I.R.C. § 9803(a) In General
A group health plan which is a multiemployer plan (as defined in section 414(f))
or which is a multiple employer welfare arrangement may not deny
an employer continued access to the same or different coverage under such plan, other
I.R.C. § 9803(a)(2)
for fraud or other intentional misrepresentation of material fact by the employer;
I.R.C. § 9803(a)(5)
in the case of a plan that offers benefits through a network plan, because there
is no longer any individual enrolled through the employer who lives, resides, or
works in the service area of the network plan and the plan applies this paragraph
uniformly without regard to the claims experience of employers or a factor described
in section 9802(a)(1) in relation to such individuals or their dependents; or
I.R.C. § 9803(a)(6)
for failure to meet the terms of an applicable collective bargaining agreement, to
renew a collective bargaining or other agreement requiring or authorizing contributions
to the plan, or to employ employees covered by such an agreement.
I.R.C. § 9803(b) Multiple Employer Welfare Arrangement
For purposes of subsection (a), the term “multiple employer welfare arrangement” has the meaning given such term
by section 3(40) of the Employee Retirement Income Security Act of 1974, as in effect on the date
of the enactment of this section.
(Added Pub. L. 104-191, Sec. 401, Aug. 21, 1996, 110 Stat. 1936.)
Effective, except as otherwise noted, for plan years beginning after June 30, 1997.
Section 401(c) of Pub. L. 104-191 provided that:
“(2) Determination of creditable coverage.--
(A) Period of coverage.--
(i) In general.--Subject to clause (ii), no period before July 1, 1996, shall be taken
into account under chapter 100 of the Internal Revenue Code of 1986 (as added by this section) in determining creditable coverage.
(ii) Special rule for certain periods.--The Secretary of the Treasury, consistent
with section 104, shall provide for a process whereby individuals who need to establish
creditable coverage for periods before July 1, 1996, and who would have such coverage
credited but for clause (i) may be given credit for creditable coverage for such periods
through the presentation of documents or other means.
(B) Certifications, etc.--
(i) In general.--Subject to clauses (ii) and (iii), subsection (e) of section 9801 of the Internal Revenue Code of 1986 (as added by this section) shall apply to events occurring after June 30,
(ii) No certification required to be provided before June 1, 1997.-- In no case is
a certification required to be provided under such subsection before June 1, 1997.
(iii) Certification only on written request for events occurring before October 1,
1996.--In the case of an event occurring after June 30, 1996, and before October 1,
1996, a certification is not required to be provided under such subsection unless
an individual (with respect to whom the certification is otherwise required to be
made) requests such certification in writing.
(C) Transitional rule.--In the case of an individual who seeks to establish creditable
coverage for any period for which certification is not required because it relates
to an event occurring before June 30, 1996--
(i) the individual may present other credible evidence of such coverage in order to
establish the period of creditable coverage; and
(ii) a group health plan and a health insurance issuer shall not be subject to any
penalty or enforcement action with respect to the plan's or issuer's crediting (or
such coverage if the plan or issuer has sought to comply in good faith with the applicable
requirements under the amendments made by this section.
(3) Special rule for collective bargaining agreements.-- Except as provided in paragraph
(2), in the case of a group health plan maintained pursuant to 1 or more collective
bargaining agreements between employee representatives and one or more employers ratified
before the date of the enactment of this Act
[Aug. 21, 1996], the amendments made by this section shall not apply to plan years
beginning before the later of-- (A) the date on which the last of the collective bargaining
agreements relating to the plan terminates (determined without regard to any extension
thereof agreed to after the date of the enactment of this Act [Aug. 21, 1996]), or
(B) July 1, 1997. For purposes of subparagraph (A), any plan amendment made pursuant
to a collective bargaining agreement relating to the plan which amends the plan solely
to conform to any requirement added by this section shall not be treated as a termination
of such collective bargaining agreement.
(4) Timely regulations.--The Secretary of the Treasury, consistent with section 104,
shall first issue by not later than April 1, 1997, such regulations as may be necessary
to carry out the amendments made by this section.
(5) Limitation on actions.--No enforcement action shall be taken, pursuant to the
amendments made by this section, against a group health plan or health insurance issuer
with respect to a violation of a requirement imposed by such amendments before January
1, 1998, or, if later, the date of issuance of regulations referred to in paragraph
(4), if the plan or issuer has sought to comply in good faith with such requirements.”