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29 U.S.C. § 1191 — Preemption; State flexibility; construction

Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1191 — Preemption; State flexibility; construction

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Source file: Laws/federal/codes/united-states-code/title-29/section-1191-preemption-state-flexibility-construction--2ee5268cf1.md
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Source location: Title 29, Chapter 18, § 1191; chapter-018-employee-retirement-income-security-program.md

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**(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](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1144&num=0&edition=prelim) 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](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1181&num=0&edition=prelim) 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](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1181/a/1&num=0&edition=prelim) 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](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1181/a/2&num=0&edition=prelim) a reference to any shorter period of time; (C) substitutes for the references to “63 days” in sections 1181(c)(2)(A) and (d)(4)(A) 11 So in original. [Section 1181(d)(4) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1181/d/4&num=0&edition=prelim) does not contain subpars. of this title a reference to any greater number of days; (D) substitutes for the reference to “30-day period” in sections 1181(b)(2) 22 So in original. [Section 1181(b)(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1181/b/2&num=0&edition=prelim) does not refer to a 30-day period. 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](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1181/d&num=0&edition=prelim) 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](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1181/f&num=0&edition=prelim); or (G) reduces the maximum period permitted in an affiliation period under section 1181(g)(1)(B) 33 So in original. Probably should be “1181(g)(1)(C)”. of this title. **(c) Rules of construction** Except as provided in [section 1185 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1185&num=0&edition=prelim), 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** — 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) **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.

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Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1144 — Other laws

**(a) Supersedure; effective date** Except as provided in subsection (b) of this section, the provisions of this subchapter and subchapter III shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan described in [section 1003(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1003/a&num=0&edition=prelim) and not exempt under [section 1003(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1003/b&num=0&edition=prelim). This section shall take effect on January 1, 1975. **(b) Construction and application** (1) This section shall not apply with respect to any cause of action which arose, or any act or omission which occurred, before January 1, 1975. (2) (A) Except as provided in subparagraph (B), nothing in this subchapter shall be construed to exempt or relieve any person from any law of any State which regulates insurance, banking, or securities. (B) Neither an employee benefit plan described in [section 1003(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1003/a&num=0&edition=prelim), which is not exempt under [section 1003(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1003/b&num=0&edition=prelim) (other than a plan established primarily for the purpose of providing death benefits), nor any trust established under such a plan, shall be deemed to be an insurance company or other insurer, bank, trust company, or investment company or to be engaged in the business of insurance or banking for purposes of any law of any State purporting to regulate insurance companies, insurance contracts, banks, trust companies, or investment compani

Source: Supplied U.S. Code snapshot — release unconfirmed · 29 U.S.C. § 1144

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Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1181 — Increased portability through limitation on preexisting condition exclusions

**(a) Limitation on preexisting condition exclusion period; crediting for periods of previous coverage** Subject to subsection (d), a group health plan, and a health insurance issuer offering group health insurance coverage, may, with respect to a participant or beneficiary, impose a preexisting condition exclusion only if— (1) such exclusion relates to a condition (whether physical or mental), regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the 6-month period ending on the enrollment date; (2) such exclusion extends for a period of not more than 12 months (or 18 months in the case of a late enrollee) after the enrollment date; and (3) the period of any such preexisting condition exclusion is reduced by the aggregate of the periods of creditable coverage (if any, as defined in subsection (c)(1)) applicable to the participant or beneficiary as of the enrollment date. **(b) Definitions** For purposes of this part— (1) **Preexisting condition exclusion** (A) *In general* — The term “preexisting condition exclusion” means, with respect to coverage, a limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the date of enrollment for such coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before such date. (B) *Treatment of genetic information* — Genetic information shall not be treated as a condition described in subsection (a)(1) in the absence of a diagnosis of the condition related to such information. (2) **Enrollment date** — The term “enrollment date” means, with respect to an individual covered under a group health plan or health insurance coverage, the date of e

Source: Supplied U.S. Code snapshot — release unconfirmed · 29 U.S.C. § 1181

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Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1003 — Coverage

