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Title 29 — LaborRelease 119-83

§1191a Special Rules Relating to Group Health Plans

Title 29 › Chapter 18— EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM › Subchapter I— PROTECTION OF EMPLOYEE BENEFIT RIGHTS › Subtitle Subtitle B— Regulatory Provisions › Part 7— group health plan requirements › Subpart C— General Provisions › § 1191a

Last updated Apr 18, 2026|Official source

Summary

Exempts some group health plans from most rules in this part, except sections 1185 and 1185o. If a plan has fewer than 2 current-employee participants on the first day of the plan year, the rules do not apply. The rules also do not apply when a plan only provides certain "excepted benefits" listed in 1191b(c)(1). For other excepted benefits in 1191b(c)(2)–(4), the rules are waived if the benefits are sold under a separate policy or are not an integral part of the main plan. For the benefits in 1191b(c)(3), the separate policy must not coordinate with the sponsor’s main plan and must pay for an event whether or not the main plan pays. Plans run by partnerships that give medical care to partners or their dependents are treated as group health plans. In those cases, the partnership counts as the employer for partners. A partner is treated as a participant, and a self-employed person who runs a plan that covers employees is also treated as a participant.

Full Legal Text

Title 29, §1191a

Labor — Source: USLM XML via OLRC

(a)The requirements of this part (other than section 1185 and 1185o of this title) shall not apply to any group health plan (and group health insurance coverage offered in connection with a group health plan) for any plan year if, on the first day of such plan year, such plan has less than 2 participants who are current employees.
(b)The requirements of this part shall not apply to any group health plan (and group health insurance coverage) in relation to its provision of excepted benefits described in section 1191b(c)(1) of this title.
(c)(1)The requirements of this part shall not apply to any group health plan (and group health insurance coverage offered in connection with a group health plan) in relation to its provision of excepted benefits described in section 1191b(c)(2) of this title if the benefits—
(A)are provided under a separate policy, certificate, or contract of insurance; or
(B)are otherwise not an integral part of the plan.
(2)The requirements of this part shall not apply to any group health plan (and group health insurance coverage offered in connection with a group health plan) in relation to its provision of excepted benefits described in section 1191b(c)(3) of this title if all of the following conditions are met:
(A)The benefits are provided under a separate policy, certificate, or contract of insurance.
(B)There is no coordination between the provision of such benefits and any exclusion of benefits under any group health plan maintained by the same plan sponsor.
(C)Such benefits are paid with respect to an event without regard to whether benefits are provided with respect to such an event under any group health plan maintained by the same plan sponsor.
(3)The requirements of this part shall not apply to any group health plan (and group health insurance coverage) in relation to its provision of excepted benefits described in section 1191b(c)(4) of this title if the benefits are provided under a separate policy, certificate, or contract of insurance.
(d)For purposes of this part—
(1)Any plan, fund, or program which would not be (but for this subsection) an employee welfare benefit plan and which is established or maintained by a partnership, to the extent that such plan, fund, or program provides medical care (including items and services paid for as medical care) to present or former partners in the partnership or to their dependents (as defined under the terms of the plan, fund, or program), directly or through insurance, reimbursement, or otherwise, shall be treated (subject to paragraph (2)) as an employee welfare benefit plan which is a group health plan.
(2)In the case of a group health plan, the term “employer” also includes the partnership in relation to any partner.
(3)In the case of a group health plan, the term “participant” also includes—
(A)in connection with a group health plan maintained by a partnership, an individual who is a partner in relation to the partnership, or
(B)in connection with a group health plan maintained by a self-employed individual (under which one or more employees are participants), the self-employed individual,

Legislative History

Notes & Related Subsidiaries

Editorial Notes

Amendments

2026—Subsec. (a). Pub. L. 119–75 substituted “section 1185 and 1185o of this title” for “section 1185 of this title”. 1996—Subsec. (a). Pub. L. 104–204, § 603(b)(2), inserted “(other than section 1185 of this title)” after “part”. Subsecs. (b), (c)(1) to (3). Pub. L. 104–204, § 603(b)(3)(I)–(L), made technical amendment to references in original act which appear in text as references to section 1191b of this title.

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. § 1191a

Title 29 — Labor

Last Updated

Apr 18, 2026

Release point: 119-83