110 STAT. 1976 PUBLIC LAW 104-191—AUG. 21, 1996 preceding calendar year and who employs at least 2 employees on the first day of the plan year. "(3) LARGE GROUP MARKET.— The term 'large group market' means the health insurance msirket under which individuals obtain health insurance coverage (directly or through any arrangement) on behalf of themselves (and their dependents) through a group health plan maintained by a large employer. "(4) SMALL EMPLOYER.—The term 'small employer' means, in connection with a group health plan with respect to a calendar year and a plan year, an employer who employed an average of at least 2 but not more than 50 employees on business days during the preceding calendcir year and who employs at least 2 employees on the first day of the plan year. "(5) SMALL GROUP MARKET.— The term 'small group market' means the health insurance market under which individuals obtain health insurance coverage (directly or through any arrangement) on behalf of themselves (and their dependents) through a group heedth plan maintained by a small employer. " (6) APPLICATION OF CERTAIN RULES IN DETERMINATION OF EMPLOYER SIZE.—For purposes of this subsection— "(A) APPLICATION OF AGGREGATION RULE FOR EMPLOY- ERS.—all persons treated as a single employer under subsection (b), (c), (m), or (o) of section 414 of the Internal Revenue Code of 1986 shall be treated as 1 employer. " (B) EMPLOYERS NOT IN EXISTENCE IN PRECEDING YEAR.— In the case of an employer which was not in existence throughout the preceding calendar year, the determination of whether such employer is a small or large employer shall be based on the average number of employ- ees that it is reasonably expected such employer will employ on business days in the current calendar year. "(C) PREDECESSORS.— Any reference in this subsection to an employer shall include a reference to any predecessor of such employer. 42 USC 300gg- "SEC. 2792. REGULATIONS. 92 "The Secretary, consistent with section 104 of the Health Care Portability and Accountability Act of 1996, may promulgate such regulations as may be necessary or appropriate to carry out the provisions of this title. The Secretary may promulgate any interim final rules as the Secretary determines are appropriate to carry out this title.". (b) APPLICATION OF RULES BY CERTAIN HEALTH MAINTENANCE ORGANIZATIONS.—Section 1301 of such Act (42 U.S.C. 300e) is amended by adding at the end the following new subsection: "(d) An organization that offers health benefits coverage shall not be considered as failing to meet the requirements of this section notwithstanding that it provides, with respect to coverage offered in connection with a group health plan in the small or large group market (as defined in section 2791(e)), an sifiiliation period consistent with the provisions of section 2701(g).". 42 USC 300gg (c) EFFECTIVE DATE. — note. (1) IN GENERAL. — Except as provided in this subsection, part A of title XXVII of the Public Health Service Act (as added by subsection (a)) shall apply with respect to group health plans, and health insurance coverage offered in connec-
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