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DOL/EBSA

RIN: 1210-AA77

Publication ID: Fall 2006

Title: Prohibiting Discrimination Against Participants and Beneficiaries Based on Health Status
Abstract: The Health Insurance Portability and Accountability Act of 1996 (HIPAA) amended title I of ERISA, the Internal Revenue Code, and the Public Health Service Act with parallel provisions to prohibit discrimination by a group health plan or a health insurance issuer based on any health status-related factor. The Departments of Labor, the Treasury, and Health and Human Services are mutually dependent due to shared interpretive jurisdiction and are proceeding concurrently to provide final regulatory guidance regarding these provisions.
Agency: Department of Labor(DOL)	Priority: Other Significant
RIN Status: Previously published in the Unified Agenda	Agenda Stage of Rulemaking: Final Rule Stage
Major: No	Unfunded Mandates: No
CFR Citation: 29 CFR 2590.702
Legal Authority: 29 USC 1027 29 USC 1059 29 USC 1135 29 USC 1182 29 USC 1191c 29 USC 1194

Legal Deadline: None

Statement of Need: Part 7 of ERISA provides that group health plans and health insurance issuers may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan based on any health status-related factor. Plan sponsors, administrators, and participants need additional guidance from the Department with regard to how they can fulfill their respective obligations under these statutory provisions.

Summary of the Legal Basis: Section 702 of ERISA specifies the respective nondiscrimination requirements for group health plans and health insurance issuers. Section 734 of ERISA provides that the Secretary may promulgate such regulations as may be necessary or appropriate to carry out the provisions of part 7 ERISA. In addition, section 505 of ERISA authorizes the Secretary to issue regulations clarifying the provisions of title I of ERISA.

Risks: Failure to provide guidance concerning part 7 of ERISA may impede compliance with the law.

Timetable:

Action	Date	FR Cite
Interim Final Rule	04/08/1997	62 FR 16894
Interim Final Rule Comment Period End	07/07/1997
NPRM	01/08/2001	66 FR 1421
NPRM Comment Period End	04/09/2001
Second Interim Final Rule	01/08/2001	66 FR 1378
Interim Final Rule Comment Period End	04/09/2001
Final Rule	12/00/2006

Additional Information: This item has been split off from RIN 1210-AA54.
Regulatory Flexibility Analysis Required: No	Government Levels Affected: Undetermined
Federalism: No
Included in the Regulatory Plan: Yes
Agency Contact: Amy J. Turner Director, Office of Health Plan Standards and Compliance Assistance Department of Labor Employee Benefits Security Administration Room N5677, 200 Constitution Avenue NW., FP Building, Room N-5653, Washington, DC 20210 Phone:202 693-8335 Fax:202 219-1942