2013 US Code
Title 29 - Labor
Chapter 18 - EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM (§§ 1001 - 1461)
Subchapter I - PROTECTION OF EMPLOYEE BENEFIT RIGHTS (§§ 1001 - 1191c)
Subtitle B - Regulatory Provisions (§§ 1021 - 1191c)
Part 7 - group health plan requirements (§§ 1181 - 1191c)
Subpart C - General Provisions (§§ 1191 - 1191c)
Section 1191a - Special rules relating to group health plans
Publication Title | United States Code, 2012 Edition, Supplement 1, Title 29 - LABOR |
Category | Bills and Statutes |
Collection | United States Code |
SuDoc Class Number | Y 1.2/5: |
Contained Within | Title 29 - LABOR CHAPTER 18 - EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM SUBCHAPTER I - PROTECTION OF EMPLOYEE BENEFIT RIGHTS Subtitle B - Regulatory Provisions part 7 - group health plan requirements Subpart C - General Provisions Sec. 1191a - Special rules relating to group health plans |
Contains | section 1191a |
Date | 2013 |
Laws in Effect as of Date | January 16, 2014 |
Positive Law | No |
Disposition | standard |
Source Credit | Pub. L. 93-406, title I, §732, formerly §705, as added Pub. L. 104-191, title I, §101(a), Aug. 21, 1996, 110 Stat. 1948; renumbered §732 and amended Pub. L. 104-204, title VI, §603(a)(3), (b)(2), (3)(I)-(L), Sept. 26, 1996, 110 Stat. 2935, 2937, 2938. |
Statutes at Large Reference | 110 Stat. 1948, 2935 |
Public Law References | Public Law 93-406, Public Law 104-191, Public Law 104-204 |
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The requirements of this part (other than section 1185 of this title) shall not apply to any group health plan (and group health insurance coverage offered in connection with a group health plan) for any plan year if, on the first day of such plan year, such plan has less than 2 participants who are current employees.
(b) Exception for certain benefitsThe requirements of this part shall not apply to any group health plan (and group health insurance coverage) in relation to its provision of excepted benefits described in section 1191b(c)(1) of this title.
(c) Exception for certain benefits if certain conditions met (1) Limited, excepted benefitsThe requirements of this part shall not apply to any group health plan (and group health insurance coverage offered in connection with a group health plan) in relation to its provision of excepted benefits described in section 1191b(c)(2) of this title if the benefits—
(A) are provided under a separate policy, certificate, or contract of insurance; or
(B) are otherwise not an integral part of the plan.
(2) Noncoordinated, excepted benefitsThe requirements of this part shall not apply to any group health plan (and group health insurance coverage offered in connection with a group health plan) in relation to its provision of excepted benefits described in section 1191b(c)(3) of this title if all of the following conditions are met:
(A) The benefits are provided under a separate policy, certificate, or contract of insurance.
(B) There is no coordination between the provision of such benefits and any exclusion of benefits under any group health plan maintained by the same plan sponsor.
(C) Such benefits are paid with respect to an event without regard to whether benefits are provided with respect to such an event under any group health plan maintained by the same plan sponsor.
(3) Supplemental excepted benefitsThe requirements of this part shall not apply to any group health plan (and group health insurance coverage) in relation to its provision of excepted benefits described in section 1191b(c)(4) of this title if the benefits are provided under a separate policy, certificate, or contract of insurance.
(d) Treatment of partnershipsFor purposes of this part—
(1) Treatment as a group health planAny plan, fund, or program which would not be (but for this subsection) an employee welfare benefit plan and which is established or maintained by a partnership, to the extent that such plan, fund, or program provides medical care (including items and services paid for as medical care) to present or former partners in the partnership or to their dependents (as defined under the terms of the plan, fund, or program), directly or through insurance, reimbursement, or otherwise, shall be treated (subject to paragraph (2)) as an employee welfare benefit plan which is a group health plan.
(2) EmployerIn the case of a group health plan, the term "employer" also includes the partnership in relation to any partner.
(3) Participants of group health plansIn the case of a group health plan, the term "participant" also includes—
(A) in connection with a group health plan maintained by a partnership, an individual who is a partner in relation to the partnership, or
(B) in connection with a group health plan maintained by a self-employed individual (under which one or more employees are participants), the self-employed individual,
if such individual is, or may become, eligible to receive a benefit under the plan or such individual's beneficiaries may be eligible to receive any such benefit.
(Pub. L. 93–406, title I, §732, formerly §705, as added Pub. L. 104–191, title I, §101(a), Aug. 21, 1996, 110 Stat. 1948; renumbered §732 and amended Pub. L. 104–204, title VI, §603(a)(3), (b)(2), (3)(I)–(L), Sept. 26, 1996, 110 Stat. 2935, 2937, 2938.)
AMENDMENTS1996—Subsec. (a). Pub. L. 104–204, §603(b)(2), inserted "(other than section 1185 of this title)" after "part".
Subsecs. (b), (c)(1) to (3). Pub. L. 104–204, §603(b)(3)(I)–(L), made technical amendment to references in original act which appear in text as references to section 1191b of this title.
EFFECTIVE DATE OF 1996 AMENDMENTAmendment by Pub. L. 104–204 applicable with respect to group health plans for plan years beginning on and after Jan. 1, 1998, see section 603(c) of Pub. L. 104–204, set out as a note under section 1003 of this title.
EFFECTIVE DATESection applicable with respect to group health plans for plan years beginning after June 30, 1997, except as otherwise provided, see section 101(g) of Pub. L. 104–191, set out as a note under section 1181 of this title.
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