Page:United States Statutes at Large Volume 110 Part 3.djvu/215

From Wikisource
Jump to: navigation, search
This page needs to be proofread.


PUBLIC LAW 104-191—AUG. 21, 1996 110 STAT. 1945 "(B) the period is applied uniformly without regard to any health status-related factors, and "(C) such period does not exceed 2 months (or 3 months in the case of a late enrollee). "(2) AFFILIATION PERIOD.— "(A) DEFINED. — For purposes of this part, the term 'affiliation period' means a period which, under the terms of the health insurance coverage offered by the health maintenance organization, must expire before the health insurance coverage becomes effective. The organization is not required to provide health care services or benefits during such period and no premium shall be charged to the participant or beneficiary for any coverage during the period. "(B) BEGINNING.— Such period shall begin on the enrollment date. "(C) RUNS CONCURRENTLY WITH WAITING PERIODS.— An affiliation period under a plan shall run concurrently with any waiting period under the plan. "(3) ALTERNATIVE METHODS. — A health maintenance organization described in paragraph (1) may use alternative methods, from those described in such paragraph, to address adverse selection as approved by the State insurance commissioner or official or officials designated by the State to enforce the requirements of part A of title XXVII of the Public Health Service Act for the State involved with respect to such issuer. "SEC. 702. PROHIBITING DISCRIMINATION AGAINST INDIVIDUAL 29 USC 1182. PARTICIPANTS AND BENEFICIARIES BASED ON HEALTH STATUS. , "(a) IN ELIGIBILITY TO ENROLL. — " (1) IN GENERAL.— Subject to paragraph (2), a group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan based on any of the following health status-related factors in relation to the individual or a dependent of the individual: "(A) Health status. "(B) Medical condition (including both physical and mental illnesses). "(C) Claims experience. "(D) Receipt of health care. "(E) Medical history. "(F) Genetic information. "(G) Evidence of insurability (including conditions arising out of acts of domestic violence). " (H) Disability. "(2) No APPLICATION TO BENEFITS OR EXCLUSIONS. —To the extent consistent with section 701, paragraph (1) shall not be construed— "(A) to require a group health plan, or group health insurance coverage, to provide particular benefits other than those provided under the terms of such plan or coverage, or "(B) to prevent such a plan or coverage from establishing Hmitations or restrictions on the amount, level, extent.