Source
(Added Pub. L. 100–647, title III, § 3011(a), Nov. 10, 1988, 102 Stat. 3616; amended Pub. L. 101–239, title VI, §§ 6202(b)(3)(B),
6701
(a)–(c), title VII, §§ 7862(c)(2)(B), (3)(C), (4)(B), (5)(A),
7891
(d)(1)(B), (2)(A), Dec. 19, 1989, 103 Stat. 2233, 2294, 2295, 2432, 2433, 2446; Pub. L. 101–508, title XI, § 11702(f), Nov. 5, 1990, 104 Stat. 1388–515; Pub. L. 103–66, title XIII, § 13422(a), Aug. 10, 1993, 107 Stat. 566; Pub. L. 104–188, title I, § 1704(g)(1)(A), (t)(21), Aug. 20, 1996, 110 Stat. 1880, 1888; Pub. L. 104–191, title III, § 321(d)(1), title IV, § 421(c), Aug. 21, 1996, 110 Stat. 2058, 2088; Pub. L. 107–210, div. A, title II, § 203(e)(3), Aug. 6, 2002, 116 Stat. 971.)
References in Text
The Public Health Service Act, referred to in subsec. (f)(1), does not contain a section
2162. The reference probably should be to section 1928 of the Social Security Act, which is classified to section
1396s of Title
42, The Public Health and Welfare, and which relates to pediatric vaccines.
The Social Security Act, referred to in subsec. (f)(2)(B)(i)(IV), (V), (iv)(II), (v), (3)(D), (6)(C), is act Aug. 14, 1935, ch. 531,
49 Stat. 620, as amended. Titles II, XVI, and XVIII of the Social Security Act are classified generally to subchapters II (§ 401 et seq.), XVI (§ 1381 et seq.), and XVIII (§ 1395 et seq.), respectively, of chapter
7 of Title
42. For complete classification of this Act to the Code, see section
1305 of Title
42 and Tables.
The Employee Retirement Income Security Act of 1974, referred to in subsecs. (f)(2)(B)(iv)(I), (5)(C)(iii), and (g)(3), is
Pub. L. 93–406, Sept. 2, 1974,
88 Stat. 832, as amended. Part 7 of subtitle B of title I of the Act is classified generally to part 7 (§ 1181 et seq.) of subtitle
B of subchapter
I of chapter
18 of Title
29, Labor. Sections 3(16)(A) and 701(c)(2) of the Act are classified to sections
1002
(16)(A) and
1181
(c)(2), respectively, of Title
29. For complete classification of this Act to the Code, see Short Title note set out under section
1001 of Title
29 and Tables.
The Public Health Service Act, referred to in subsec. (f)(2)(B)(iv)(I), (5)(C)(iii), is act July 1, 1944, ch. 373,
58 Stat. 682, as amended. Title XXVII of the Act is classified generally to subchapter XXV (§ 300gg et seq.) of chapter
6A of Title
42, The Public Health and Welfare. Section 2701(c)(2) of the Act is classified to section
300gg
(c)(2) of Title
42. For complete classification of this Act to the Code, see Short Title note set out under section
201 of Title
42 and Tables.
Amendments
2002—Subsec. (f)(5)(C).
Pub. L. 107–210 added subpar. (C).
1996—Subsec. (f)(2)(B)(i).
Pub. L. 104–191, § 421(c)(1)(A), in concluding provisions, substituted “at any time during the first 60 days of continuation coverage under this section” for “at the time of a qualifying event described in paragraph (3)(B)”, struck out “with respect to such event” after “(II) to 18 months”, and inserted “(with respect to all qualified beneficiaries)” after “29 months”.
Pub. L. 104–188, § 1704(t)(21), made technical amendment to directory language of
Pub. L. 101–239, § 6701(a)(1). See 1989 Amendment note below.
Subsec. (f)(2)(B)(i)(V).
Pub. L. 104–188, § 1704(g)(1)(A), substituted “Medicare entitlement followed by qualifying event” for “Qualifying event involving medicare entitlement” in heading and amended text generally. Prior to amendment, text read as follows: “In the case of an event described in paragraph (3)(D) (without regard to whether such event is a qualifying event), the period of coverage for qualified beneficiaries other than the covered employee for such event or any subsequent qualifying event shall not terminate before the close of the 36-month period beginning on the date the covered employee becomes entitled to benefits under title XVIII of the Social Security Act.”
Subsec. (f)(2)(B)(iv)(I).
Pub. L. 104–191, § 421(c)(1)(B), inserted “(other than such an exclusion or limitation which does not apply to (or is satisfied by) such beneficiary by reason of chapter
100 of this title, part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974, or title XXVII of the Public Health Service Act)” before “, or”.
Subsec. (f)(2)(B)(v).
Pub. L. 104–191, § 421(c)(1)(C), substituted “at any time during the first 60 days of continuation coverage under this section” for “at the time of a qualifying event described in paragraph (3)(B)”.
Subsec. (f)(6)(C).
