PRIA, Government Policy, Made Personal

Title 42, §300gg–23

The Public Health and Welfare, Source: USLM XML via OLRC

(a)(1)Subject to paragraph (2) and except as provided in subsection (b), this part, part D, and part C insofar as it relates to this part or part D 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 individual or group health insurance coverage except to the extent that such standard or requirement prevents the application of a requirement of this part or part D.

(2)Nothing in this part or part D shall be construed to affect or modify the provisions of section 1144 of title 29 with respect to group health plans.

(b)(1)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 701 11 See References in Text note below. which differs from the standards or requirements specified in such section.

(2)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—

(i)substitutes for the reference to “6-month period” in section 2701(a)(1) 1 a reference to any shorter period of time;

(ii)substitutes for the reference to “12 months” and “18 months” in section 2701(a)(2) 1 a reference to any shorter period of time;

(iii)substitutes for the references to “63” days in section 2701(c)(2)(A) 1 and 2701(d)(4)(A) 1 a reference to any greater number of days;

(iv)substitutes for the reference to “30-day period” in section 2701(b)(2) 1 and 2701(d)(1) 1 a reference to any greater period;

(v)prohibits the imposition of any preexisting condition exclusion in cases not described in section 2701(d) 1 or expands the exceptions described in such section;

(vi)requires special enrollment periods in addition to those required under section 2701(f) 1; or

(vii)reduces the maximum period permitted in an affiliation period under section 2701(g)(1)(B) 1.

(c)Nothing in this part (other than section 2704) 1 or part D 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)For purposes of this section—

(1)The term “State law” includes all laws, decisions, rules, regulations, or other State action having the effect of law, of any State. A law of the United States applicable only to the District of Columbia shall be treated as a State law rather than a law of the United States.

(2)The term “State” includes a State (including the Northern Mariana Islands), any political subdivisions of a State or such Islands, or any agency or instrumentality of either.

Notes & Related Subsidiaries

Editorial Notes

References in Text

section 2701, referred to in subsec. (b), is a reference to section 2701 of act

July 1, 1944. section 2701, which was classified to section 300gg of this title, was renumbered section 2704, effective for plan years beginning on or after Jan. 1, 2014, with certain exceptions, and amended, by Pub. L. 111–148, title I, §§ 1201(2), 1563(c)(1), formerly § 1562(c)(1), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 154, 264, 911, and was transferred to section 300gg–3 of this title. A new section 2701 of act

July 1, 1944, related to fair health insurance premiums, was added, effective for plan years beginning on or after Jan. 1, 2014, and amended, by Pub. L. 111–148, title I, § 1201(4), title X, § 10103(a), Mar. 23, 2010, 124 Stat. 155, 892, and is classified to section 300gg of this title. section 701, referred to in subsec. (b)(1), probably means “section 2701” of act

July 1, 1944. See note above. section 2704, referred to in subsec. (c), is a reference to section 2704 of act

July 1, 1944. section 2704, which was classified to section 300gg–4 of this title, was renumbered section 2725, and amended by Pub. L. 111–148, title I, §§ 1001(2), 1563(c)(3), formerly § 1562(c)(3), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 130, 265, 911, and was transferred to section 300gg–25 of this title. A new section 2704 of act

July 1, 1944, related to prohibition of preexisting condition exclusions or other discrimination based on health status, was added, effective for plan years beginning on or after Jan. 1, 2014, with certain exceptions, and amended, by Pub. L. 111–148, title I, §§ 1201(2), 1563(c)(1), formerly § 1562(c)(1), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 154, 264, 911, and is classified to section 300gg–3 of this title.

Amendments

2020—Subsec. (a)(1). Pub. L. 116–260, § 102(a)(3)(D)(i), substituted “this part, part D, and part C insofar as it relates to this part or part D” for “this part and part C insofar as it relates to this part” and inserted “or part D” before period at end. Subsec. (a)(2). Pub. L. 116–260, § 102(a)(3)(D)(ii), inserted “or part D” after “this part”. Subsec. (c). Pub. L. 116–260, § 102(a)(3)(D)(iii), inserted “or part D” after “this part (other than section 2704)”. 2010—Subsec. (a)(1). Pub. L. 111–148, § 1563(c)(14)(A), formerly § 1562(c)(14)(A), as renumbered by Pub. L. 111–148, § 10107(b)(1), inserted “individual or” before “group health insurance”. 1996—Subsec. (c). Pub. L. 104–204 inserted “(other than section 2704)” after “part”.

Statutory Notes and Related Subsidiaries

Effective Date

of 2020 AmendmentAmendment by Pub. L. 116–260 applicable with respect to plan years beginning on or after Jan. 1, 2022, see section 102(e) of div. BB of Pub. L. 116–260, set out as a note under section 8902 of Title 5, Government Organization and Employees.

Effective Date

of 1996 AmendmentAmendment by Pub. L. 104–204 applicable with respect to group health plans for plan years beginning on or after Jan. 1, 1998, see section 604(c) of Pub. L. 104–204 set out as an

Effective Date

note under section 300gg–25 of this title.

Effective Date

Section applicable with respect to group health plans, and health insurance coverage offered in connection with group health plans, for plan years beginning after June 30, 1997, except as otherwise provided, see section 102(c) of Pub. L. 104–191, set out as a note under section 300gg of this title.

§300gg–23 Preemption; State Flexibility; Construction

Title 42, §300gg–23

Notes & Related Subsidiaries

Editorial Notes

References in Text

Amendments

Statutory Notes and Related Subsidiaries

Effective Date

Effective Date

Effective Date

Effective Date

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