Page:United States Statutes at Large Volume 110 Part 3.djvu/252

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110 STAT. 1982 PUBLIC LAW 104-191—AUG. 21, 1996 "(2) CONVERSION POLICIES.—A health insurance issuer offering health insurance coverage in connection with group health plans under this title shall not be deemed to be a health insurance issuer offering individual health insurance coverage solely because such issuer offers a conversion policy. "(f) CONSTRUCTION.— Nothing in this section shall be construed— "(1) to restrict the amount of the premium rates that an issuer may charge an individual for health insurance coverage provided in the individual market under applicable State law; or "(2) to prevent a health insurance issuer offering health insurance coverage in the individual market from establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention. 42 USC 300gg- •«£€. 2742. GUARANTEED RENEWABILnY OF INDIVTOUAL HEALTH 42. INSURANCE COVERAGE. "(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 mctor of covered individuals. "(c) REQUIREMENTS FOR UNIFORM TERMINATION OF COV- ERAGE. — "(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