{"identifier":"/us/usc/t29/s1191","title":29,"num":"\u00a7\u202f1191.","heading":"Preemption; State flexibility; construction","text":"\u00a7\u202f1191.\nPreemption; State flexibility; construction\n(a)\nContinued applicability of State law with respect to health insurance issuers\n(1)\nIn general\nSubject to paragraph (2) and except as provided in subsection (b), this part shall not be construed to supersede any provision of State law which establishes, implements, or continues in effect any standard or requirement solely relating to health insurance issuers in connection with group health insurance coverage except to the extent that such standard or requirement prevents the application of a requirement of this part.\n(2)\nContinued preemption with respect to group health plans\nNothing in this part shall be construed to affect or modify the provisions of\nsection 1144 of this title\n(b)\nSpecial rules in case of portability requirements\n(1)\nIn general\nSubject to paragraph (2), the provisions of this part relating to health insurance coverage offered by a health insurance issuer supersede any provision of State law which establishes, implements, or continues in effect a standard or requirement applicable to imposition of a preexisting condition exclusion specifically governed by\nsection 1181 of this title\n(2)\nExceptions\nOnly in relation to health insurance coverage offered by a health insurance issuer, the provisions of this part do not supersede any provision of State law to the extent that such provision\u2014\n(A) substitutes for the reference to \u201c6-month period\u201d in\nsection 1181(a)(1) of this title\n(B) substitutes for the reference to \u201c12 months\u201d and \u201c18 months\u201d in\nsection 1181(a)(2) of this title\n(C) substitutes for the references to \u201c63 days\u201d in sections 1181(c)(2)(A) and (d)(4)(A)\n1\n1 So in original.\nSection 1181(d)(4) of this title\ndoes not contain subpars.\n(D) substitutes for the reference to \u201c30-day period\u201d in sections 1181(b)(2)\n2\n2 So in original.\nSection 1181(b)(2) of this title\ndoes not refer to a 30-day period.\n(E) prohibits the imposition of any preexisting condition exclusion in cases not described in\nsection 1181(d) of this title\n(F) requires special enrollment periods in addition to those required under\nsection 1181(f) of this title\n(G) reduces the maximum period permitted in an affiliation period under section 1181(g)(1)(B)\n3\n3 So in original. Probably should be \u201c1181(g)(1)(C)\u201d.\n(c)\nRules of construction\nExcept as provided in\nsection 1185 of this title\n(d)\nDefinitions\nFor purposes of this section\u2014\n(1)\nState law\nThe term \u201cState law\u201d includes all laws, decisions, rules, regulations, or other State action having the effect of law, of any State. A law of the United States applicable only to the District of Columbia shall be treated as a State law rather than a law of the United States.\n(2)\nState\nThe term \u201cState\u201d includes a State, the Northern Mariana Islands, any political subdivisions of a State or such Islands, or any agency or instrumentality of either.","url":"https://projectusc.org/usc/t29/s1191.html","content":[{"t":"sec","id":"/us/usc/t29/s1191","children":[{"t":"num","text":"\u00a7\u202f1191."},{"t":"heading","text":"Preemption; State flexibility; construction"},{"t":"subsec","id":"/us/usc/t29/s1191/a","children":[{"t":"num","text":"(a)"},{"t":"heading","text":"Continued applicability of State law with respect to health insurance issuers"},{"t":"para","id":"/us/usc/t29/s1191/a/1","children":[{"t":"num","text":"(1)"},{"t":"heading","text":"In general"},{"t":"content","children":[{"t":"p","text":"Subject to paragraph (2) and except as provided in subsection (b), this part shall not be construed to supersede any provision of State law which establishes, implements, or continues in effect any standard or requirement solely relating to health insurance issuers in connection with group health insurance coverage except to the extent that such standard or requirement prevents the application of a requirement of this part.","tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"para","id":"/us/usc/t29/s1191/a/2","children":[{"t":"num","text":"(2)"},{"t":"heading","text":"Continued preemption with respect to group health plans"},{"t":"content","children":[{"t":"p","text":"Nothing in this part shall be construed to affect or modify the provisions of ","children":[{"t":"ref","text":"section 1144 of this title","href":"/us/usc/t29/s1144","tail":" with respect to group health plans."}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"subsec","id":"/us/usc/t29/s1191/b","children":[{"t":"num","text":"(b)"},{"t":"heading","text":"Special rules in case of portability requirements"},{"t":"para","id":"/us/usc/t29/s1191/b/1","children":[{"t":"num","text":"(1)"},{"t":"heading","text":"In general"},{"t":"content","children":[{"t":"p","text":"Subject to paragraph (2), the provisions of this part relating to health insurance coverage offered by a health insurance issuer supersede any provision of State law which establishes, implements, or continues in effect a standard or requirement applicable to imposition of a preexisting condition exclusion specifically governed by ","children":[{"t":"ref","text":"section 1181 of this title","href":"/us/usc/t29/s1181","tail":" which differs from the standards or requirements specified in such section."