Page:United States Statutes at Large Volume 110 Part 3.djvu/349

 PUBLIC LAW 104-191—AUG. 21, 1996 110 STAT. 2079 "(2) No APPLICATION TO BENEFITS OR EXCLUSIONS.— To the extent consistent with section 9801, paragraph (1) shall not be construed— "(A) to require a group health plan to provide particular benefits (or benefits with respect to a specific procedure, treatment, or service) other than those provided under the terms of such plan; or "(B) to prevent such a plan from establishing limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for similarly situated individuals enrolled in the plan or coverage. "(3) CONSTRUCTION.— For purposes of paragraph (1), rules for eligibility to enroll under a plan include rules defining any applicable waiting periods for such enrollment. "(b) IN PREMIUM CONTRIBUTIONS.— "(1) IN GENERAL,—^A group health plan may not require any individual (as a condition of enrollment or continued enrollment under the plan) to pay a premium or contribution which is greater than such premium or contribution for a similarly situated individual enrolled in the plan on the basis of any factor described in subsection (a)(1) in relation to the individual or to an individual enrolled under the plan as a dependent of the individual. "(2) CONSTRUCTION.— Nothing in paragraph (1) shall be construed— "(A) to restrict the amount that an employer may be charged for coverage under a group health plan; or "(B) to prevent a group health plan from establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention. "SEC. 9803. GUARANTEED RENEWABILITY IN MULTIEMPLOYER PLANS AND CERTAIN MULTIPLE EMPLOYER WELFARE ARRANGEMENTS. "(a) IN GENERAL,—^A group health plan which is a multiemployer plan (as defined in section 414(f)) or which is a multiple employer welfare arrangement may not deny an employer continued access to the same or different coverage under such plan, other than— "(1) for nonpayment of contributions; "(2) for fraud or other intentional misrepresentation of material fact by the employer; "(3) for noncompliance with material plan provisions; "(4) because the plan is ceasing to offer any coverage in a geographic area; "(5) in the case of a plan that offers benefits through a network plan, because there is no longer any individual enrolled through the employer who lives, resides, or works in the service area of the network plan and the plan applies this paragraph uniformly without regard to the claims experience of employers or a factor described in section 9802(a)(1) in relation to such individuals or their dependents; or "(6) for failure to meet the terms of an applicable collective bargaining agreement, to renew a collective bargaining or other

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