
From the U.S. Code Online via GPO Access
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[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC300bb-2]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
 SUBCHAPTER XX--REQUIREMENTS FOR CERTAIN GROUP HEALTH PLANS FOR CERTAIN 
                        STATE AND LOCAL EMPLOYEES
 
Sec. 300bb-2. Continuation coverage

    For purposes of section 300bb-1 of this title, the term 
``continuation coverage'' means coverage under the plan which meets the 
following requirements:

                    (1) Type of benefit coverage

        The coverage must consist of coverage which, as of the time the 
    coverage is being provided, is identical to the coverage provided 
    under the plan to similarly situated beneficiaries under the plan 
    with respect to whom a qualifying event has not occurred. If 
    coverage is modified under the plan for any group of similarly 
    situated beneficiaries, such coverage shall also be modified in the 
    same manner for all individuals who are qualified beneficiaries 
    under the plan pursuant to this part \1\ in connection with such 
    group.
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    \1\ So in original. This subchapter is not divided into parts.
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                       (2) Period of coverage

        The coverage must extend for at least the period beginning on 
    the date of the qualifying event and ending not earlier than the 
    earliest of the following:

        (A) Maximum required period

            (i) General rule for terminations and reduced hours

                In the case of a qualifying event described in section 
            300bb-3(2) of this title, except as provided in clause (ii), 
            the date which is 18 months after the date of the qualifying 
            event.
            (ii) Special rule for multiple qualifying events

                If a qualifying event occurs during the 18 months after 
            the date of a qualifying event described in section 300bb-
            3(2) of this title, the date which is 36 months after the 
            date of the qualifying event described in section 300bb-3(2) 
            of this title.
            (iii) General rule for other qualifying events

                In the case of a qualifying event not described in 
            section 300bb-3(2) of this title, the date which is 36 
            months after the date of the qualifying event.
            (iv) Medicare entitlement followed by qualifying 
                    event

                In the case of a qualifying event described in section 
            300bb-3(2) of this title that occurs less than 18 months 
            after the date the covered employee became entitled to 
            benefits under title XVIII of the Social Security Act [42 
            U.S.C. 1395 et seq.], the period of coverage for qualified 
            beneficiaries other than the covered employee shall not 
            terminate under this subparagraph before the close of the 
            36-month period beginning on the date the covered employee 
            became so entitled.

        In the case of a qualified beneficiary who is determined, under 
        title II or XVI of the Social Security Act [42 U.S.C. 401 et 
        seq., 1381 et seq.], to have been disabled at any time during 
        the first 60 days of continuation coverage under this 
        subchapter, any reference in clause (i) or (ii) to 18 months is 
        deemed a reference to 29 months (with respect to all qualified 
        beneficiaries), but only if the qualified beneficiary has 
        provided notice of such determination under section 300bb-6(3) 
        of this title before the end of such 18 months.

        (B) End of plan

            The date on which the employer ceases to provide any group 
        health plan to any employee.

        (C) Failure to pay premium

            The date on which coverage ceases under the plan by reason 
        of a failure to make timely payment of any premium required 
        under the plan with respect to the qualified beneficiary. The 
        payment of any premium (other than any payment referred to in 
        the last sentence of paragraph (3)) shall be considered to be 
        timely if made within 30 days after the date due or within such 
        longer period as applies to or under the plan.

        (D) Group health plan coverage or medicare entitlement

            The date on which the qualified beneficiary first becomes, 
        after the date of the election--
                (i) covered under any other group health plan (as an 
            employee or otherwise) which does not contain any exclusion 
            or limitation with respect to any preexisting condition of 
            such beneficiary (other than such an exclusion or limitation 
            which does not apply to (or is satisfied by) such 
            beneficiary by reason of chapter 100 of title 26, part 7 of 
            subtitle B of title I of the Employee Retirement Income 
            Security Act of 1974 [29 U.S.C. 1181 et seq.], or subchapter 
            XXV of this chapter), or
                (ii) entitled to benefits under title XVIII of the 
            Social Security Act [42 U.S.C. 1395 et seq.].

