§ 1183 TITLE 29—LABOR Page 476

(A) to restrict the amount that an employer may be charged for coverage under a

group health plan; 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 programs of

health promotion and disease prevention.

(Pub. L. 93–406, title I, §702, as added Pub. L.

104–191, title I, §101(a), Aug. 21, 1996, 110 Stat.

1945.)

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in section 1191b of this

title.

§ 1183. Guaranteed renewability in multiemployer plans and multiple employer welfare

arrangements

A group health plan which is a multiemployer

plan or which is a multiple employer welfare arrangement may not deny an employer whose

employees are covered under such a plan continued access to the same or different coverage

under the terms of such a plan, other than—

(1) for nonpayment of contributions;

(2) for fraud or other intentional misrepresentation of material fact by the employer;

(3) for noncompliance with material plan

provisions;

(4) because the plan is ceasing to offer any

coverage in a geographic area;

(5) in the case of a plan that offers benefits

through a network plan, there is no longer any

individual enrolled through the employer who

lives, resides, or works in the service area of

the network plan and the plan applies this

paragraph uniformly without regard to the

claims experience of employers or any health

status-related factor in relation to such individuals or their dependents; and

(6) for failure to meet the terms of an applicable collective bargaining agreement, to

renew a collective bargaining or other agreement requiring or authorizing contributions to

the plan, or to employ employees covered by

such an agreement.

(Pub. L. 93–406, title I, §703, as added Pub. L.

104–191, title I, §101(a), Aug. 21, 1996, 110 Stat.

1946.)

Subpart B—Other Requirements

§ 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 individual participant or beneficiary in accordance with this section;

(4) provide incentives (monetary or otherwise) to an attending provider to induce such

provider to provide care to an individual participant or beneficiary in a manner inconsistent with this section; or

(5) subject to subsection (c)(3) of this section, restrict benefits for any portion of a period within a hospital length of stay required

under subsection (a) of this section in a manner which is less favorable than the benefits

provided for any preceding portion of such

stay.

(c) Rules of construction

(1) Nothing in this section shall be construed

to require a mother who is a participant or beneficiary—

(A) to give birth in a hospital; or

(B) to stay in the hospital for a fixed period

of time following the birth of her child.

(2) This section shall not apply with respect to

any group health plan, or any group health insurance coverage offered by a health insurance

issuer, which does not provide benefits for hospital lengths of stay in connection with childbirth for a mother or her newborn child.

(3) Nothing in this section shall be construed

as preventing a group health plan or issuer from

imposing deductibles, coinsurance, or other

cost-sharing in relation to benefits for hospital

lengths of stay in connection with childbirth for

a mother or newborn child under the plan (or