29 U.S.C. § 1182 — Prohibiting discrimination against indi-

Page 578 TITLE 29—LABOR § 1182 coordination disclosure form developed under subpara- graph (C) [set out above] shall apply with respect to re- quests made by States beginning with the first plan year that begins after the date on which such model coverage coordination disclosure form is first issued.’’ § 1182. Prohibiting discrimination against indi- vidual participants and beneficiaries based on health status (a) In eligibility to enroll (1) In general Subject to paragraph (2), a group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not establish rules for eligibility (including continued eligi- bility) of any individual to enroll under the terms of the plan based on any of the fol- lowing health status-related factors in rela- tion to the individual or a dependent of the in- dividual: (A) Health status. (B) Medical condition (including both physical and mental illnesses). (C) Claims experience. (D) Receipt of health care. (E) Medical history. (F) Genetic information. (G) Evidence of insurability (including conditions arising out of acts of domestic vi- olence). (H) Disability. (2) No application to benefits or exclusions To the extent consistent with section 1181 of this title, paragraph (1) shall not be con- strued— (A) to require a group health plan, or group health insurance coverage, to provide particular benefits other than those pro- vided under the terms of such plan or cov- erage, or (B) to prevent such a plan or coverage from establishing limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for similarly situ- ated individuals enrolled in the plan or cov- erage. (3) Construction For purposes of paragraph (1), rules for eligi- bility to enroll under a plan include rules de- fining any applicable waiting periods for such enrollment. (b) In premium contributions (1) In general A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, may not require any individual (as a condition of en- rollment or continued enrollment under the plan) to pay a premium or contribution which is greater than such premium or contribution for a similarly situated individual enrolled in the plan on the basis of any health status-re- lated factor in relation to the individual or to an individual enrolled under the plan as a de- pendent of the individual. (2) Construction Nothing in paragraph (1) shall be con- strued— (A) to restrict the amount that an em- ployer may be charged for coverage under a group health plan except as provided in paragraph (3); or (B) to prevent a group health plan, and a health insurance issuer offering group health insurance coverage, from establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to pro- grams of health promotion and disease pre- vention. (3) No group-based discrimination on basis of genetic information (A) In general For purposes of this section, a group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not adjust premium or contribution amounts for the group covered under such plan on the basis of genetic information. (B) Rule of construction Nothing in subparagraph (A) or in para- graphs (1) and (2) of subsection (d) shall be construed to limit the ability of a health in- surance issuer offering health insurance cov- erage in connection with a group health plan to increase the premium for an employer based on the manifestation of a disease or disorder of an individual who is enrolled in the plan. In such case, the manifestation of a disease or disorder in one individual can- not also be used as genetic information about other group members and to further increase the premium for the employer. (c) Genetic testing (1) Limitation on requesting or requiring ge- netic testing A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, shall not request or require an individual or a family member of such individual to undergo a ge- netic test. (2) Rule of construction Paragraph (1) shall not be construed to limit the authority of a health care professional who is providing health care services to an in- dividual to request that such individual under- go a genetic test. (3) Rule of construction regarding payment (A) In general Nothing in paragraph (1) shall be con- strued to preclude a group health plan, or a health insurance issuer offering health in- surance coverage in connection with a group health plan, from obtaining and using the re- sults of a genetic test in making a deter- mination regarding payment (as such term is defined for the purposes of applying the regulations promulgated by the Secretary of Health and Human Services under part C of title XI of the Social Security Act [42 U.S.C. 1320d et seq.] and section 264 of the Health Insurance Portability and Accountability Act of 1996, as may be revised from time to time) consistent with subsection (a). Page 579 TITLE 29—LABOR § 1183 (B) Limitation For purposes of subparagraph (A), a group health plan, or a health insurance issuer of- fering