§4317 — Title 38 Veterans' Benefits | U.S. Code

Summary

Employers must let someone who has job-related health coverage keep that coverage if they leave work to serve in the uniformed services or if they become eligible for military medical and dental care under chapter 55 of title 10 because of section 1074(d). The person (and their dependents) can keep coverage for up to the lesser of 24 months from the start of the absence or the day after they fail to apply for or return to their job as defined by the law. The person may have to pay up to 102 percent of the full premium. If the service is under 31 days, they cannot be charged more than the normal employee share. For multiemployer plans, the plan sponsor decides who pays, or failing that, the last employer or the plan will be responsible. When the person returns to work, the health plan cannot make them or their covered family wait or impose exclusions that would not have applied if they had not left for service. That protection does not cover illnesses or injuries the Secretary of Veterans Affairs finds were caused or made worse by the person’s service. If someone became eligible for military care because of an order to active duty but the order was canceled before active duty began, the same return-to-work protection applies when that eligibility ends.

Title 38, §4317

Veterans' Benefits — Source: USLM XML via OLRC

(a)(1)In any case in which a person (or the person’s dependents) has coverage under a health plan in connection with the person’s position of employment, including a group health plan (as defined in section 607(1) of the Employee Retirement Income Security Act of 1974), and such person is absent from such position of employment by reason of service in the uniformed services, or such person becomes eligible for medical and dental care under chapter 55 of title 10 by reason of subsection (d) of section 1074 of that title, the plan shall provide that the person may elect to continue such coverage as provided in this subsection. The maximum period of coverage of a person and the person’s dependents under such an election shall be the lesser of—

(A)the 24-month period beginning on the date on which the person’s absence begins; or

(B)the day after the date on which the person fails to apply for or return to a position of employment, as determined under section 4312(e).

(2)A person who elects to continue health-plan coverage under this paragraph may be required to pay not more than 102 percent of the full premium under the plan (determined in the same manner as the applicable premium under section 4980B(f)(4) of the Internal Revenue Code of 1986) associated with such coverage for the employer’s other employees, except that in the case of a person who performs service in the uniformed services for less than 31 days, such person may not be required to pay more than the employee share, if any, for such coverage.

(3)In the case of a health plan that is a multiemployer plan, as defined in section 3(37) of the Employee Retirement Income Security Act of 1974, any liability under the plan for employer contributions and benefits arising under this paragraph shall be allocated—

(A)by the plan in such manner as the plan sponsor shall provide; or

(B)if the sponsor does not provide—

(i)to the last employer employing the person before the period served by the person in the uniformed services, or

(ii)if such last employer is no longer functional, to the plan.

(b)(1)Except as provided in paragraph (2), in the case of a person whose coverage under a health plan was terminated by reason of service in the uniformed services, or by reason of the person’s having become eligible for medical and dental care under chapter 55 of title 10 by reason of subsection (d) of section 1074 of that title, an exclusion or waiting period may not be imposed in connection with the reinstatement of such coverage upon reemployment under this chapter if an exclusion or waiting period would not have been imposed under a health plan had coverage of such person by such plan not been terminated as a result of such service or eligibility. This paragraph applies to the person who is reemployed and to any individual who is covered by such plan by reason of the reinstatement of the coverage of such person.

(2)Paragraph (1) shall not apply to the coverage of any illness or injury determined by the Secretary of Veterans Affairs to have been incurred in, or aggravated during, performance of service in the uniformed services.

(3)In the case of a person whose coverage under a health plan is terminated by reason of the person having become eligible for medical and dental care under chapter 55 of title 10 by reason of subsection (d) of section 1074 of that title but who subsequently does not commence a period of active duty under the order to active duty that established such eligibility because the order is canceled before such active duty commences, the provisions of paragraph (1) relating to any exclusion or waiting period in connection with the reinstatement of coverage under a health plan shall apply to such person’s continued employment, upon the termination of such eligibility for medical and dental care under chapter 55 of title 10 that is incident to the cancellation of such order, in the same manner as if the person had become reemployed upon such termination of eligibility.

Notes & Related Subsidiaries

Editorial Notes

References in Text

section 3(37) and 607(1) of the Employee Retirement Income Security Act of 1974, referred to in subsec. (a)(1), (3), are classified to section 1002(37) and 1167(1), respectively, of Title 29, Labor. section 4980B(f)(4) of the Internal Revenue Code of 1986, referred to in subsec. (a)(2), is classified to section 4980B(f)(4) of Title 26, Internal Revenue Code.

Prior Provisions

A prior section 4317 was renumbered section 7617 of this title.

Amendments

2006—Subsec. (a)(1). Pub. L. 109–233, § 303(a), inserted “or such person becomes eligible for medical and dental care under chapter 55 of title 10 by reason of subsection (d) of section 1074 of that title,” after “by reason of service in the uniformed services,”. Subsec. (b)(1). Pub. L. 109–233, § 303(b)(1), inserted “or by reason of the person’s having become eligible for medical and dental care under chapter 55 of title 10 by reason of subsection (d) of section 1074 of that title,” after “by reason of service in the uniformed services,” and “or eligibility” after “such service”. Subsec. (b)(3). Pub. L. 109–233, § 303(b)(2), added par. (3). 2004—Subsec. (a)(1)(A). Pub. L. 108–454 substituted “24-month period” for “18-month period”. 1996—Subsec. (a). Pub. L. 104–275 substituted “(a)(1) In” for “(a)(1)(A) Subject to paragraphs (2) and (3), in”, redesignated cls. (i) and (ii) of par. (1) as subpars. (A) and (B), respectively, redesignated former subpars. (B) and (C) as pars. (2) and (3), respectively, and in par. (3), redesignated cls. (i) and (ii) as subpars. (A) and (B), respectively, and subcls. (I) and (II) as cls. (i) and (ii), respectively.

Statutory Notes and Related Subsidiaries

Effective Date

of 2004 Amendment Pub. L. 108–454, title II, § 201(b), Dec. 10, 2004, 118 Stat. 3606, provided that: “The amendment made by subsection (a) [amending this section] shall apply to elections made under section 4317 of title 38, United States Code, on or after the date of the enactment of this Act [Dec. 10, 2004].”

Effective Date

of 1996 AmendmentAmendment by Pub. L. 104–275 effective Oct. 13, 1994, see section 313 of Pub. L. 104–275, set out as a note under section 4301 of this title.

Effective Date

Section effective with respect to reemployments initiated on or after the first day after the 60-day period beginning Oct. 13, 1994, with transition rules, except that a person on active duty on Oct. 13, 1994, or a family member or personal representative of such person, may, after Oct. 13, 1994, elect to reinstate or continue a health plan provided in this section, and the health plan shall remain in effect for the remaining portion of the 18-month period that began on the date of such person’s separation from civilian employment or the period of the person’s service in the uniformed service, whichever is of lesser duration, see section 8 of Pub. L. 103–353, set out as a note under section 4301 of this title.

§4317 Health Plans

Summary

Title 38, §4317

Notes & Related Subsidiaries

Editorial Notes

References in Text

Prior Provisions

Amendments

Statutory Notes and Related Subsidiaries

Effective Date

Effective Date

Effective Date

Citations & Metadata