42 USC 300gg - Fair health insurance premiums

U.S Code last checked for updates: Nov 25, 2024

§ 300gg.

Fair health insurance premiums

(a)

 So in original. No subsec. (b) has been enacted.

Prohibiting discriminatory premium rates

(1)

In general

With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market—

(A)

such rate shall vary with respect to the particular plan or coverage involved only by—

(i)

whether such plan or coverage covers an individual or family;

(ii)

rating area, as established in accordance with paragraph (2);

(iii)

age, except that such rate shall not vary by more than 3 to 1 for adults (consistent with section 300gg–6(c) of this title); and

(iv)

tobacco use, except that such rate shall not vary by more than 1.5 to 1; and

(B)

such rate shall not vary with respect to the particular plan or coverage involved by any other factor not described in subparagraph (A).

(2)

Rating area

(A)

In general

(B)

Secretarial review

(3)

Permissible age bands

(4)

Application of variations based on age or tobacco use

(5)

Special rule for large group market

(July 1, 1944, ch. 373, title XXVII, § 2701, as added and amended Pub. L. 111–148, title I, § 1201(4), title X, § 10103(a), Mar. 23, 2010, 124 Stat. 155, 892.)

cite as: 42 USC 300gg