Source: https://www.ecfr.gov/cgi-bin/text-idx?mc=true&node=se26.19.54_19801_62&rgn=div8
Timestamp: 2020-02-17 14:07:40
Document Index: 536484508

Matched Legal Cases: ['art 54', '§54', '§54', '§54', '§54', '§54', '§54', '§54', '§54', '§54', '§54', '§54', '§54', '§54']

Title 26 → Chapter I → Subchapter D → Part 54 → §54.9801-2
§54.9801-2 Definitions.
Unless otherwise provided, the definitions in this section govern in applying the provisions of sections 9801 through 9815 and 9831 through 9833.
(3) COBRA continuation provision means section 4980B (other than paragraph (f)(1) of section 4980B insofar as it relates to pediatric vaccines), sections 601-608 of ERISA, or title XXII of the PHS Act.
Creditable coverage means creditable coverage within the meaning of §54.9801-4(a).
Employee Retirement Income Security Act of 1974 (ERISA) means the Employee Retirement Income Security Act of 1974, as amended (29 U.S.C. 1001 et seq.).
Excepted benefits means the benefits described as excepted in §54.9831(c).
Genetic information has the meaning given the term in §54.9802-3T(a)(3).
Group health plan or plan means a group health plan within the meaning of §54.9831-1(a).
Health insurance coverage means benefits consisting of medical care (provided directly, through insurance or reimbursement, or otherwise) under any hospital or medical service policy or certificate, hospital or medical service plan contract, or HMO contract offered by a health insurance issuer. Health insurance coverage includes group health insurance coverage, individual health insurance coverage, and short-term, limited-duration insurance. However, benefits described in §54.9831(c)(2) are not treated as benefits consisting of medical care.
Health insurance issuer or issuer means an insurance company, insurance service, or insurance organization (including an HMO) that is required to be licensed to engage in the business of insurance in a State and that is subject to State law that regulates insurance (within the meaning of section 514(b)(2) of ERISA). Such term does not include a group health plan.
Late enrollment means enrollment of an individual under a group health plan other than on the earliest date on which coverage can become effective for the individual under the terms of the plan; or through special enrollment. (For rules relating to special enrollment, see §54.9801-6.) If an individual ceases to be eligible for coverage under a plan, and then subsequently becomes eligible for coverage under the plan, only the individual's most recent period of eligibility is taken into account in determining whether the individual is a late enrollee under the plan with respect to the most recent period of coverage. Similar rules apply if an individual again becomes eligible for coverage following a suspension of coverage that applied generally under the plan.
Medical care has the meaning given such term by section 213(d), determined without regard to section 213(d)(1)(C) and so much of section 213(d)(1)(D) as relates to qualified long-term care insurance.
Participant means participant within the meaning of section 3(7) of ERISA.
Public health plan means public health plan within the meaning of §54.9801-4(a)(1)(ix).
Significant break in coverage means a significant break in coverage within the meaning of §54.9801-4(b)(2)(iii).
Special enrollment means enrollment in a group health plan under the rights described in §54.9801-6 or in group health insurance coverage under the rights described in 29 CFR 2590.701-6 or 45 CFR 146.117.
State health benefits risk pool means a State health benefits risk pool within the meaning of §54.9801-4(a)(1)(vii).
Waiting period means waiting period within the meaning of §54.9815-2708(b).
[T.D. 9166, 69 FR 78746, Dec. 30, 2004, as amended by T.D. 9299, 71 FR 75056, Dec. 13, 2006; T.D. 9427, 73 FR 62420, Oct. 20, 2008; T.D. 9464, 74 FR 51678, Oct. 7, 2009; T.D. 9491, 75 FR 37222, June 28, 2010; T.D. 9656, 79 FR 10304, Feb. 24, 2014; T.D. 9744, 80 FR 72238, Nov. 18, 2015; T.D. 9791, 81 FR 75324, Oct. 31, 2016; T.D. 9837, 83 FR 38241, Aug. 3, 2018; T.D. 9867, 84 FR 28987, June 20, 2019]