§ 1163 TITLE 29—LABOR Page 464

lows: ‘‘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 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 6703(d) of Pub. L. 101–239 provided that: ‘‘The

amendments made by this section [amending this section and section 1166 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.’’

Amendment by section 7862(c)(3)(B) of Pub. L. 101–239

applicable to (i) qualifying events occurring after Dec.

31, 1989, and (ii) in the case of qualified beneficiaries

who elected continuation coverage after Dec. 31, 1988,

the period for which the required premium was paid (or

was attempted to be paid but was rejected as such), see

section 7862(c)(3)(D) of Pub. L. 101–239, set out as a note

under section 162 of Title 26, Internal Revenue Code.

Amendment by section 7862(c)(4)(A) of Pub. L. 101–239

applicable to plan years beginning after Dec. 31, 1989,

see section 7862(c)(4)(C) of Pub. L. 101–239, set out as a

note under section 4980B of Title 26.

Amendment by section 7862(c)(5)(B) of Pub. L. 101–239

applicable to plan years beginning after Dec. 31, 1989,

see section 7862(c)(5)(C) of Pub. L. 101–239, set out as a

note under section 4980B of Title 26.

EFFECTIVE DATE OF 1986 AMENDMENTS

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.

Amendment by Pub. L. 99–509 effective, except as

otherwise provided, as if included in title X of the Consolidated Omnibus Budget Reconciliation Act of 1985,

Pub. L. 99–272, see section 9501(e) of Pub. L. 99–509, set

out as a note under section 162 of Title 26.

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 [§§1101–1147

and 1171–1177] or title XVIII [§§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.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 1167 of this title.

§ 1163. Qualifying event

For purposes of this part, the term ‘‘qualifying

event’’ means, with respect to any covered employee, any of the following events which, but

for the continuation coverage required under

this part, would result in the loss of coverage of

a qualified beneficiary:

(1) The death of the covered employee.

(2) The termination (other than by reason of

such employee’s gross misconduct), or reduction of hours, of the covered employee’s employment.

(3) The divorce or legal separation of the

covered employee from the employee’s spouse.

(4) The covered employee becoming entitled

to benefits under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.].

(5) A dependent child ceasing to be a dependent child under the generally applicable requirements of the plan.

(6) A proceeding in a case under title 11,

commencing on or after July 1, 1986, with respect to the employer from whose employment

the covered employee retired at any time.

In the case of an event described in paragraph

(6), a loss of coverage includes a substantial

elimination of coverage with respect to a qualified beneficiary described in section 1167(3)(C) of

this title within one year before or after the

date of commencement of the proceeding.

(Pub. L. 93–406, title I, §603, as added Pub. L.

99–272, title X, §10002(a), Apr. 7, 1986, 100 Stat.

229; amended Pub. L. 99–509, title IX, §9501(a)(2),

Oct. 21, 1986, 100 Stat. 2076.)

REFERENCES IN TEXT

The Social Security Act, referred to in par. (4), is act

Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Title

XVIII of the Social Security Act is classified generally

to subchapter XVIII (§1395 et seq.) of chapter 7 of Title

42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title

42 and Tables.

AMENDMENTS

1986—Pub. L. 99–509 added par. (6) and last sentence.

EFFECTIVE DATE OF 1986 AMENDMENT

Amendment by Pub. L. 99–509 effective, except as

otherwise provided, as if included in title X of the Consolidated Omnibus Budget Reconciliation Act of 1985,

Pub. L. 99–272, see section 9501(e) of Pub. L. 99–509, set

out as a note under section 162 of Title 26, Internal Revenue Code.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1162, 1166, 1167

of this title.

§ 1164. Applicable premium

For purposes of this part—

(1) In general

The term ‘‘applicable premium’’ means, with

respect to any period of continuation coverage

of qualified beneficiaries, the cost to the plan

for such period of the coverage for similarly

situated beneficiaries with respect to whom a

qualifying event has not occurred (without regard to whether such cost is paid by the employer or employee).

(2) Special rule for self-insured plans

To the extent that a plan is a self-insured

plan—

(A) In general

Except as provided in subparagraph (B),

the applicable premium for any period of

continuation coverage of qualified beneficiaries shall be equal to a reasonable esti-