Page 481 TITLE 29—LABOR § 1191c

(provided directly, through insurance or reimbursement, or otherwise and including items

and services paid for as medical care) under

any hospital or medical service policy or certificate, hospital or medical service plan contract, or health maintenance organization

contract offered by a health insurance issuer.

(2) Health insurance issuer

The term ‘‘health insurance issuer’’ means

an insurance company, insurance service, or

insurance organization (including a health

maintenance organization, as defined in paragraph (3)) which is licensed to engage in the

business of insurance in a State and which is

subject to State law which regulates insurance

(within the meaning of section 1144(b)(2) of

this title). Such term does not include a group

health plan.

(3) Health maintenance organization

The term ‘‘health maintenance organization’’ means—

(A) a federally qualified health maintenance organization (as defined in section

1301(a) of the Public Health Service Act (42

U.S.C. 300e(a))),

(B) an organization recognized under State

law as a health maintenance organization,

or

(C) a similar organization regulated under

State law for solvency in the same manner

and to the same extent as such a health

maintenance organization.

(4) Group health insurance coverage

The term ‘‘group health insurance coverage’’

means, in connection with a group health

plan, health insurance coverage offered in connection with such plan.

(c) Excepted benefits

For purposes of this part, the term ‘‘excepted

benefits’’ means benefits under one or more (or

any combination thereof) of the following:

(1) Benefits not subject to requirements

(A) Coverage only for accident, or disability

income insurance, or any combination thereof.

(B) Coverage issued as a supplement to liability insurance.

(C) Liability insurance, including general liability insurance and automobile liability insurance.

(D) Workers’ compensation or similar insurance.

(E) Automobile medical payment insurance.

(F) Credit-only insurance.

(G) Coverage for on-site medical clinics.

(H) Other similar insurance coverage, specified in regulations, under which benefits for

medical care are secondary or incidental to

other insurance benefits.

(2) Benefits not subject to requirements if offered separately

(A) Limited scope dental or vision benefits.

(B) Benefits for long-term care, nursing

home care, home health care, communitybased care, or any combination thereof.

(C) Such other similar, limited benefits as

are specified in regulations.

(3) Benefits not subject to requirements if offered as independent, noncoordinated benefits

(A) Coverage only for a specified disease or

illness.

(B) Hospital indemnity or other fixed indemnity insurance.

(4) Benefits not subject to requirements if offered as separate insurance policy

Medicare supplemental health insurance (as

defined under section 1395ss(g)(1) of title 42),

coverage supplemental to the coverage provided under chapter 55 of title 10, and similar

supplemental coverage provided to coverage

under a group health plan.

(d) Other definitions

For purposes of this part—

(1) COBRA continuation provision

The term ‘‘COBRA continuation provision’’

means any of the following:

(A) Part 6 of this subtitle.

(B) Section 4980B of title 26, other than

subsection (f)(1) of such section insofar as it

relates to pediatric vaccines.

(C) Title XXII of the Public Health Service

Act [42 U.S.C. 300bb–1 et seq.].

(2) Health status-related factor

The term ‘‘health status-related factor’’

means any of the factors described in section

1182(a)(1) of this title.

(3) Network plan

The term ‘‘network plan’’ means health insurance coverage offered by a health insurance

issuer under which the financing and delivery

of medical care (including items and services

paid for as medical care) are provided, in

whole or in part, through a defined set of providers under contract with the issuer.

(4) Placed for adoption

The term ‘‘placement’’, or being ‘‘placed’’,

for adoption, has the meaning given such term

in section 1169(c)(3)(B) of this title.

(Pub. L. 93–406, title I, §733, formerly §706, as

added Pub. L. 104–191, title I, §101(a), Aug. 21,

1996, 110 Stat. 1949; renumbered §733, Pub. L.

104–204, title VI, §603(a)(3), Sept. 26, 1996, 110

Stat. 2935.)

REFERENCES IN TEXT

The Public Health Service Act, referred to in subsec.

(d)(1)(C), is act July 1, 1944, ch. 373, 58 Stat. 682, as

amended. Title XXII of the Act is classified generally

to subchapter XX (§300bb–1 et seq.) of chapter 6A of

Title 42, The Public Health and Welfare. For complete

classification of this Act to the Code, see Short Title

note set out under section 201 of Title 42 and Tables.

EFFECTIVE DATE

Section applicable with respect to group health plans

for plan years beginning after June 30, 1997, except as

otherwise provided, see section 101(g) of Pub. L. 104–191,

set out as a note under section 1181 of this title.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 1003, 1021, 1022,

1024, 1132, 1136, 1181, 1191a of this title.

§ 1191c. Regulations

The Secretary, consistent with section 104 of

the Health Care Portability and Accountability
§ 1201 TITLE 29—LABOR Page 482

Act of 1996, may promulgate such regulations as

may be necessary or appropriate to carry out

the provisions of this part. The Secretary may

promulgate any interim final rules as the Secretary determines are appropriate to carry out

this part.

