SEC. 2742. GUARANTEED RENEWABILITY OF INDIVIDUAL HEALTH INSURANCE COVERAGE.
Title[ Title I\Subtitle B\Sec. 111 Contents
<<NOTE: 42 USC 300gg-42.>>
``(a) In General.--Except as provided in this section, a health
insurance issuer that provides individual health insurance coverage to
an individual shall renew or continue in force such coverage at the
option of the individual.
``(b) General Exceptions.--A health insurance issuer may nonrenew or
discontinue health insurance coverage of an individual in the individual
market based only on one or more of the following:
``(1) Nonpayment of premiums.--The individual has failed to
pay premiums or contributions in accordance with the terms of
the health insurance coverage or the issuer has not received
timely premium payments.
``(2) Fraud.--The individual has performed an act or
practice that constitutes fraud or made an intentional
misrepresentation of material fact under the terms of the
coverage.
``(3) Termination of plan.--The issuer is ceasing to offer
coverage in the individual market in accordance with subsection
(c) and applicable State law.
``(4) Movement outside service area.--In the case of a
health insurance issuer that offers health insurance coverage in
the market through a network plan, the individual no longer
resides, lives, or works in the service area (or in an area for
which the issuer is authorized to do business) but only if such
coverage is terminated under this paragraph uniformly without
regard to any health status-related factor of covered
individuals.
``(5) Association membership ceases.--In the case of health
insurance coverage that is made available in the individual
market only through one or more bona fide associations, the
membership of the individual in the association (on the basis of
which the coverage is provided) ceases but only if such coverage
is terminated under this paragraph uniformly without regard to
any health status-related factor of covered individuals.
``(c) Requirements for Uniform Termination of Coverage.--
``(1) Particular type of coverage not offered.--In any case
in which an issuer decides to discontinue offering a particular
type of health insurance coverage offered in the individual
market, coverage of such type may be discontinued by the issuer
only if--
``(A) the issuer provides notice to each covered
individual provided coverage of this type in such market
of such discontinuation at least 90 days prior to the
date of the discontinuation of such coverage;
``(B) the issuer offers to each individual in the
individual market provided coverage of this type, the
option to purchase any other individual health insurance
coverage currently being offered by the issuer for
individuals in such market; and
``(C) in exercising the option to discontinue
coverage of this type and in offering the option of
coverage under subparagraph (B), the issuer acts
uniformly without regard to any health status-related
factor of enrolled individuals or individuals who may
become eligible for such coverage.
``(2) Discontinuance of all coverage.--
``(A) In general.--Subject to subparagraph (C), in
any case in which a health insurance issuer elects to
discontinue offering all health insurance coverage in
the individual market in a State, health insurance
coverage may be discontinued by the issuer only if--
``(i) the issuer provides notice to the
applicable State authority and to each individual
of such discontinuation at least 180 days prior to
the date of the expiration of such coverage, and
``(ii) all health insurance issued or
delivered for issuance in the State in such market
are discontinued and coverage under such health
insurance coverage in such market is not renewed.
``(B) Prohibition on market reentry.--In the case of
a discontinuation under subparagraph (A) in the
individual market, the issuer may not provide for the
issuance of any health insurance coverage in the market
and State involved during the 5-year period beginning on
the date of the discontinuation of the last health
insurance coverage not so renewed.
``(d) Exception for Uniform Modification of Coverage.--At the time
of coverage renewal, a health insurance issuer may modify the health
insurance coverage for a policy form offered to individuals in the
individual market so long as such modification is consistent with State
law and effective on a uniform basis among all individuals with that
policy form.
``(e) Application to Coverage Offered Only Through Associations.--In
applying this section in the case of health insurance coverage that is
made available by a health insurance issuer in the individual market to
individuals only through one or more associations, a reference to an
`individual' is deemed to include a reference to such an association (of
which the individual is a member).
``
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