42 U.S.C. § 300gg–6 — Comprehensive health insurance coverage

submitted 82 years ago by Pub. L. 111-148 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 159 words · no verdicts yet

in plain englishAI-generated · not legal advice

Insurers selling individual or small-group health coverage must include the essential health benefits package. Group health plans can't impose annual cost-sharing above the federal limit. If an insurer offers adult coverage, it must also offer a child-only version for people under 21.

(a) Coverage for essential health benefits package: An insurer selling health coverage in the individual or small group market must make sure that coverage includes the essential health benefits package required under section 18022(a). (b) Cost-sharing under group health plans: A group health plan must make sure any annual cost-sharing it imposes doesn't go over the limits set in section 18022(c)(1). (c) Child-only plans: If an insurer offers coverage at any of the levels specified in section 18022(d), it must also offer that same level as a plan where the only enrollees are people who, at the start of the plan year, haven't yet turned 21. (d) Dental only: This section doesn't apply to a plan described in section 18031(d)(2)(B)(ii) — a stand-alone dental plan.

the actual law source: uscode.house.gov ↗public domain

(a) Coverage for essential health benefits package

A health insurance issuer that offers health insurance coverage in the individual or small group market shall ensure that such coverage includes the essential health benefits package required under section 18022(a) of this title.

(b) Cost-sharing under group health plans

A group health plan shall ensure that any annual cost-sharing imposed under the plan does not exceed the limitations provided for under paragraph (1) of section 18022(c) 1 of this title.

If a health insurance issuer offers health insurance coverage in any level of coverage specified under section 18022(d) of this title, the issuer shall also offer such coverage in that level as a plan in which the only enrollees are individuals who, as of the beginning of a plan year, have not attained the age of 21.

(d) Dental only

This section shall not apply to a plan described in section 18031(d)(2)(B)(ii) ¹ of this title.

Source credit: (July 1, 1944, ch. 373, title XXVII, § 2707, as added Pub. L. 111–148, title I, § 1201(4), Mar. 23, 2010, 124 Stat. 161; amended Pub. L. 113–93, title II, § 213(b), Apr. 1, 2014, 128 Stat. 1047.)

history & why it existsrecord from the source credit

1944Enacted · Pub. L. 111-148 · 124 Stat. 161
2014Amended · Pub. L. 113-93 · 128 Stat. 1047

A history note hasn’t been published yet. The record shows enactment by Pub. L. 111-148 on 1944-07-01.

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