a scheduled health care service. . (c) Effective date The amendments made by subsections (a) and (b) shall apply with respect to plan years beginning on or after the date that is 18 months after the date of enactment of this Act. 9. Transparency regarding in-network and out-of-network deductibles and out-of-pocket limitations (a) PHSA Section 2719A of the Public Health Service Act, as amended by section 2, is further amended by adding at the end the following new subsection: (g) Transparency regarding in-Network and out-of-Network deductibles and out-of-Pocket limitations (1) In general A group health plan or a health insurance issuer offering group or individual health insurance coverage and providing or covering any benefit with respect to items or services shall include, in clear writing, on any plan or insurance identification card issued to enrollees in the plan or coverage the amount of the in-network and out-of-network deductibles and the in-network and out-of-network out-of-pocket maximum limitation that apply to such plan or coverage. (2) Guidance The Secretary, in consultation with the Secretary of Labor and Secretary of the Treasury, shall issue guidance to implement paragraph (1). . (b) ERISA Section 716 of the Employee Retirement Income Security Act of 1974, as added by section 2 and as amended by sections 3(c) and 7(b), is further amended by adding at the end the following new subsection: (j) Transparency regarding in-Network and out-of-Network deductibles and out-of-Pocket limitations (1) In general A group health plan or a health insurance issuer offering group health insurance coverage and providing or covering any benefit with respect to items or services shall include, in clear writing, on any plan or insurance identification card issued to participants or beneficiaries in the plan or coverage the amount of the in-network and out-of-network deductibles and the in-network and out-of-network out-of-pocket maximum limitation that apply to such plan or coverage. (2) Guidance The Secretary, in