        (E) Termination of extended coverage for disability

            In the case of a qualified beneficiary who is disabled at 
        any time during the first 60 days of continuation coverage under 
        this subchapter, the month that begins more than 30 days after 
        the date of the final determination under title II or XVI of the 
        Social Security Act [42 U.S.C. 401 et seq., 1381 et seq.] that 
        the qualified beneficiary is no longer disabled.

                      (3) Premium requirements

        The plan may require payment of a premium for any period of 
    continuation coverage, except that such premium--
            (A) shall not exceed 102 percent of the applicable premium 
        for such period, and
            (B) may, at the election of the payor, be made in monthly 
        installments.

    In no event may the plan require the payment of any premium before 
    the day which is 45 days after the day on which the qualified 
    beneficiary made the initial election for continuation coverage.\2\ 
    In the case of an individual described in the last sentence of 
    paragraph (2)(A), any reference in subparagraph (A) of this 
    paragraph to ``102 percent'' is deemed a reference to ``150 
    percent'' for any month after the 18th month of continuation 
    coverage described in clause (i) or (ii) of paragraph (2)(A).
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    \2\ See 1989 Amendment note below.
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                 (4) No requirement of insurability

        The coverage may not be conditioned upon, or discriminate on the 
    basis of lack of, evidence of insurability.

                        (5) Conversion option

        In the case of a qualified beneficiary whose period of 
    continuation coverage expires under paragraph (2)(A), the plan must, 
    during the 180-day period ending on such expiration date, provide to 
    the qualified beneficiary the option of enrollment under a 
    conversion health plan otherwise generally available under the plan.

(July 1, 1944, ch. 373, title XXII, Sec. 2202, as added Pub. L. 99-272, 
title X, Sec. 10003(a), Apr. 7, 1986, 100 Stat. 233; amended Pub. L. 99-
514, title XVIII, Sec. 1895(d)(1)(C), (2)(C), (3)(C), (4)(C), Oct. 22, 
1986, 100 Stat. 2937-2939; Pub. L. 101-239, title VI, Secs. 6702(a), 
(b), 6801(b)(1)(A), (2)(A), (3)(A), Dec. 19, 1989, 103 Stat. 2295, 2297; 
Pub. L. 104-188, title I, Sec. 1704(g)(1)(C), Aug. 20, 1996, 110 Stat. 
1880; Pub. L. 104-191, title IV, Sec. 421(a)(1), Aug. 21, 1996, 110 
Stat. 2087.)

                       References in Text

    The Social Security Act, referred to in par. (2)(A), (D)(ii), and 
(E), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Titles II, 
XVI, and XVIII of the Social Security Act are classified generally to 
subchapters II (Sec. 401 et seq.), XVI (Sec. 1381 et seq.), and XVIII 
(Sec. 1395 et seq.), respectively, of chapter 7 of this title. For 
complete classification of this Act to the Code, see section 1305 of 
this title and Tables.
    The Employee Retirement Income Security Act of 1974, referred to in 
par. (2)(D)(i), is Pub. L. 93-406, Sept. 2, 1974, 88 Stat. 829, as 
amended. Part 7 of subtitle B of title I of the Act is classified 
generally to part 7 (Sec. 1181 et seq.) of subtitle B of subchapter I of 
chapter 18 of Title 29, Labor. For complete classification of this Act 
to the Code, see Short Title note set out under section 1001 of Title 29 
and Tables.


