PUBLIC LAW 104-204—SEPT. 26, 1996
110 STAT. 2947
"(2) INCREASED COST EXEMPTION. — This section shall not
apply with respect to a group health plan (or health insurance
coverage offered in connection with a group health plan) if
the application of this section to such plan (or to such coverage)
results in an increase in the cost under the plan (or for such
coverage) of at least 1 percent.
"(d) SEPARATE APPLICATION TO EACH OPTION OFFERED. —In the
case of a group health plan that offers a participant or beneficiary
two or more benefit package options under the plan, the requirements of this section shall be applied separately with respect to
each such option.
"(e) DEFINITIONS.— For purposes of this section—
"(1) AGGREGATE LIFETIME LIMIT. —The term 'aggregate lifetime limit' means, with respect to benefits under a group health
plan or health insurance coverage, a dollar limitation on the
total amount that may be paid with respect to such benefits
under the plan or health insurance coverage with respect to
an individual or other coverage unit.
"(2) ANNUAL LIMIT.—The term 'annual limit' means, with
respect to benefits under a group health plan or health insurance coverage, a dollar limitation on the total amount of
benefits that may be paid with respect to such benefits in
a 12-month period under the plan or health insurance coverage
with respect to an individual or other coverage unit.
"(3) MEDICAL OR SURGICAL BENEFITS. —The term 'medical
or surgical benefits' means benefits with respect to
medical or surgical services, as defined under the terms of
the plan or coverage (as the case may be), but does not include
mental health benefits.
"(4) MENTAL HEALTH BENEFITS. —The term 'mental health
benefits' means benefits with respect to mental health services,
as defined under the terms of the plan or coverage (as the
case may be), but does not include benefits with respect to
treatment of substance abuse or chemical dependency.
"(f) SUNSET. —This section shall not apply to benefits for services
furnished on or after September 30, 2001.".
(b) CLERICAL AMENDMENT. — The table of contents in section
1 of such Act, as amended by section 603 of this Act, is amended
by inserting after the item relating to section 711 the following
new item:
"Sec. 712. Parity in the application of certain limits to menteil health benefits.".
(c) EFFECTIVE DATE. —The amendments made by this section
shall apply with respect to group health plans for plan years beginning on or after January 1, 1998.
SEC. 703. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT
RELATING TO THE GROUP MARKET. — (a) IN GENERAL. —Subpart 2
of part A of title XXVII of the Public Health Service Act (as
added by section 604(a)) is amended by adding at the end the
following new section:
"SEC. 2705. PARITY IN THE APPLICATION OF CERTAIN LIMITS TO 42 USC 300gg-5.
MENTAL HEALTH BENEFITS.
"(a) IN GENERAL. —
"(1) AGGREGATE LIFETIME LIMITS.—In the case of a group
health plan (or health insurance coverage offered in connection
with such a plan) that provides both medical and surgical
benefits and mental health benefits—
Applicabliity.
29 USC 1183b
note.
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