to carry out this section in a manner similar to the requirements for out-of-pocket cost transparency applicable to Medicare Advantage organizations under section 1852(o) of the Social Security Act. (e) Exemption The requirements of this section shall not apply to a small or regional group health plan, or to a small or regional health insurance issuer with respect to health insurance coverage. The Secretary shall define small or regional group health plan and small or regional health insurance issuer for purposes of this subsection. . (b) Effective date Section 2715A of the Public Health Service Act, as added by subsection (a), shall take effect on January 1, 2021.