                               Amendments

    1996--Par. (2)(A). Pub. L. 104-191, Sec. 421(a)(1)(A)(ii)(IV), 
inserted ``(with respect to all qualified beneficiaries)'' after ``29 
months'' in concluding provisions.
    Pub. L. 104-191, Sec. 421(a)(1)(A)(ii)(III), which directed 
amendment of concluding provisions by striking ``with respect to such 
event,'', was executed by striking that phrase, which did not contain a 
comma at end, before ``is deemed a reference'' to reflect the probable 
intent of Congress.
    Pub. L. 104-191, Sec. 421(a)(1)(A)(ii)(I), (II), in concluding 
provisions, substituted ``a qualified beneficiary'' for ``an 
individual'' and ``at any time during the first 60 days of continuation 
coverage under this subchapter'' for ``at the time of a qualifying event 
described in section 300bb-3(2) of this title''.
    Pub. L. 104-191, Sec. 421(a)(1)(A)(i), transferred sentence 
following cl. (iii) to appear as concluding provisions following cl. 
(iv).
    Par. (2)(A)(iv). Pub. L. 104-188 amended heading and text of cl. 
(iv) generally. Prior to amendment, text read as follows: ``In the case 
of an event described in section 300bb-3(4) of this title (without 
regard to whether such event is a qualifying event), the period of 
coverage for qualified beneficiaries other than the covered employee for 
such event or any subsequent qualifying event shall not terminate before 
the close of the 36-month period beginning on the date the covered 
employee becomes entitled to benefits under title XVIII of the Social 
Security Act.''
    Par. (2)(D)(i). Pub. L. 104-191, Sec. 421(a)(1)(B), inserted 
``(other than such an exclusion or limitation which does not apply to 
(or is satisfied by) such beneficiary by reason of chapter 100 of title 
26, part 7 of subtitle B of title I of the Employee Retirement Income 
Security Act of 1974, or subchapter XXV of this chapter)'' before ``, 
or''.
    Par. (2)(E). Pub. L. 104-191, Sec. 421(a)(1)(C), substituted ``at 
any time during the first 60 days of continuation coverage under this 
subchapter'' for ``at the time of a qualifying event described in 
section 300bb-3(2) of this title''.
    1989--Par. (2)(A). Pub. L. 101-239, Sec. 6702(a)(1), inserted after 
cl. (iii) ``In the case of an individual who is determined, under title 
II or XVI of the Social Security Act, to have been disabled at the time 
of a qualifying event described in section 300bb-3(2) of this title, any 
reference in clause (i) or (ii) to 18 months with respect to such event 
is deemed a reference to 29 months, but only if the qualified 
beneficiary has provided notice of such determination under section 
300bb-6(3) of this title before the end of such 18 months.''
    Par. (2)(A)(iv). Pub. L. 101-239, Sec. 6801(b)(1)(A), added cl. 
(iv).
    Par. (2)(D). Pub. L. 101-239, Sec. 6801(b)(2)(A), substituted 
``entitlement'' for ``eligibility'' in heading and inserted ``which does 
not contain any exclusion or limitation with respect to any preexisting 
condition of such beneficiary'' after ``or otherwise)'' in cl. (i).
    Par. (2)(E). Pub. L. 101-239, Sec. 6702(a)(2), added subpar. (E).
    Par. (3). Pub. L. 101-239, Sec. 6801(b)(3)(A), which directed the 
general amendment of the concluding provision was executed by amending 
the first sentence of the concluding provision generally to reflect the 
probable intent of Congress and amendment of concluding provision by 
Pub. L. 101-239, Sec. 6702(b). Prior to amendment, first sentence of the 
concluding provision read as follows: ``If an election is made after the 
qualifying event, the plan shall permit payment for continuation 
coverage during the period preceding the election to be made within 45 
days of the date of the election.''
    Pub. L. 101-239, Sec. 6702(b), inserted at end of concluding 
provision ``In the case of an individual described in the last sentence 
of paragraph (2)(A), any reference in subparagraph (A) of this paragraph 
to `102 percent' is deemed a reference to `150 percent' for any month 
after the 18th month of continuation coverage described in clause (i) or 
(ii) of paragraph (2)(A).'' See Amendment note above.
    1986--Par. (1). Pub. L. 99-514, Sec. 1895(d)(1)(C), inserted at end 
``If coverage is modified under the plan for any group of similarly 
situated beneficiaries, such coverage shall also be modified in the same 
manner for all individuals who are qualified beneficiaries under the 
plan pursuant to this part in connection with such group.''
    Par. (2)(A). Pub. L. 99-514, Sec. 1895(d)(2)(C), amended subpar. (A) 
generally. Prior to amendment, subpar. (A) read as follows: ``Maximum 
period.--In the case of--
        ``(i) a qualifying event described in section 300bb-3(2) of this 
    title (relating to terminations and reduced hours), the date which 
    is 18 months after the date of the qualifying event, and
        ``(ii) any qualifying event not described in clause (i), the 
    date which is 36 months after the date of the qualifying event.''
    Par. (2)(C). Pub. L. 99-514, Sec. 1895(d)(3)(C), inserted at end 
``The payment of any premium (other than any payment referred to in the 
last sentence of paragraph (3)) shall be considered to be timely if made 
within 30 days after the date due or within such longer period as 
applies to or under the plan.''
    Par. (2)(D). Pub. L. 99-514, Sec. 1895(d)(4)(C)(ii), (iii), 
substituted ``Group health plan coverage'' for ``Reemployment'' in 
heading, added cl. (i), and struck out former cl. (i) which read as 
follows: ``a covered employee under any other group health plan, or''.
    Par. (2)(E). Pub. L. 99-514, Sec. 1895(d)(4)(C)(i), struck out 
subpar. (E), remarriage of spouse, which read as follows: ``In the case 
of an individual who is a qualified beneficiary by reason of being the 
spouse of a covered employee, the date on which the beneficiary 
remarries and becomes covered under a group health plan.''


