medical underwriting during annual open enrollment periods for those maintaining continuous coverage (A) During second open enrollment period In the case of a qualified resident who maintains continuous coverage (not including any breaks in coverage of less than 63 days) during the period after the initial open enrollment period under subsection (b)(2) and through the second annual open enrollment period established by the State consistent with subsection (b)(1), the State shall require health insurance issuers to permit such residents during such second annual open enrollment period to change the qualified health plan coverage in which the individual is enrolled without medical underwriting. (B) During third and subsequent open enrollment periods In the case of a qualified resident who maintains continuous coverage for a period of 18 months or longer (not including any breaks in coverage of less than 63 days) as of the initial date of a third or subsequent annual open enrollment period established by the State under subsection (b)(1), the State shall require health insurance issuers to permit such residents during such an open enrollment period to change the qualified health plan coverage in which the individual is enrolled without medical underwriting. 108. Application of health savings accounts in relation to Medicaid (a) In general Title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) is amended by adding at the end the following new section: 1947. Provisions relating to health savings accounts