}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"para","id":"/us/usc/t29/s1191/b/2","children":[{"t":"num","text":"(2)"},{"t":"heading","text":"Exceptions"},{"t":"chapeau","text":"Only in relation to health insurance coverage offered by a health insurance issuer, the provisions of this part do not supersede any provision of State law to the extent that such provision\u2014"},{"t":"subpara","id":"/us/usc/t29/s1191/b/2/A","children":[{"t":"num","text":"(A)"},{"t":"content","text":" substitutes for the reference to \u201c6-month period\u201d in ","children":[{"t":"ref","text":"section 1181(a)(1) of this title","href":"/us/usc/t29/s1181/a/1","tail":" a reference to any shorter period of time;"}],"tail":"\n"}],"tail":"\n"},{"t":"subpara","id":"/us/usc/t29/s1191/b/2/B","children":[{"t":"num","text":"(B)"},{"t":"content","text":" substitutes for the reference to \u201c12 months\u201d and \u201c18 months\u201d in ","children":[{"t":"ref","text":"section 1181(a)(2) of this title","href":"/us/usc/t29/s1181/a/2","tail":" a reference to any shorter period of time;"}],"tail":"\n"}],"tail":"\n"},{"t":"subpara","id":"/us/usc/t29/s1191/b/2/C","children":[{"t":"num","text":"(C)"},{"t":"content","text":" substitutes for the references to \u201c63 days\u201d in sections 1181(c)(2)(A) and (d)(4)(A)\u202f","children":[{"t":"ref","text":"1"},{"t":"num","text":"1","tail":"\u202fSo in original. "},{"t":"text","text":"\u202fSo in original. "},{"t":"ref","text":"Section 1181(d)(4) of this title","href":"/us/usc/t29/s1181/d/4","tail":" does not contain subpars."},{"t":"text","text":" does not contain subpars.","tail":" of this title a reference to any greater number of days;"}],"tail":"\n"}],"tail":"\n"},{"t":"subpara","id":"/us/usc/t29/s1191/b/2/D","children":[{"t":"num","text":"(D)"},{"t":"content","text":" substitutes for the reference to \u201c30-day period\u201d in sections 1181(b)(2)\u202f","children":[{"t":"ref","text":"2"},{"t":"num","text":"2","tail":"\u202fSo in original. "},{"t":"text","text":"\u202fSo in original. "},{"t":"ref","text":"Section 1181(b)(2) of this title","href":"/us/usc/t29/s1181/b/2","tail":" does not refer to a 30-day period."},{"t":"text","text":" does not refer to a 30-day period.","tail":" and (d)(1) of this title a reference to any greater period;"}],"tail":"\n"}],"tail":"\n"},{"t":"subpara","id":"/us/usc/t29/s1191/b/2/E","children":[{"t":"num","text":"(E)"},{"t":"content","text":" prohibits the imposition of any preexisting condition exclusion in cases not described in ","children":[{"t":"ref","text":"section 1181(d) of this title","href":"/us/usc/t29/s1181/d","tail":" or expands the exceptions described in such section;"}],"tail":"\n"}],"tail":"\n"},{"t":"subpara","id":"/us/usc/t29/s1191/b/2/F","children":[{"t":"num","text":"(F)"},{"t":"content","text":" requires special enrollment periods in addition to those required under ","children":[{"t":"ref","text":"section 1181(f) of this title","href":"/us/usc/t29/s1181/f","tail":"; or"}],"tail":"\n"}],"tail":"\n"},{"t":"subpara","id":"/us/usc/t29/s1191/b/2/G","children":[{"t":"num","text":"(G)"},{"t":"content","text":" reduces the maximum period permitted in an affiliation period under section 1181(g)(1)(B)\u202f","children":[{"t":"ref","text":"3"},{"t":"num","text":"3","tail":"\u202fSo in original. Probably should be \u201c1181(g)(1)(C)\u201d."},{"t":"text","text":"\u202fSo in original. Probably should be \u201c1181(g)(1)(C)\u201d.","tail":" of this title."}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"subsec","id":"/us/usc/t29/s1191/c","children":[{"t":"num","text":"(c)"},{"t":"heading","text":"Rules of construction"},{"t":"content","children":[{"t":"p","text":"Except as provided in ","children":[{"t":"ref","text":"section 1185 of this title","href":"/us/usc/t29/s1185","tail":", nothing in this part shall be construed as requiring a group health plan or health insurance coverage to provide specific benefits under the terms of such plan or coverage."}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"subsec","id":"/us/usc/t29/s1191/d","children":[{"t":"num","text":"(d)"},{"t":"heading","text":"Definitions"},{"t":"chapeau","text":"For purposes of this section\u2014"},{"t":"para","id":"/us/usc/t29/s1191/d/1","children":[{"t":"num","text":"(1)"},{"t":"heading","text":"State law"},{"t":"content","children":[{"t":"p","text":"The term \u201cState law\u201d includes all laws, decisions, rules, regulations, or other State action having the effect of law, of any State. A law of the United States applicable only to the District of Columbia shall be treated as a State law rather than a law of the United States.","tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"para","id":"/us/usc/t29/s1191/d/2","children":[{"t":"num","text":"(2)"},{"t":"heading","text":"State"},{"t":"content","children":[{"t":"p","text":"The term \u201cState\u201d includes a State, the Northern Mariana Islands, any political subdivisions of a State or such Islands, or any agency or instrumentality of either.","tail":"\n"}],"tail":"\n"}],"tail":"\n"}],"tail":"\n"},{"t":"text","text":"\n"},{"t":"text","text":"\n"}]}]}