**(a) In general** Except as provided in subsection (b) or (c) and in sections 1051, 1081, and 1101 of this title, this subchapter shall apply to any employee benefit plan if it is established or maintained— (1) by any employer engaged in commerce or in any industry or activity affecting commerce; or (2) by any employee organization or organizations representing employees engaged in commerce or in any industry or activity affecting commerce; or (3) by both. **(b) Exceptions for certain plans** The provisions of this subchapter shall not apply to any employee benefit plan if— (1) such plan is a governmental plan (as defined in [section 1002(32) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1002/32&num=0&edition=prelim)); (2) such plan is a church plan (as defined in [section 1002(33) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1002/33&num=0&edition=prelim)) with respect to which no election has been made under [section 410(d) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section410/d&num=0&edition=prelim); (3) such plan is maintained solely for the purpose of complying with applicable workmen’s compensation laws or unemployment compensation or disability insurance laws; (4) such plan is maintained outside of the United States primarily for the benefit of persons substantially all of whom are nonresident aliens; or (5) such plan is an excess benefit plan (as defined in [section 1002(36) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1002/36&num=0&edition=prelim)) and is unfunded. The provisions of part 7 of subtitle B of this subchapter shall not apply to a health insurance issuer (as defined i

Source: Supplied U.S. Code snapshot — release unconfirmed · 29 U.S.C. § 1003

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Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1185 — Standards relating to benefits for mothers and newborns

**(a) Requirements for minimum hospital stay following birth** (1) **In general** — A group health plan, and a health insurance issuer offering group health insurance coverage, may not— (A) except as provided in paragraph (2)— (i) restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child, following a normal vaginal delivery, to less than 48 hours, or (ii) restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child, following a cesarean section, to less than 96 hours; or (B) require that a provider obtain authorization from the plan or the issuer for prescribing any length of stay required under subparagraph (A) (without regard to paragraph (2)). (2) **Exception** — Paragraph (1)(A) shall not apply in connection with any group health plan or health insurance issuer in any case in which the decision to discharge the mother or her newborn child prior to the expiration of the minimum length of stay otherwise required under paragraph (1)(A) is made by an attending provider in consultation with the mother. **(b) Prohibitions** A group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not— (1) deny to the mother or her newborn child eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan, solely for the purpose of avoiding the requirements of this section; (2) provide monetary payments or rebates to mothers to encourage such mothers to accept less than the minimum protections available under this section; (3) penalize or otherwise reduce or limit the reimbursement of an attending provider because such provider provided care to an ind

Source: Supplied U.S. Code snapshot — release unconfirmed · 29 U.S.C. § 1185

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Federal law — U.S. Code and appendices · legal_authorities

29 U.S.C. § 1191 — Preemption; State flexibility; construction

Page 611 TITLE 29—LABOR § 1191 1 So in original. Section 1181(d)(4) of this title does not contain subpars. 2 So in original. Section 1181(b)(2) of this title does not refer to a 30-day period. 3 So in original. Probably should be ‘‘1181(g)(1)(C)’’. (iii) costs for prescription drugs; and (iv) other medical costs, including wellness services; and (B) spending on prescription drugs by— (i) the health plan or coverage; and (ii) the participants and beneficiaries. (8) The average monthly premium— (A) paid by employers on behalf of partici- pants and beneficiaries, as applicable; and (B) paid by participants and beneficiaries. (9) Any impact on premiums by rebates, fees, and any other remuneration paid by drug man- ufacturers to the plan or coverage or its ad- ministrators or service providers, with respect to prescription drugs prescribed to partici- pants or beneficiaries in the plan or coverage, including— (A) the amounts so paid for each thera- peutic class of drugs; and (B) the amounts so paid for each of the 25 drugs that yielded the highest amount of re- bates and other remuneration under the plan or coverage from drug manufacturers during the plan year. (10) Any reduction in premiums and out-of- pocket costs associated with rebates, fees, or other remuneration described in paragraph (9). (b) Report Not later than 18 months after the date on which the first report is required under sub- section (a) and biannually thereafter, the Sec- retary, acting in coordination with the Inspec- tor General of the Department of Labor, shall make available on the internet website of the Department of Labor a report on prescription drug reimbursements under group health plans (or health insurance coverage offered in connec- tion with such a plan), prescrip

Source: Supplied 2024 U.S. Code historical extraction · 29 U.S.C. § 1191

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