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SEC. 705. SPECIAL RULES RELATING TO GROUP HEALTH PLANS.

                                                                                                                                                                                                                                                                                                                        

 Title[ Title I\Subtitle A\Sec. 101                                               Contents

                                                                                                                                                                                                                                                                                                                       


 <<NOTE: 29 USC 1185.>>


    ``(a) General Exception for Certain Small Group Health Plans.--The

requirements of this part shall not apply to any group health plan (and

group health insurance coverage offered in connection with a group

health plan) for any plan year if, on the first day of such plan year,

such plan has less than 2 participants who are current employees.


    ``(b) Exception for Certain Benefits.--The requirements of this part

shall not apply to any group health plan (and group health insurance

coverage) in relation to its provision of excepted benefits described in

section 706(c)(1).


    ``(c) Exception for Certain Benefits if Certain Conditions Met.--

            ``(1) Limited, excepted benefits.--The requirements of this

        part shall not apply to any group health plan (and group health

        insurance coverage offered in connection with a group health

        plan) in relation to its provision of excepted benefits

        described in section 706(c)(2) if the benefits--

                    ``(A) are provided under a separate policy,

                certificate, or contract of insurance; or


                    ``(B) are otherwise not an integral part of the

                plan.


            ``(2) Noncoordinated, excepted benefits.--The requirements

        of this part shall not apply to any group health plan (and group

        health insurance coverage offered in connection with a group

        health plan) in relation to its provision of excepted benefits

        described in section 706(c)(3) if all of the following

        conditions are met:

                    ``(A) The benefits are provided under a separate

                policy, certificate, or contract of insurance.


                    ``(B) There is no coordination between the provision

                of such benefits and any exclusion of benefits under any

                group health plan maintained by the same plan sponsor.


                    ``(C) Such benefits are paid with respect to an

                event without regard to whether benefits are provided

                with respect to such an event under any group health

                plan maintained by the same plan sponsor.


            ``(3) Supplemental excepted benefits.--The requirements of

        this part shall not apply to any group health plan (and group

        health insurance coverage) in relation to its provision of

        excepted benefits described in section 706(c)(4) if the benefits

        are provided under a separate policy, certificate, or contract

        of insurance.


    ``(d) Treatment of Partnerships.--For purposes of this part--

            ``(1) Treatment as a group health plan.--Any plan, fund, or

        program which would not be (but for this subsection) an employee

        welfare benefit plan and which is established or maintained by a

        partnership, to the extent that such plan, fund, or program

        provides medical care (including items and services paid for as

        medical care) to present or former partners in the partnership

        or to their dependents (as defined under the terms of the plan,

        fund, or program), directly or through insurance, reimbursement,

        or otherwise, shall be treated (subject to paragraph (2)) as an

        employee welfare benefit plan which is a group health plan.


            ``(2) Employer.--In the case of a group health plan, the

        term `employer' also includes the partnership in relation to any

        partner.


            ``(3) Participants of group health plans.--In the case of a

        group health plan, the term `participant' also includes--

                    ``(A) in connection with a group health plan

                maintained by a partnership, an individual who is a

                partner in relation to the partnership, or


                    ``(B) in connection with a group health plan

                maintained by a self-employed individual (under which

                one or more employees are participants), the self-

                employed individual,

        if such individual is, or may become, eligible to receive a

        benefit under the plan or such individual's beneficiaries may be

        eligible to receive any such benefit.



 

                                                                                                                                                                                                                                                                                                                                                                        

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