Title 29, Part 2590 — Rules and Regulations for Group Health Plans

General notice of continuation coverage.

Notice requirement for employers.

Notice requirements for covered employees and qualified beneficiaries.

Notice requirements for plan administrators.

[Reserved]

National Medical Support Notice.

Basis and scope.

Definitions.

Limitations on preexisting condition exclusion period.

Rules relating to creditable coverage.

Evidence of creditable coverage.

Special enrollment periods.

HMO affiliation period as an alternative to a preexisting condition exclusion.

Interaction With the Family and Medical Leave Act. [Reserved]

Prohibiting discrimination against participants and beneficiaries based on a health factor.

Additional requirements prohibiting discrimination based on genetic information.

Special rule allowing integration of Health Reimbursement Arrangements (HRAs) and other account-based group health plans with individual health insurance coverage and Medicare and prohibiting discrimination in HRAs and other account-based group health plans.

Guaranteed renewability in multiemployer plans and multiple employer welfare arrangements. [Reserved]

Standards relating to benefits for mothers and newborns.

Parity in mental health and substance use disorder benefits.

Nonquantitative treatment limitation comparative analysis requirements.

Preservation of right to maintain existing coverage.

Prohibition of preexisting condition exclusions.

Prohibiting discrimination against participants and beneficiaries based on a health factor.

Prohibition on waiting periods that exceed 90 days.

No lifetime or annual limits.

Rules regarding rescissions.

Coverage of preventive health services.

Accommodations in connection with coverage of preventive health services.

Eligibility of children until at least age 26.

Summary of benefits and coverage and uniform glossary.

Transparency in coverage—definitions.

Transparency in coverage—required disclosures to participants and beneficiaries.

Transparency in coverage—requirements for public disclosure.

Internal claims and appeals and external review processes.

Patient protections.

Basis and scope.

Applicability.

Definitions.

Preventing surprise medical bills for emergency services.

Preventing surprise medical bills for non-emergency services performed by nonparticipating providers at certain participating facilities.

Methodology for calculating qualifying payment amount.

Complaints process for surprise medical bills regarding group health plans and group health insurance coverage.

Independent dispute resolution process.

Preventing surprise medical bills for air ambulance services.

Independent dispute resolution process for air ambulance services.

Choice of health care professional.

Definitions.

Reporting requirements related to prescription drug and health care spending.

Aggregate reporting.

Required information.

Preemption; State flexibility; construction.

Special rules relating to group health plans.

Enforcement. [Reserved]

Applicability dates.