42 U.S.C. § 18011 — Preservation of right to maintain exist-

Page 9092 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 18011 1 See References in Text note below. ‘‘(E) Coverage under a high risk pool under section 18001 of this title.’’ SUBCHAPTER II—OTHER PROVISIONS § 18011. Preservation of right to maintain exist- ing coverage (a) No changes to existing coverage (1) In general Nothing in this Act (or an amendment made by this Act) shall be construed to require that an individual terminate coverage under a group health plan or health insurance cov- erage in which such individual was enrolled on March 23, 2010. (2) Continuation of coverage Except as provided in paragraph (3), with re- spect to a group health plan or health insur- ance coverage in which an individual was en- rolled on March 23, 2010, this subtitle and sub- title A (and the amendments made by such subtitles) shall not apply to such plan or cov- erage, regardless of whether the individual re- news such coverage after March 23, 2010. (3) Application of certain provisions The provisions of sections 2715 [42 U.S.C. 300gg–15] and 2718 [42 U.S.C. 300gg–18] of the Public Health Service Act (as added by sub- title A) shall apply to grandfathered health plans for plan years beginning on or after March 23, 2010. (4) Application of certain provisions (A) In general The following provisions of the Public Health Service Act [42 U.S.C. 201 et seq.] (as added by this title) 1 shall apply to grand- fathered health plans for plan years begin- ning with the first plan year to which such provisions would otherwise apply: (i) Section 2708 [42 U.S.C. 300gg–7] (relat- ing to excessive waiting periods). (ii) Those provisions of section 2711 [42 U.S.C. 300gg–11] relating to lifetime limits. (iii) Section 2712 [42 U.S.C. 300gg–12] (re- lating to rescissions). (iv) Section 2714 [42 U.S.C. 300gg–14] (re- lating to extension of dependent coverage). (B) Provisions applicable only to group health plans (i) Provisions described Those provisions of section 2711 [42 U.S.C. 300gg–11] relating to annual limits and the provisions of section 2704 [42 U.S.C. 300gg–3] (relating to pre-existing condition exclusions) of the Public Health Service Act (as added by this subtitle) shall apply to grandfathered health plans that are group health plans for plan years begin- ning with the first plan year to which such provisions otherwise apply. (ii) Adult child coverage For plan years beginning before January 1, 2014, the provisions of section 2714 of the Public Health Service Act [42 U.S.C. 300gg–14] (as added by this subtitle) shall apply in the case of an adult child with re- spect to a grandfathered health plan that is a group health plan only if such adult child is not eligible to enroll in an eligible employer-sponsored health plan (as defined in section 5000A(f)(2) of title 26) other than such grandfathered health plan. (5) Application of additional provisions Sections 300gg–111, 300gg–112, and 300gg–117 of this title shall apply to grandfathered health plans for plan years beginning on or after January 1, 2022. (b) Allowance for family members to join current coverage With respect to a group health plan or health insurance coverage in which an individual was enrolled on March 23, 2010, and which is renewed after such date, family members of such indi- vidual shall be permitted to enroll in such plan or coverage if such enrollment is permitted under the terms of the plan in effect as of March 23, 2010. (c) Allowance for new employees to join current plan A group health plan that provides coverage on March 23, 2010, may provide for the enrolling of new employees (and their families) in such plan, and this subtitle and subtitle A (and the amend- ments made by such subtitles) shall not apply with respect to such plan and such new employ- ees (and their families). (d) Effect on collective bargaining agreements In the case of health insurance coverage main- tained pursuant to one or more collective bar- gaining agreements between employee rep- resentatives and one or more employers that was ratified before March 23, 2010, the provisions of this subtitle and subtitle A (and the amend- ments made by such subtitles) shall not apply until the date on which the last of the collective bargaining agreements relating to the coverage terminates. Any coverage amendment made pur- suant to a collective bargaining agreement re- lating to the coverage which amends the cov- erage solely to conform to any requirement added by this subtitle or subtitle A (or amend- ments) shall not be treated as a termination of such collective bargaining agreement. (e) Definition In this title,1 the term ‘‘grandfathered health plan’’ means any group health plan or health in- surance coverage to which this section applies. (Pub. L. 111–148, title I, § 1251, title X, § 10103(d), Mar. 23, 2010, 124 Stat. 161, 895; Pub. L. 111–152, title II, § 2301(a), Mar. 30, 2010, 124 Stat. 1081; Pub. L. 116–260, div. BB, title I, § 102(d)(2), Dec. 27, 2020, 134 Stat. 2797.) Editorial Notes REFERENCES IN TEXT This Act, referred to in subsec. (a)(1), is Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 119, known as the Pa- tient Protection and Affordable Care Act. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of this title and Tables. This subtitle, referred to in subsecs. (a)(2), (4)(B), (c), and (d), is subtitle C (§§ 1201–1255) of title I of Pub. L. Page 9093 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 18014 1 See References in Text note below. 