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42 U.S.C. § 300gg–9Disclosure of information

submitted 82 years ago by Pub. L. 104-191 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 239 words · no verdicts yet

in plain englishAI-generated · not legal advice

Insurers must tell small employers or individuals, in their sales materials, that certain information is available. On request, the insurer must actually give them that information. This covers how premiums can change and what other coverage options they qualify for.

(a) Disclosure of information by health plan issuers: When offering health coverage to a small employer or an individual, an insurer must (1) make a reasonable disclosure, in its solicitation and sales materials, that the information described in subsection (b) is available, and (2) actually provide that information if the employer or individual requests it. (b) Information described (1) In general: Subject to paragraph (3), this information covers, for the employer or individual: (A) the insurer's right to change premium rates, and what factors can affect those changes; and (B) the benefits and premiums available under all coverage the employer or individual is qualified for. (2) Form of information: The insurer must give this information in a way the average employer or individual can understand, and it must be enough to reasonably inform them of their rights and duties under the coverage. (3) Exception: The insurer doesn't have to disclose information that's proprietary and a trade secret under applicable law.
the actual law source: uscode.house.gov ↗public domain
(a) Disclosure of information by health plan issuers

In connection with the offering of any health insurance coverage to a small employer or an individual, a health insurance issuer

(1)

shall make a reasonable disclosure to such employer, or individual, as applicable,,1 as part of its solicitation and sales materials, of the availability of information described in subsection (b), and

(2)

upon request of such a 2 employer, or individual, as applicable,,1 provide such information.

(b) Information described
(1) In general

Subject to paragraph (3), with respect to a health insurance issuer offering health insurance coverage to a 2 employer, or individual, as applicable,,1 information described in this subsection is information concerning—

(A)

the provisions of such coverage concerning issuer’s right to change premium rates and the factors that may affect changes in premium rates; and

(B)

the benefits and premiums available under all health insurance coverage for which the employer, or individual, as applicable, is qualified.

(2) Form of information

Information under this subsection shall be provided to employers, or individuals, as applicable, in a manner determined to be understandable by the average employer, or individual, as applicable,,1 and shall be sufficient to reasonably inform employers, or individuals, as applicable, of their rights and obligations under the health insurance coverage.

(3) Exception

An issuer is not required under this section to disclose any information that is proprietary and trade secret information under applicable law.

Source credit: (July 1, 1944, ch. 373, title XXVII, § 2709, formerly § 2713, as added Pub. L. 104–191, title I, § 102(a), Aug. 21, 1996, 110 Stat. 1966; renumbered § 2733, renumbered § 2709, and amended Pub. L. 111–148, title I, §§ 1001(3), 1563(c)(10), formerly § 1562(c)(10), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 130, 268, 911.)

history & why it existsrecord from the source credit
  • 1944Enacted · Pub. L. 104-191 · 110 Stat. 1966
  • 2010Amended · Pub. L. 111-148 · 124 Stat. 130, 268, 911

A history note hasn’t been published yet. The record shows enactment by Pub. L. 104-191 on 1944-07-01.

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