(ix) Short-term limited duration in-
surance.
(x) Credit-only, dental-only, or vision-
only insurance.
(xi) A health insurance policy provid-
ing benefits only for long-term care, nurs-
ing home care, home health care, commu-
nity-based care, or any combination there-
of.
(4) GROUP
PURCHASER.—The term ‘‘group
purchaser’’ means any person (as defined under
paragraph (9) of section 3 of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C.
1002(9)) or entity that purchases or pays for health
benefits (such as provider or hospital benefits) on
behalf of participants or beneficiaries in connection
with an employee health benefit plan.
(5) HEALTH PLAN.—
(A) IN GENERAL.—The term ‘‘health plan’’
means any group health plan or individual
health plan.
(B) GROUP
HEALTH
PLAN.—The term
‘‘group health plan’’ means any contract, policy,
certificate or other arrangement offered by a
health plan issuer to a group purchaser that
provides or pays for health benefits (such as
provider and hospital benefits) in connection
with an employee health benefit plan.
(C) INDIVIDUAL HEALTH PLAN.—The term
‘‘individual health plan’’ means any contract,
policy, certificate or other arrangement offered
to individuals by a health plan issuer that pro-
vides or pays for health benefits (such as pro-
vider and hospital benefits) and that is not a
group health plan.
(D) ARRANGEMENTS
NOT
INCLUDED.—
Such term does not include the following, or
any combination thereof:
(i) Coverage only for accident, or dis-
ability income insurance, or any combina-
tion thereof.
(ii) Medicare supplemental health in-
surance 
(as 
defined 
under 
section
1882(g)(1) of the Social Security Act).
(iii) Coverage issued as a supplement
to liability insurance.
(iv) Liability insurance, including gen-
eral liability insurance and automobile li-
ability insurance.
(v) Workers compensation or similar
insurance.
(vi) Automobile medical payment in-
surance.
(vii) Coverage for a specified disease
or illness.
(viii) Hospital or fixed indemnity in-
surance.
(ix) Short-term limited duration in-
surance.
(x) Credit-only, dental-only, or vision-
only insurance.
(xi) A health insurance policy provid-
ing benefits only for long-term care, nurs-
ing home care, home health care, commu-
nity-based care, or any combination there-
of.
(E) CERTAIN
PLANS
INCLUDED.—Such
term includes any plan or arrangement not de-
scribed in any clause of subparagraph (D)
which provides for benefit payments, on a peri-
odic basis, for—
(i) a specified disease or illness, or
(ii) a period of hospitalization,
without regard to the costs incurred or services
rendered during the period to which the pay-
ments relate.
(6) HEALTH PLAN ISSUER.—The term ‘‘health
plan issuer’’ means any entity that is licensed (prior
to or after the date of enactment of this Act) by a
State to offer a health plan.
(7) PARTICIPANT.—The term ‘‘participant’’ has
the meaning given such term under section 3(7) of
the Employee Retirement Income Security Act of
1974 (29 U.S.C. 1002(7)).
(8) SECRETARY.—The term ‘‘Secretary’’ unless
otherwise specified means the Secretary of Labor.
SEC. 10. PREEMPTION.
The provisions of this Act shall not preempt those
provisions of State law that require health plans to provide
a minimum of 48 hours of in-patient care in the case of
a normal vaginal delivery, and 96 hours of in-patient care
in the case of a caesarean section, or that require health
plans to provide for maternity and pediatric care that is
in accordance with guidelines established by the American
College of Obstetricians and Gynecologists and the Amer-
ican Academy of Pediatrics, and to provide follow-up care
consistent with this Act.
SEC. 11. EFFECTIVE DATE.
Except as otherwise provided for in this Act, the pro-
visions of this Act shall apply as follows:
(1) With respect to health plans, such provi-
sions shall apply to plans offered, sold, issued, re-
newed, in effect, or operated on or after January 1,
1997.
(2) With respect to employee health benefit
plans, such provisions shall apply to such plans on
the first day of the first plan year beginning on or
after January 1, 1997.
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