Page:United States Statutes at Large Volume 110 Part 3.djvu/235

This page needs to be proofread.

PUBLIC LAW 104-191—AUG. 21, 1996 110 STAT. 1965 "(5) MOVEMENT OUTSIDE SERVICE AREA.— In the case of a health insurance issuer that offers health insurance coverage in the market through a network plan, there is no longer any enrollee in connection with such plan who lives, resides, or works in the service area of the issuer (or in the area for which the issuer is authorized to do business) and, in the case of the small group market, the issuer would deny enrollment with respect to such plan under section 2711(c)(1)(A). "(6) ASSOCIATION MEMBERSHIP CEASES. —In the case of health insurance coverage that is made available in the small or large group market (as the case may be) only through one or more bona fide associations, the membership of an employer in the association (on the basis of which the coverage is provided) ceases but only if such coverage is terminated under this paragraph luiiformly without regard to any health statusrelated factor relating to any covered individual. " (c) REQUIREMENTS FOR UNIFORM TERMINATION OF COV- ERAGE.— "(1) PARTICULAR ':rYPE OF COVERAGE NOT OFFERED. —In any case in which an issuer decides to discontinue offering a particular tj^e of group health insurance coverage offered in the small or large group market, coverage of such type may be discontinued by the issuer in accordance with applicable State law in such market only if— "(A) the issuer provides notice to each plan sponsor provided coverage of this tj^e in such market (and participants and beneficiaries covered under such coverage) of such discontinuation at least 90 days prior to the date of the discontinuation of such coverage; "(B) the issuer offers to each plan sponsor provided coverage of this type in such market, the option to purchase all (or, in the case of the large group market, any) other heeJth insurance coverage currently being offered by the issuer to a group health plan in such market; and "(C) in exercising the option to discontinue coverage of this t5rpe and in offering the option of coverage under subparagraph (B), the issuer acts uniformly without regard to the claims experience of those sponsors or any health status-related factor relating to any participants or beneficiaries covered or new participants or beneficiaries who may become eligible for such coverage. " (2) DISCONTINUANCE OF ALL COVERAGE. — "(A) IN GENERAL.— In any case in which a health insurance issuer elects to discontinue offering all health insurance coverage in. the small group market or the large group market, or both markets, in a State, health insurance coverage may be discontinued by the issuer only in accordance with applicable State law and if— "(i) the issuer provides notice to the applicable State authority and to each plan sponsor (and participants and beneficiaries covered under such coverage) of such discontinuation at least 180 days prior to the date of the discontinuation of such coverage; and "(ii) all health insurance issued or delivered for issuance in the State in such market (or markets) are discontinued and coverage under such health insur-