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Title 29, LaborRelease 119-110

§1191 Preemption; State Flexibility; Construction

Title 29 › 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 › § 1191

Last updated Sep 23, 2026|Official source

Summary

Lets state rules for health insurance companies that only deal with group health plans stay in effect unless they stop a federal rule from working. Federal preemption for group health plans under section 1144 is not changed. Federal rules about portability and preexisting condition exclusions (section 1181) generally override state rules that conflict. For coverage sold by an insurer, states may still require shorter waiting or look‑back periods instead of the 6‑month, 12‑month, or 18‑month references, and may allow longer gap periods instead of the 63‑day or 30‑day references. States can also ban extra preexisting‑condition exclusions, widen the listed exceptions, add special enrollment periods, or shorten the allowed affiliation period. Plans are not forced to provide particular benefits except where another federal rule (section 1185) says so. "State law" means laws, rules, court decisions, and similar actions; "State" includes states, the Northern Mariana Islands, their local governments, and agencies.

Full Legal Text

Title 29, §1191

Labor, Source: USLM XML via OLRC

(a)Continued applicability of State law with respect to health insurance issuers
(1)In general
Subject to paragraph (2) and except as provided in subsection (b), this part shall not be construed to supersede any provision of State law which establishes, implements, or continues in effect any standard or requirement solely relating to health insurance issuers in connection with group health insurance coverage except to the extent that such standard or requirement prevents the application of a requirement of this part.
(2)Continued preemption with respect to group health plans
Nothing in this part shall be construed to affect or modify the provisions of section 1144 of this title with respect to group health plans.
(b)Special rules in case of portability requirements
(1)In general
Subject to paragraph (2), the provisions of this part relating to health insurance coverage offered by a health insurance issuer supersede any provision of State law which establishes, implements, or continues in effect a standard or requirement applicable to imposition of a preexisting condition exclusion specifically governed by section 1181 of this title which differs from the standards or requirements specified in such section.
(2)Exceptions
Only in relation to health insurance coverage offered by a health insurance issuer, the provisions of this part do not supersede any provision of State law to the extent that such provision—
(A)substitutes for the reference to “6-month period” in section 1181(a)(1) of this title a reference to any shorter period of time;
(B)substitutes for the reference to “12 months” and “18 months” in section 1181(a)(2) of this title a reference to any shorter period of time;
(C)substitutes for the references to “63 days” in section 1181(c)(2)(A) and (d)(4)(A) of this title a reference to any greater number of days;
(D)substitutes for the reference to “30-day period” in section 1181(b)(2) and (d)(1) of this title a reference to any greater period;
(E)prohibits the imposition of any preexisting condition exclusion in cases not described in section 1181(d) of this title or expands the exceptions described in such section;
(F)requires special enrollment periods in addition to those required under section 1181(f) of this title; or
(G)reduces the maximum period permitted in an affiliation period under section 1181(g)(1)(B) of this title.
(c)Rules of construction
Except as provided in section 1185 of this title, nothing in this part shall be construed as requiring a group health plan or health insurance coverage to provide specific benefits under the terms of such plan or coverage.
(d)Definitions
For purposes of this section
(1) State law
(2)State
The term “State” includes a State, the Northern Mariana Islands, any political subdivisions of a State or such Islands, or any agency or instrumentality of either.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

Amendments

1996—Subsec. (c). Pub. L. 104–204, § 603(b)(1), substituted “Except as provided in section 1185 of this title, nothing” for “Nothing”.

Statutory Notes and Related Subsidiaries

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 Date

Section 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.

Reference

Citations & Metadata

Citation

29 U.S.C. § 1191

Title 29, Labor

Last Updated

Sep 23, 2026

Release point: 119-110