(Pub. L. 93–406, title I, §734, formerly §707, as

added Pub. L. 104–191, title I, §101(a), Aug. 21,

1996, 110 Stat. 1951; renumbered §734, Pub. L.

104–204, title VI, §603(a)(3), Sept. 26, 1996, 110

Stat. 2935.)

REFERENCES IN TEXT

Section 104 of the Health Care Portability and Accountability Act of 1996, referred to in text, probably

means section 104 of the Health Insurance Portability

and Accountability Act of 1996, Pub. L. 104–191, which is

set out as a note under section 300gg–92 of Title 42, The

Public Health and Welfare.

EFFECTIVE DATE

Section applicable with respect to group health plans

for plan years beginning after June 30, 1997, except as

otherwise provided, see section 101(g) of Pub. L. 104–191,

set out as a note under section 1181 of this title.

SUBCHAPTER II—JURISDICTION, ADMINISTRATION, ENFORCEMENT; JOINT PENSION TASK FORCE, ETC.

SUBCHAPTER REFERRED TO IN OTHER SECTIONS

This subchapter is referred to in section 1135 of this

title.

SUBTITLE A—JURISDICTION, ADMINISTRATION,

AND ENFORCEMENT

§ 1201. Procedures in connection with the issuance of certain determination letters by the

Secretary of the Treasury covering qualifications under Internal Revenue Code

(a) Additional material required of applicants

Before issuing an advance determination of

whether a pension, profit-sharing, or stock

bonus plan, a trust which is a part of such a

plan, or an annuity or bond purchase plan meets

the requirements of part I of subchapter D of

chapter 1 of title 26, the Secretary of the Treasury shall require the person applying for the determination to provide, in addition to any material and information necessary for such determination, such other material and information

as may reasonably be made available at the

time such application is made as the Secretary

of Labor may require under subchapter I of this

chapter for the administration of that subchapter. The Secretary of the Treasury shall

also require that the applicant provide evidence

satisfactory to the Secretary that the applicant

has notified each employee who qualifies as an

interested party (within the meaning of regulations prescribed under section 7476(b)(1) of title

26 (relating to declaratory judgements in connection with the qualification of certain retirement plans)) of the application for a determination.

(b) Opportunity to comment on application

(1) Whenever an application is made to the

Secretary of the Treasury for a determination of

whether a pension, profit-sharing, or stock

bonus plan, a trust which is a part of such a

plan, or an annuity or bond purchase plan meets

the requirements of part I of subchapter D of

chapter 1 of title 26, the Secretary shall upon request afford an opportunity to comment on the

application at any time within 45 days after receipt thereof to—

(A) any employee or class of employee qualifying as an interested party within the meaning of the regulations referred to in subsection

(a) of this section.

(B) the Secretary of Labor, and

(C) the Pension Benefit Guaranty Corporation.

(2) The Secretary of Labor may not request an

opportunity to comment upon such an application unless he has been requested in writing to

do so by the Pension Benefit Guaranty Corporation or by the lesser of—

(A) 10 employees, or

(B) 10 percent of the employees

who qualify as interested parties within the

meaning of the regulations referred to in subsection (a) of this section. Upon receiving such

a request, the Secretary of Labor shall furnish a

copy of the request to the Secretary of the

Treasury within 5 days (excluding Saturdays,

Sundays, and legal public holidays (as set forth

in section 6103 of title 5)).

(3) Upon receiving such a request from the

Secretary of Labor, the Secretary of the Treasury shall furnish to the Secretary of Labor such

information held by the Secretary of the Treasury relating to the application as the Secretary

of Labor may request.

(4) The Secretary of Labor shall, within 30

days after receiving a request from the Pension

Benefit Guaranty Corporation or from the necessary number of employees who qualify as interested parties, notify the Secretary of the

Treasury, the Pension Benefit Guaranty Corporation, and such employees with respect to

whether he is going to comment on the application to which the request relates and with respect to any matters raised in such request on

which he is not going to comment. If the Secretary of Labor indicates in the notice required

under the preceding sentence that he is not

going to comment on all or part of the matters

raised in such request, the Secretary of the

Treasury shall afford the corporation, and such

employees, an opportunity to comment on the

application with respect to any matter on which

the Secretary of Labor has declined to comment.

(c) Intervention by Pension Benefit Guaranty

Corporation or Secretary of Labor into declaratory judgment action under section 7476

of title 26, action by Corporation authorized

The Pension Benefit Guaranty Corporation

and, upon petition of a group of employees referred to in subsection (b)(2) of this section, the

Secretary of Labor, may intervene in any action

brought for declaratory judgment under section

7476 of title 26 in accordance with the provisions

of such section. The Pension Benefit Guaranty

Corporation is permitted to bring an action

under such section 7476 under such rules as may

be prescribed by the United States Tax Court.