Page:United States Statutes at Large Volume 110 Part 3.djvu/227

This page needs to be proofread.

PUBLIC LAW 104-191—AUG. 21, 1996 110 STAT. 1957 account in determining the continuous period under subparagraph (A). "(3) METHOD OF CREDITING COVERAGE.— "(A) STANDARD METHOD.— Except as otherwise provided under subparagraph (B), for purposes of applying subsection (a)(3), a group health plan, and a health insurance issuer offering group health insurance coverage, shall count a period of creditable coverage without regard to the specific benefits covered during the period. "(B) ELECTION OF ALTERNATIVE METHOD. — A group health plan, or a health insurance issuer offering group health insurance, may elect to apply subsection (a)(3) based on coverage of benefits within each of several classes or categories of benefits specified in regulations rather than as provided under subparagraph (A). Such election shall be made on a uniform basis for all participants and beneficiaries. Under such election a group health pleui or issuer shall count a period of creditable coverage with respect to any class or category of benefits if any level of benefits is covered within such class or category. "(C) PLAN NOTICE.—In the case of an election with respect to a group health plan under subparagraph (B) (whether or not health insurance coverage is provided in connection with such plan), the plan shall— "(i) prominently state in any disclosure statements concerning the plan, and state to each enrollee at the time of enrollment under the plan, that the plan has made such election, and "(ii) include in such statements a description of the effect of this election. "(D) ISSUER NOTICE. —In the case of an election under subparagraph (B) with respect to heedth insurance coverage offered by an issuer in the small or large group market, the issuer— "(i) shall prominently state in any disclosure statements concerning the coverage, and to each employer at the time of the offer or sale of the coverage, that the issuer has made such election, and "(ii) shall include in such statements a description of the effect of such election. "(4) ESTABLISHMENT OF PERIOD.— Periods of creditable coverage with respect to an individual shall be established through presentation of certifications described in subsection (e) or in such other maimer as may be specified in regulations. " (d) EXCEPTIONS.— " (1) EXCLUSION NOT APPLICABLE TO CERTAIN NEWBORNS. — Subject to paragraph (4), a group health plan, and a health insurance issuer offering group health insurance coverage, may not impose any preexisting condition exclusion in the case of an individual who,, as of the last day of the 30-day period beginning with the date of birth, is covered under creditable coverage. "(2) EXCLUSION NOT APPLICABLE TO CERTAIN ADOPTED CHIL- DREN. —Subject to paragraph (4), a group health plan, and a health insurance issuer offering group health insurance coverage, may not impose any preexisting condition exclusion in the case of a child who is adopted or placed for adoption