health insurance coverage in connec- tion with a group health plan, may request only the minimum amount of information necessary to accomplish the intended pur- pose. (4) Research exception Notwithstanding paragraph (1), a group health plan, or a health insurance issuer offer- ing health insurance coverage in connection with a group health plan, may request, but not require, that a participant or beneficiary un- dergo a genetic test if each of the following conditions is met: (A) The request is made, in writing, pursu- ant to research that complies with part 46 of title 45, Code of Federal Regulations, or equivalent Federal regulations, and any ap- plicable State or local law or regulations for the protection of human subjects in re- search. (B) The plan or issuer clearly indicates to each participant or beneficiary, or in the case of a minor child, to the legal guardian of such beneficiary, to whom the request is made that— (i) compliance with the request is vol- untary; and (ii) non-compliance will have no effect on enrollment status or premium or con- tribution amounts. (C) No genetic information collected or ac- quired under this paragraph shall be used for underwriting purposes. (D) The plan or issuer notifies the Sec- retary in writing that the plan or issuer is conducting activities pursuant to the excep- tion provided for under this paragraph, in- cluding a description of the activities con- ducted. (E) The plan or issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this paragraph. (d) Prohibition on collection of genetic informa- tion (1) In general A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, shall not request, require, or purchase genetic informa- tion for underwriting purposes (as defined in section 1191b of this title). (2) Prohibition on collection of genetic infor- mation prior to enrollment A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, shall not request, require, or purchase genetic informa- tion with respect to any individual prior to such individual’s enrollment under the plan or coverage in connection with such enrollment. (3) Incidental collection If a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, obtains genetic information incidental to the request- ing, requiring, or purchasing of other informa- tion concerning any individual, such request, requirement, or purchase shall not be consid- ered a violation of paragraph (2) if such re- quest, requirement, or purchase is not in vio- lation of paragraph (1). (e) Application to all plans The provisions of subsections (a)(1)(F), (b)(3), (c), and (d), and subsection (b)(1) and section 1181 of this title with respect to genetic information, shall apply to group health plans and health in- surance issuers without regard to section 1191a(a) of this title. (f) Genetic information of a fetus or embryo Any reference in this part to genetic informa- tion concerning an individual or family member of an individual shall— (1) with respect to such an individual or fam- ily member of an individual who is a pregnant woman, include genetic information of any fetus carried by such pregnant woman; and (2) with respect to an individual or family member utilizing an assisted reproductive technology, include genetic information of any embryo legally held by the individual or family member. (Pub. L. 93–406, title I, § 702, as added Pub. L. 104–191, title I, § 101(a), Aug. 21, 1996, 110 Stat. 1945; amended Pub. L. 110–233, title I, § 101(a)–(c), May 21, 2008, 122 Stat. 883, 885.) Editorial Notes REFERENCES IN TEXT The Social Security Act, referred to in subsec. (c)(3)(A), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Part C of title XI of the Act is classified generally to part C (§ 1320d et seq.) of subchapter XI of chapter 7 of Title 42, The Public Health and Welfare. For complete classi- fication of this Act to the Code, see section 1305 of Title 42 and Tables. Section 264 of the Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (c)(3)(A), is section 264 of Pub. L. 104–191, which is set out as a note under section 1320d–2 of Title 42, The Pub- lic Health and Welfare. AMENDMENTS 2008—Subsec. (b)(2)(A). Pub. L. 110–233, § 101(a)(1), in- serted ‘‘except as provided in paragraph (3)’’ before semicolon. Subsec. (b)(3). Pub. L. 110–233, § 101(a)(2), added par. (3). Subsecs. (c) to (e). Pub. L. 110–233, § 101(b), added sub- secs. (c) to (e). Subsec. (f). Pub. L. 110–233, § 101(c), added subsec. (f). Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 2008 AMENDMENT Amendment by Pub. L. 110–233 applicable with re- spect to group health plans for plan years beginning after the date that is one year after May 21, 2008, see section 101(f)(2) of Pub. L. 110–233, set out as a note under section 1132 of this title. § 1183. Guaranteed renewability in multiem- ployer plans and multiple employer welfare arrangements A group health plan which is a multiemployer plan or which is a multiple employer welfare ar-