111–148, Mar. 23, 2010, 124 Stat. 154, which enacted this subchapter and sections 300gg to 300gg–2 and 300gg–4 to 300gg–7 of this title, transferred section 300gg of this title to section 300gg–3 of this title, amended sections 300gg–1 and 300gg–4 of this title, and enacted provisions set out as a note under section 300gg of this title. For complete classification of subtitle C to the Code, see Tables. Subtitle A, referred to in subsecs. (a)(2), (3), (c), and (d), is subtitle A (§§ 1001–1004) of title I of Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 130, which enacted sec- tions 300gg–11 to 300gg–19, 300gg–93, and 300gg–94 of this title, transferred sections 300gg–4 to 300gg–7 and 300gg–13 of this title to sections 300gg–25 to 300gg–28 and 300gg–9 of this title, respectively, amended sections 300gg–11, 300gg–12, and 300gg–21 to 300gg–23 of this title, and enacted provisions set out as a note under section 300gg–11 of this title. For complete classification of subtitle A to the Code, see Tables. The Public Health Service Act, referred to in subsec. (a)(4)(A), is act July 1, 1944, ch. 373, 58 Stat. 682, which is classified generally to chapter 6A (§ 201 et seq.) of this title. For complete classification of this Act to the Code, see Short Title note set out under section 201 of this title and Tables. This title, referred to in subsecs. (a)(4)(A) and (e), is title I of Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 130, which enacted this chapter and enacted, amended, and transferred numerous other sections and notes in the Code. For complete classification of title I to the Code, see Tables. AMENDMENTS 2020—Subsec. (a)(5). Pub. L. 116–260 added par. (5). 2010—Subsec. (a)(2). Pub. L. 111–148, § 10103(d)(1), sub- stituted ‘‘Except as provided in paragraph (3), with’’ for ‘‘With’’. Subsec. (a)(3). Pub. L. 111–148, § 10103(d)(2), added par. (3). Subsec. (a)(4). Pub. L. 111–152 added par. (4). Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 2020 AMENDMENT Amendment by Pub. L. 116–260 applicable with re- spect 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 Or- ganization and Employees. EFFECTIVE DATE Section effective Mar. 23, 2010, see section 1255(1) of Pub. L. 111–148, set out as a note under section 300gg of this title. § 18012. Rating reforms must apply uniformly to all health insurance issuers and group health plans Any standard or requirement adopted by a State pursuant to this title,1 or any amendment made by this title,1 shall be applied uniformly to all health plans in each insurance market to which the standard and requirements apply. The preceding sentence shall also apply to a State standard or requirement relating to the stand- ard or requirement required by this title 1 (or any such amendment) that is not the same as the standard or requirement but that is not pre- empted under section 18041(d) of this title. (Pub. L. 111–148, title I, § 1252, Mar. 23, 2010, 124 Stat. 162.) Editorial Notes REFERENCES IN TEXT This title, referred to in text, is title I of Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 130, which enacted this chapter and enacted, amended, and transferred numer- ous other sections and notes in the Code. For complete classification of title I to the Code, see Tables. Statutory Notes and Related Subsidiaries EFFECTIVE DATE Section effective for plan years beginning on or after Jan. 1, 2014, see section 1255 of Pub. L. 111–148, set out as a note under section 300gg of this title. § 18013. Annual report on self-insured plans Not later than 1 year after March 23, 2010, and annually thereafter, the Secretary of Labor shall prepare an aggregate annual report, using data collected from the Annual Return/Report of Employee Benefit Plan (Department of Labor Form 5500), that shall include general informa- tion on self-insured group health plans (includ- ing plan type, number of participants, benefits offered, funding arrangements, and benefit ar- rangements) as well as data from the financial filings of self-insured employers (including in- formation on assets, liabilities, contributions, investments, and expenses). The Secretary shall submit such reports to the appropriate commit- tees of Congress. (Pub. L. 111–148, title I, § 1253, as added Pub. L. 111–148, title X, § 10103(f)(2), Mar. 23, 2010, 124 Stat. 895.) Editorial Notes PRIOR PROVISIONS A prior section 1253 of Pub. L. 111–148 was renumbered section 1255 and is set out as a note under section 300gg of this title. Statutory Notes and Related Subsidiaries EFFECTIVE DATE Section effective for plan years beginning on or after Jan. 1, 2014, see section 1255 of Pub. L. 111–148, set out as a note under section 300gg of this title. § 18014. Treatment of expatriate health plans under ACA (a) In general Subject to subsection (b), the provisions of (in- cluding any amendment made by) the Patient Protection and Affordable Care Act (Public Law 111–148) and of title I and subtitle B of title II of the Health Care and Education Reconciliation Act of 2010 (Public Law 111–152) shall not apply with respect to— (1) expatriate health plans; (2) employers with respect to such plans, solely in their capacity as plan sponsors for such plans; or (3) expatriate health insurance issuers with respect to coverage offered by such issuers under such plans. (b) Minimum essential coverage and reporting requirements (1) In general For the purpose of section 5000A(f) of title 26, and any other section of title 26 that incor-