Pub. L. 104–191, § 421(c)(2), substituted “at any time during the first 60 days of continuation coverage under this section” for “at the time of a qualifying event described in paragraph (3)(B)”.
Subsec. (g)(1)(A).
Pub. L. 104–191, § 421(c)(3), inserted at end “Such term shall also include a child who is born to or placed for adoption with the covered employee during the period of continuation coverage under this section.”
Subsec. (g)(2).
Pub. L. 104–191, § 321(d)(1), inserted at end “Such term shall not include any plan substantially all of the coverage under which is for qualified long-term care services (as defined in section
7702B
(c)).”
1993—Subsec. (f)(1).
Pub. L. 103–66 inserted “the coverage of the costs of pediatric vaccines (as defined under section 2162 of the Public Health Service Act) is not reduced below the coverage provided by the plan as of May 1, 1993, and only if” after “only if”.
1990—Subsec. (d)(1).
Pub. L. 101–508 amended par. (1) generally. Prior to amendment, par. (1) read as follows: “any failure of a group health plan to meet the requirements of subsection (f) if all employers maintaining such plan normally employed fewer than 20 employees on a typical business day during the preceding calendar year,”.
1989—Subsec. (f)(2)(B)(i).
Pub. L. 101–239, § 6701(a)(1), as amended by
Pub. L. 104–188, § 1704(t)(21), inserted at end “In the case of a qualified beneficiary who is determined, under title II or XVI of the Social Security Act, to have been disabled at the time of a qualifying event described in paragraph (3)(B), any reference in subclause (I) or (II) to 18 months with respect to such event is deemed a reference to 29 months, but only if the qualified beneficiary has provided notice of such determination under paragraph (6)(C) before the end of such 18 months.”
Subsec. (f)(2)(B)(i)(V).
Pub. L. 101–239, § 7862(c)(5)(A), added subcl. (V).
Subsec. (f)(2)(B)(iv).
Pub. L. 101–239, § 7862(c)(3)(C), substituted “entitlement” for “eligibility” in heading and inserted “which does not contain any exclusion or limitation with respect to any preexisting condition of such beneficiary” after “or otherwise)” in subcl. (I).
Subsec. (f)(2)(B)(v).
Pub. L. 101–239, § 6701(a)(2), added cl. (v).
Subsec. (f)(2)(C).
Pub. L. 101–239, § 7862(c)(4)(B), amended last sentence generally. Prior to amendment, last sentence read as follows: “If an election is made after the qualifying event, the plan shall permit payment for continuation coverage during the period preceding the election to be made within 45 days of the date of the election.”
Pub. L. 101–239, § 6701(b), inserted at end “In the case of an individual described in the last sentence of subparagraph (B)(i), any reference in clause (i) of this subparagraph to ‘102 percent’ is deemed a reference to ‘150 percent’ for any month after the 18th month of continuation coverage described in subclause (I) or (II) of subparagraph (B)(i).”
Subsec. (f)(6).
Pub. L. 101–239, § 7891(d)(1)(B)(ii), inserted after and below subpar. (D) the following new flush sentence “The requirements of subparagraph (B) shall be considered satisfied in the case of a multiemployer plan in connection with a qualifying event described in paragraph (3)(B) if the plan provides that the determination of the occurrence of such qualifying event will be made by the plan administrator.”
Pub. L. 101–239, § 7891(d)(1)(B)(i)(II), inserted “(or, in the case of a group health plan which is a multiemployer plan, such longer period of time as may be provided in the terms of the plan)” after “14 days” in last sentence.
Subsec. (f)(6)(B).
Pub. L. 101–239, § 7891(d)(1)(B)(i)(I), inserted “(or, in the case of a group health plan which is a multiemployer plan, such longer period of time as may be provided in the terms of the plan)” after “30 days”.
Subsec. (f)(6)(C).
Pub. L. 101–239, § 6701(c), inserted before period at end “and each qualified beneficiary who is determined, under title II or XVI of the Social Security Act, to have been disabled at the time of a qualifying event described in paragraph (3)(B) is responsible for notifying the plan administrator of such determination within 60 days after the date of the determination and for notifying the plan administrator within 30 days of the date of any final determination under such title or titles that the qualified beneficiary is no longer disabled”.
Subsec. (f)(7).
Pub. L. 101–239, § 7862(c)(2)(B), substituted “the performance of services by the individual for 1 or more persons maintaining the plan (including as an employee defined in section
401
(c)(1))” for “the individual’s employment or previous employment with an employer”.
Subsec. (f)(8).
Pub. L. 101–239, § 7891(d)(2)(A), added par. (8).
Subsec. (g)(2).
Pub. L. 101–239, § 6202(b)(3)(B), substituted “section
5000
(b)(1)” for “section
162
(i)”.
Effective Date of 2002 Amendment
Amendment by
Pub. L. 107–210 applicable to petitions for certification filed under part 2 or 3 of subchapter
II of chapter
12 of Title
19, Customs Duties, on or after the date that is 90 days after Aug. 6, 2002, except as otherwise provided, see section 151 of
Pub. L. 107–210, set out as a note preceding section
2271 of Title
19.
