§ 300gg–11. No lifetime or annual limits
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/usc/title-42/section-300gg-11A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish— lifetime limits on the dollar value of benefits for any participant or beneficiary; or except as provided in paragraph (2), annual limits on the dollar value of benefits for any participant or beneficiary. With respect to plan years beginning prior to January 1, 2014 , a group health plan and a health insurance issuer offering group or individual health insurance coverage may only establish a restricted annual limit on the dollar value of benefits for any participant or beneficiary with respect to the scope of benefits that are essential health benefits under section 18022(b) of this title , as determined by the Secretary.
In defining the term “restricted annual limit” for purposes of the preceding sentence, the Secretary shall ensure that access to needed services is made available with a minimal impact on premiums. Subsection
(a)shall not be construed to prevent a group health plan or health insurance coverage from placing annual or lifetime per beneficiary limits on specific covered benefits that are not essential health benefits under section 18022(b) of this title , to the extent that such limits are otherwise permitted under Federal or State law. ( July 1, 1944, ch. 373 , title XXVII, § 2711, as added and amended Pub. L. 111–148, title I, § 1001(5) , title X, § 10101(a), Mar. 23, 2010 , 124 Stat. 131 , 883.)
Connections6 cite this
6 references not yet in our index
- Pub. L. 111-148
- 124 Stat. 131
- Pub. L. 104-191
- 110 Stat. 1962
- 124 Stat. 130
- 124 Stat. 140
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§ 300gg–11
No lifetime or annual limits
Fed. Reg.×5
Stat. Comp.×1
Pub. L.Pub. L. 111-148
Stat.124 Stat. 131
Pub. L.Pub. L. 104-191
Stat.110 Stat. 1962
Stat.124 Stat. 130
Cites 6 · showing 5Cited by 6 across 2 sources