Internal Revenue Code:Sec. 9832. Definitions

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Location in Internal Revenue Code

     TITLE 26 - INTERNAL REVENUE CODE
      Subtitle K - Group Health Plan Requirements
       CHAPTER 100 - GROUP HEALTH PLAN REQUIREMENTS
        Subchapter C - General Provisions
      

Statute

    Sec. 9832. Definitions
 
    (a) Group health plan
      For purposes of this chapter, the term ''group health plan'' has
    the meaning given to such term by section 5000(b)(1).
    (b) Definitions relating to health insurance
      For purposes of this chapter -
      (1) Health insurance coverage
        (A) In general
          Except as provided in subparagraph (B), the term ''health
        insurance coverage'' means benefits consisting of medical care
        (provided directly, through insurance or reimbursement, or
        otherwise) under any hospital or medical service policy or
        certificate, hospital or medical service plan contract, or
        health maintenance organization contract offered by a health
        insurance issuer.
        (B) No application to certain excepted benefits
          In applying subparagraph (A), excepted benefits described in
        subsection (c)(1) shall not be treated as benefits consisting
        of medical care.
      (2) Health insurance issuer
        The term ''health insurance issuer'' means an insurance
      company, insurance service, or insurance organization (including
      a health maintenance organization, as defined in paragraph (3))
      which is licensed to engage in the business of insurance in a
      State and which is subject to State law which regulates insurance
      (within the meaning of section 514(b)(2) of the Employee
      Retirement Income Security Act of 1974, as in effect on the date
      of the enactment of this section).  Such term does not include a
      group health plan.
      (3) Health maintenance organization
        The term ''health maintenance organization'' means -
          (A) a federally qualified health maintenance organization (as
        defined in section 1301(a) of the Public Health Service Act (42
        U.S.C. 300e(a))),
          (B) an organization recognized under State law as a health
        maintenance organization, or
          (C) a similar organization regulated under State law for
        solvency in the same manner and to the same extent as such a
        health maintenance organization.
    (c) Excepted benefits
      For purposes of this chapter, the term ''excepted benefits''
    means benefits under one or more (or any combination thereof) of
    the following:
      (1) Benefits not subject to requirements
        (A) Coverage only for accident, or disability income insurance,
      or any combination thereof.
        (B) Coverage issued as a supplement to liability insurance.
        (C) Liability insurance, including general liability insurance
      and automobile liability insurance.
        (D) Workers' compensation or similar insurance.
        (E) Automobile medical payment insurance.
        (F) Credit-only insurance.
        (G) Coverage for on-site medical clinics.
        (H) Other similar insurance coverage, specified in regulations,
      under which benefits for medical care are secondary or incidental
      to other insurance benefits.
      (2) Benefits not subject to requirements if offered separately
        (A) Limited scope dental or vision benefits.
        (B) Benefits for long-term care, nursing home care, home health
      care, community-based care, or any combination thereof.
        (C) Such other similar, limited benefits as are specified in
      regulations.
      (3) Benefits not subject to requirements if offered as
          independent, noncoordinated benefits
        (A) Coverage only for a specified disease or illness.
        (B) Hospital indemnity or other fixed indemnity insurance.
      (4) Benefits not subject to requirements if offered as separate
          insurance policy
        Medicare supplemental health insurance (as defined under
      section 1882(g)(1) of the Social Security Act), coverage
      supplemental to the coverage provided under chapter 55 of title
      10, United States Code, and similar supplemental coverage
      provided to coverage under a group health plan.
    (d) Other definitions
      For purposes of this chapter -
      (1) COBRA continuation provision
        The term ''COBRA continuation provision'' means any of the
      following:
          (A) Section 4980B, other than subsection (f)(1) thereof
        insofar as it relates to pediatric vaccines.
          (B) Part 6 of subtitle B of title I of the Employee
        Retirement Income Security Act of 1974 (29 U.S.C. 1161 et
        seq.), other than section 609 of such Act.
          (C) Title XXII of the Public Health Service Act.
      (2) Governmental plan
        The term ''governmental plan'' has the meaning given such term
      by section 414(d).
      (3) Medical care
        The term ''medical care'' has the meaning given such term by
      section 213(d) determined without regard to -
          (A) paragraph (1)(C) thereof, and
          (B) so much of paragraph (1)(D) thereof as relates to
        qualified long-term care insurance.
      (4) Network plan
        The term ''network plan'' means health insurance coverage of a
      health insurance issuer under which the financing and delivery of
      medical care are provided, in whole or in part, through a defined
      set of providers under contract with the issuer.
      (5) Placed for adoption defined
        The term ''placement'', or being ''placed'', for adoption, in
      connection with any placement for adoption of a child with any
      person, means the assumption and retention by such person of a
      legal obligation for total or partial support of such child in
      anticipation of adoption of such child.  The child's placement
      with such person terminates upon the termination of such legal
      obligation.
 

Sources

    (Added Pub. L. 104-191, title IV, Sec. 401(a), Aug. 21, 1996, 110
    Stat. 2080; Sec. 9805; renumbered Sec. 9832, Pub. L. 105-34, title
    XV, Sec. 1531(a)(2), Aug. 5, 1997, 111 Stat. 1081.)
 

References in Text

                             REFERENCES IN TEXT
      The Employee Retirement Income Security Act of 1974, referred to
    in subsecs. (b)(2) and (d)(1)(B), is Pub. L. 93-406, Sept. 2, 1974,
    88 Stat. 832, as amended.  Section 514(b)(2) of the Act is
    classified to section 1144(b)(2) of Title 29, Labor. Section 609 of
    the Act is classified to section 1169 of Title 29. Part 6 of
    subtitle B of title I of the Act is classified generally to part 6
    (Sec. 1161 et seq.) of subtitle B of subchapter I of chapter 18 of
    Title 29. For complete classification of this Act to the Code, see
    Short Title note set out under section 1001 of Title 29 and Tables.
      The date of the enactment of this section, referred to in subsec.
    (b)(2), is the date of enactment of Pub. L. 104-191, which was
    approved Aug. 21, 1996.
      Section 1882(g)(1) of the Social Security Act, referred to in
    subsec. (c)(4), is classified to section 1395ss(g)(1) of Title 42,
    The Public Health and Welfare.
      The Public Health Service Act, referred to in subsec. (d)(1)(C),
    is act July 1, 1944, ch. 373, 58 Stat. 682, as amended.  Title XXII
    of the Act is classified generally to subchapter XX (Sec. 300bb-1
    et seq.) of chapter 6A of Title 42. For complete classification of
    this Act to the Code, see Short Title note set out under section
    201 of Title 42 and Tables.
 

Miscellaneous

                                 AMENDMENTS
      1997 - Pub. L. 105-34 renumbered section 9805 of this title as
    this section.
 

References

                   SECTION REFERRED TO IN OTHER SECTIONS
      This section is referred to in sections 4980D, 9801, 9831 of this
    title; title 29 section 1144a.