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42 U.S.C. § 300bb–6Notice requirements

submitted 82 years ago by Pub. L. 99-272 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 378 words · no verdicts yet

in plain englishAI-generated · not legal advice

Plans must tell employees and spouses about their continuation-coverage rights when their coverage starts. Employers must notify the plan within 30 days of most qualifying events. Employees or beneficiaries must self-report divorce, a child losing dependent status, or a disability finding, within set deadlines.

Under regulations the Secretary sets: (1) The group health plan must give written notice, when coverage under the plan begins, to each covered employee and their spouse (if any), explaining the rights described in this section. (2) The employer must tell the plan administrator about a qualifying event that is the employee's death, job loss or reduced hours, or Medicare entitlement (the events in section 300bb–3(1), (2), or (4)) within 30 days of that event. (3) The covered employee or qualified beneficiary must tell the plan administrator about a qualifying event that is a divorce/legal separation or a child losing dependent status (section 300bb–3(3) or (5)) within 60 days of that event. A beneficiary found disabled during the first 60 days of continuation coverage must also tell the plan administrator of that finding within 60 days, and must report within 30 days if a later ruling says they're no longer disabled. (4) The plan administrator must then notify: (A) for events under section 300bb–3(1), (2), or (4), any affected qualified beneficiary; and (B) for events under section 300bb–3(3) or (5) — once the employee has notified the administrator under paragraph (3) — any affected qualified beneficiary, about that beneficiary's rights. This notice from the plan administrator must go out within 14 days of the administrator being notified under paragraph (2) or (3), whichever applies. If the notice goes to a qualified beneficiary who is the covered employee's spouse, it counts as notice to every other qualified beneficiary who lives with that spouse at the time.
the actual law source: uscode.house.gov ↗public domain

In accordance with regulations prescribed by the Secretary

(1)

the group health plan shall provide, at the time of commencement of coverage under the plan, written notice to each covered employee and spouse of the employee (if any) of the rights provided under this subsection,1

(2)

the employer of an employee under a plan must notify the plan administrator of a qualifying event described in paragraph (1), (2), or (4) of section 300bb–3 of this title within 30 days of the date of the qualifying event,

(3)

each covered employee or qualified beneficiary is responsible for notifying the plan administrator of the occurrence of any qualifying event described in paragraph (3) or (5) of section 300bb–3 of this title within 60 days after the date of the qualifying event and each qualified beneficiary who is determined, under title II or XVI of the Social Security Act [42 U.S.C. 401 et seq., 1381 et seq.], to have been disabled at any time during the first 60 days of continuation coverage under this subchapter is responsible for notifying the plan administrator of such determination within 60 days after the date of the determination and for notifying the plan administrator within 30 days after the date of any final determination under such title or titles that the qualified beneficiary is no longer disabled, and

(4)

the plan administrator shall notify—

(A)

in the case of a qualifying event described in paragraph (1), (2), or (4) of section 300bb–3 of this title, any qualified beneficiary with respect to such event, and

(B)

in the case of a qualifying event described in paragraph (3) or (5) of section 300bb–3 of this title where the covered employee notifies the plan administrator under paragraph (3), any qualified beneficiary with respect to such event,

of such beneficiary’s rights under this subsection.1

For purposes of paragraph (4), any notification shall be made within 14 days of the date on which the plan administrator is notified under paragraph (2) or (3), whichever is applicable, and any such notification to an individual who is a qualified beneficiary as the spouse of the covered employee shall be treated as notification to all other qualified beneficiaries residing with such spouse at the time such notification is made.

Source credit: (July 1, 1944, ch. 373, title XXII, § 2206, as added Pub. L. 99–272, title X, § 10003(a), Apr. 7, 1986, 100 Stat. 235; amended Pub. L. 99–514, title XVIII, § 1895(d)(6)(C), Oct. 22, 1986, 100 Stat. 2939; Pub. L. 100–203, title IV, § 4009(j)(8), Dec. 22, 1987, 101 Stat. 1330–59; Pub. L. 101–239, title VI, § 6702(c), Dec. 19, 1989, 103 Stat. 2295; Pub. L. 104–191, title IV, § 421(a)(2), Aug. 21, 1996, 110 Stat. 2088.)

history & why it existsrecord from the source credit
  • 1944Enacted · Pub. L. 99-272 · 100 Stat. 235
  • 1986Amended · Pub. L. 99-514 · 100 Stat. 2939
  • 1987Amended · Pub. L. 100-203 · 101 Stat. 1330
  • 1989Amended · Pub. L. 101-239 · 103 Stat. 2295
  • 1996Amended · Pub. L. 104-191 · 110 Stat. 2088

A history note hasn’t been published yet. The record shows enactment by Pub. L. 99-272 on 1944-07-01.

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