                    Effective Date of 1996 Amendments

    Amendment by Pub. L. 104-191 effective Jan. 1, 1997, regardless of 
whether the qualifying event occurred before, on, or after such date, 
see section 421(d) of Pub. L. 104-191, set out as a note under section 
4980B of Title 26, Internal Revenue Code.
    Amendment by Pub. L. 104-188 applicable to plan years beginning 
after Dec. 31, 1989, see section 1704(g)(2) of Pub. L. 104-188, set out 
as a note under section 4980B of Title 26.


                    Effective Date of 1989 Amendment

    Section 6702(d) of Pub. L. 101-239 provided that: ``The amendments 
made by this section [amending this section and section 300bb-6 of this 
title] shall apply to plan years beginning on or after the date of the 
enactment of this Act [Dec. 19, 1989], regardless of whether the 
qualifying event occurred before, on, or after such date.''
    Section 6801(b)(1)(B) of Pub. L. 101-239 provided that: ``The 
amendments made by this paragraph [amending this section] shall apply to 
plan years beginning after December 31, 1989.''
    Section 6801(b)(2)(B) of Pub. L. 101-239 provided that: ``The 
amendments made by subparagraph (A) [amending this section] shall apply 
to--
        ``(i) qualifying events occurring after December 31, 1989, and
        ``(ii) in the case of qualified beneficiaries who elected 
    continuation coverage after December 31, 1988, the period for which 
    the required premium was paid (or was attempted to be paid but was 
    rejected as such).''
    Section 6801(b)(3)(B) of Pub. L. 101-239 provided that: ``The 
amendment made by subparagraph (A) [amending this section] shall apply 
to plan years beginning after December 31, 1989.''


                    Effective Date of 1986 Amendment

    Amendment by Pub. L. 99-514 effective, except as otherwise provided, 
as if included in enactment of the Consolidated Omnibus Budget 
Reconciliation Act of 1985, Pub. L. 99-272, see section 1895(e) of Pub. 
L. 99-514, set out as a note under section 162 of Title 26, Internal 
Revenue Code.


           Plan Amendments Not Required Until January 1, 1989

    For provisions directing that if any amendments made by subtitle A 
or subtitle C of title XI [Secs. 1101-1147 and 1171-1177] or title XVIII 
[Secs. 1800-1899A] of Pub. L. 99-514 require an amendment to any plan, 
such plan amendment shall not be required to be made before the first 
plan year beginning on or after Jan. 1, 1989, see section 1140 of Pub. 
L. 99-514, as amended, set out as a note under section 401 of Title 26, 
Internal Revenue Code.