Effective Date of 1996 Amendments
Amendment by section 321(d)(1) of
Pub. L. 104–191 applicable to contracts issued after Dec. 31, 1996, see section 321(f) of
Pub. L. 104–191, set out as an Effective Date note under section
7702B of this title.
Section 421(d) of
Pub. L. 104–191 provided that: “The amendments made by this section [amending this section, sections
1162,
1166, and
1167 of Title
29, Labor, and sections
300bb–2,
300bb–6, and
300bb–8 of Title
42, The Public Health and Welfare] shall become effective on January 1, 1997, regardless of whether the qualifying event occurred before, on, or after such date.”
Section 1704(g)(2) of
Pub. L. 104–188 provided that: “The amendments made by this subsection [amending this section, section
1162 of Title
29, Labor, and section
300bb–2 of Title
42, The Public Health and Welfare] shall apply to plan years beginning after December 31, 1989.”
Effective Date of 1993 Amendment
Section 13422(b) of
Pub. L. 103–66 provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to plan years beginning after the date of the enactment of this Act [Aug. 10, 1993].”
Effective Date of 1990 Amendment
Amendment by
Pub. L. 101–508 effective as if included in the provision of the Technical and Miscellaneous Revenue Act of 1988,
Pub. L. 100–647, to which such amendment relates, see section 11702(j) of
Pub. L. 101–508, set out as a note under section
59 of this title.
Effective Date of 1989 Amendment
Amendment by section 6202(b)(3)(B) of
Pub. L. 101–239 applicable to items and services furnished after Dec. 19, 1989, see section 6202(b)(5) of
Pub. L. 101–239, set out as a note under section
162 of this title.
Section 6701(d) of
Pub. L. 101–239 provided that: “The amendments made by this section [amending this section] shall apply to plan years beginning on or after the date of the enactment of this Act [Dec. 19, 1989], regardless of whether the qualifying event occurred before, on, or after such date.”
Section 7862(c)(2)(C) of
Pub. L. 101–239 provided that: “The amendments made by this paragraph [amending this section and section
1167 of Title
29, Labor] shall apply to plan years beginning after December 31, 1989.”
Amendment by section 7862(c)(3)(C) of
Pub. L. 101–239 applicable to (i) qualifying events occurring after Dec. 31, 1989, and (ii) in the case of qualified beneficiaries who elected continuation coverage after Dec. 31, 1988, the period for which the required premium was paid (or was attempted to be paid but was rejected as such), see section 7862(c)(3)(D) of
Pub. L. 101–239, set out as a note under section
162 of this title.
Section 7862(c)(4)(C) of
Pub. L. 101–239 provided that: “The amendments made by this paragraph [amending this section and section
1162 of Title
29, Labor] shall apply to plan years beginning after December 31, 1989.”
Section 7862(c)(5)(C) of
Pub. L. 101–239 provided that: “The amendments made by this paragraph [amending this section and section
1162 of Title
29] shall apply to plan years beginning after December 31, 1989.”
Section 7891(d)(1)(C) of
Pub. L. 101–239 provided that: “The amendments made by this paragraph [amending this section and section
1166 of Title
29] shall apply with respect to plan years beginning on or after January 1, 1990.”
Section 7891(d)(2)(C) of
Pub. L. 101–239 provided that: “The amendments made by this paragraph [amending this section and section
1167 of Title
29] shall apply with respect to plan years beginning on or after January 1, 1990.”
Effective Date
Section applicable to taxable years beginning after Dec. 31, 1988, but not applicable to any plan for any plan year to which section
162
(k) of this title (as in effect on the day before Nov. 10, 1988) did not apply by reason of section 10001(e)(2) of
Pub. L. 99–272, see section 3011(d) of
Pub. L. 100–647, set out as an Effective Date of 1988 Amendment note under section
162 of this title.
Construction of 2002 Amendment
Nothing in amendment by
Pub. L. 107–210, other than provisions relating to COBRA continuation coverage and reporting requirements, to be construed as creating new mandate on any party regarding health insurance coverage, see section 203(f) of
Pub. L. 107–210, set out as a note under section
2918 of Title
29, Labor.
Notification of Changes in Continuation Coverage
Section 421(e) of
Pub. L. 104–191 provided that: “Not later than November 1, 1996, each group health plan (covered under title XXII of the Public Health Service Act [
42 U.S.C.
300bb–1 et seq.], part 6 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 [
29 U.S.C.
1161 et seq.], and section 4980B(f) of the Internal Revenue Code of 1986) shall notify each qualified beneficiary who has elected continuation coverage under such title, part or section of the amendments made by this section [amending this section, sections
1162,
1166, and
1167 of Title
29, Labor, and sections
300bb–2,
300bb–6, and
300bb–8 of Title
42, The Public Health and Welfare].”