Page:United States Statutes at Large Volume 103 Part 3.djvu/162

 103 STAT. 2230 PUBLIC LAW 101-239—DEC. 19, 1989 "(ii) EXCLUSION OF GROUP HEALTH PLAN OF A SMALL EMPLOYER. —Clause (i) shall not apply to a group health plan unless the plan is sponsored by or contributed to by an employer that has 20 or more employees for each working day in each of 20 or more calendar weeks in the current calendar year or the preceding calendar year. "(iii) EXCEPTION FOR SMALL EMPLOYERS IN MULTI- EMPLOYER OR MULTIPLE EMPLOYER GROUP HEALTH PLANS.—Clause (i) also shall not apply with respect to individuals enrolled in a multiemployer or mul- tiple employer group health plan if the coverage of the individuals under the plan is by virtue of emplo3ntnent with an employer that does not have 20 or more employees for each working day in each of 20 or more calendar weeks in the current cal- endar year or the preceding calendar year; except that the exception provided in this clause shall only apply if the plan elects treatment under this clause. " (iv) EXCEPTION FOR INDIVIDUALS WITH END STAGE RENAL DISEASE. —Clause (i) shall not apply to an item or service furnished in a month to an individ- ual if for the month the individual is, or would upon application be, entitled to benefits under sec- tion 226A. "(v) GROUP HEALTH PLAN DEFINED. — In this subparagraph, and subparagraph (C), the term 'group health plan' has the meaning given such term in section 50000t>Xl) of the Internal Revenue Code of 1986. " (B) DISABLED ACTIVE INDIVIDUALS IN LARGE GROUP HEALTH PLANS. — "(i) IN GENERAL. — ^A large group health plan (as de- fined in clause (ivXID) may not take into account that an active individual (as defined in clause (ivXD) is entitled to benefits under this title under section 226(b). "(ii) EXCEPTION FOR INDIVIDUALS WITH END STAGE RENAL DISEASE.— Clause (i) shall not apply to an item or service furnished in a month to an individual if for the month the individual is, or would upon application be, entitled to benefits under section 226A. "(iii) SuNSET.Dlause (i) shall only apply to items and services furnished on or after January 1, 1987, and before January 1, 1992. "(iv) DEFINITIONS.—In this subparagraph: "(I) ACTIVE INDIVIDUAL. —The term 'active individual' means an employee (as may be defined in regulations), the employer, self-employed individual (such as the employer), an individual associated with the employer in a business rela- tionship, or a member of the family of any of such persons. "(II) LARGE GROUP HEALTH PLAN.— The term 'large group health plan' has the meaning given such term in section 5000(b)(2) of the Internal Revenue Code of 1986.

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