Page:United States Statutes at Large Volume 110 Part 4.djvu/99

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PUBLIC LAW 104-204—SEPT. 26, 1996 110 STAT. 2945 " SEC. 712. PARITY IN THE APPLICATION OF CERTAIN LIMITS TO 29 USC 1185a. MENTAL HEALTH BENEFITS. "(a) IN GENERAL.— "(1) AGGREGATE LIFETIME LIMITS.— In the case of a group health plan (or health insurance coverage offered in connection with such a plan) that provides both medical and surgical benefits and mental health benefits— "(A) No LIFETIME LIMIT.— I f the plan or coverage does not include an aggregate lifetime limit on substantially all medical and surgical benefits, the plan or coverage may not impose any aggregate lifetime limit on mental health benefits. "(B) LIFETIME LIMIT.— If the plan or coverage includes an aggregate lifetime limit on substantially all medical and surgical benefits (in this paragraph referred to as the 'applicable lifetime limit'), the plan or coverage shall either— "(i) apply the applicable lifetime limit both to the medical and surgical benefits to which it otherwise would apply and to mental health benefits and not distinguish in the application of such limit between such medical and surgical benefits and mental health benefits; or "(ii) not include any aggregate lifetime limit on mental health benefits that is less than the applicable lifetime limit. "(C) RULE IN CASE OF DIFFERENT LIMITS.— In the case of a plan or coverage that is not described in subparagraph (A) or (B) and that includes no or different aggregate lifetime limits on different categories of medical and surgical benefits, the Secretary shall establish rules under which subparagraph (B) is applied to such plan or coverage with respect to mental health benefits by substituting for the applicable lifetime limit an average aggregate lifetime limit that is computed taking into account the weighted average of the aggregate lifetime limits applicable to such categories. "(2) ANNUAL LIMITS. —In the case of a group health plan (or health insurance coverage offered in connection with such a plan) that provides both medical and surgical benefits and mental health benefits— "(A) No ANNUAL LIMIT. —If the plan or coverage does not include an annual limit on substantially all medical and surgical benefits, the plan or coverage may not impose any annual limit on mental health benefits. "(B) ANNUAL LIMIT.— If the plan or coverage includes an annual limit on substantially all medical and surgical benefits (in this paragraph referred to as the 'applicable annual limit'), the plan or coverage shall either— "(i) apply the applicable annual limit both to medical and surgical benefits to which it otherwise would apply and to mental health benefits and not distinguish in the application of such limit between such medical and surgical benefits and mental health benefits; or "(ii) not include any annual limit on mental health benefits that is less than the applicable annual limit.