Legal corpus: the complete U.S. Code (59,740 sections, all 53 titles)

Ingested titles 12–51 and 54 from OLRC USLM XML @119-100 (the whole Code
now, uniform edition; Title 53 is reserved/empty). LegalText 11,221 ->
59,740; repo total 105,704 records. Deterministic (byte-identical rerun,
verified on Title 42's 8,356 sections); make check green. make
legal-us-code default now covers every title.

Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>
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# 29 U.S.C. § 1001a - Additional Congressional findings and declaration of policy
## Text
(a) Effects of multiemployer pension plans The Congress finds that—
(1) multiemployer pension plans have a substantial impact on interstate commerce and are affected with a national public interest;
(2) multiemployer pension plans have accounted for a substantial portion of the increase in private pension plan coverage over the past three decades;
(3) the continued well-being and security of millions of employees, retirees, and their dependents are directly affected by multiemployer pension plans; and
(4) (A) withdrawals of contributing employers from a multiemployer pension plan frequently result in substantially increased funding obligations for employers who continue to contribute to the plan, adversely affecting the plan, its participants and beneficiaries, and labor-management relations, and
(B) in a declining industry, the incidence of employer withdrawals is higher and the adverse effects described in subparagraph (A) are exacerbated.
(b) Modification of multiemployer plan termination insurance provisions and replacement of program The Congress further finds that—
(1) it is desirable to modify the current multiemployer plan termination insurance provisions in order to increase the likelihood of protecting plan participants against benefit losses; and
(2) it is desirable to replace the termination insurance program for multiemployer pension plans with an insolvency-based benefit protection program that will enhance the financial soundness of such plans, place primary emphasis on plan continuation, and contain program costs within reasonable limits.
(c) Policy It is hereby declared to be the policy of this Act—
(1) to foster and facilitate interstate commerce,
(2) to alleviate certain problems which tend to discourage the maintenance and growth of multiemployer pension plans,
(3) to provide reasonable protection for the interests of participants and beneficiaries of financially distressed multiemployer pension plans, and
(4) to provide a financially self-sufficient program for the guarantee of employee benefits under multiemployer plans.
(Pub. L. 96364, § 3, Sept. 26, 1980, 94 Stat. 1209.)
## Notes
Editorial Notes
References in TextThis Act, referred to in subsec. (c), is Pub. L. 96364, Sept. 26, 1980, 94 Stat. 1208, known as the Multiemployer Pension Plan Amendments Act of 1980. For complete classification of this Act to the Code, see Short Title of 1980 Amendment note set out under section 1001 of this title and Tables.
Codification Section was enacted as part of the Multiemployer Pension Plan Amendments Act of 1980, and not as part of the Employee Retirement Income Security Act of 1974 which comprises this chapter.
Statutory Notes and Related Subsidiaries
Effective DateSection effective Sept. 26, 1980, see section 1461(e)(1) of this title.
Study and Report Respecting Collective Bargaining for Contributions to, and Benefits From, Multiemployer PlansPub. L. 96364, title IV, § 412(b), Sept. 26, 1980, 94 Stat. 1309, directed Secretary of Labor to study feasibility of requiring collective bargaining on both issues of contributions to, and benefits from, multiemployer plans, and submit a report on the study to Congress within 3 years of Sept. 26, 1980.
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# 29 U.S.C. § 1001b - Findings and declaration of policy
## Text
(a) Findings The Congress finds that—
(1) single-employer defined benefit pension plans have a substantial impact on interstate commerce and are affected with a national interest;
(2) the continued well-being and retirement income security of millions of workers, retirees, and their dependents are directly affected by such plans;
(3) the existence of a sound termination insurance system is fundamental to the retirement income security of participants and beneficiaries of such plans; and
(4) the current termination insurance system in some instances encourages employers to terminate pension plans, evade their obligations to pay benefits, and shift unfunded pension liabilities onto the termination insurance system and the other premium-payers.
(b) Additional findings The Congress further finds that modification of the current termination insurance system and an increase in the insurance premium for single-employer defined benefit pension plans—
(1) is desirable to increase the likelihood that full benefits will be paid to participants and beneficiaries of such plans;
(2) is desirable to provide for the transfer of liabilities to the termination insurance system only in cases of severe hardship;
(3) is necessary to maintain the premium costs of such system at a reasonable level; and
(4) is necessary to finance properly current funding deficiencies and future obligations of the single-employer pension plan termination insurance system.
(c) Declaration of policy It is hereby declared to be the policy of this title—
(1) to foster and facilitate interstate commerce;
(2) to encourage the maintenance and growth of single-employer defined benefit pension plans;
(3) to increase the likelihood that participants and beneficiaries under single-employer defined benefit pension plans will receive their full benefits;
(4) to provide for the transfer of unfunded pension liabilities onto the single-employer pension plan termination insurance system only in cases of severe hardship;
(5) to maintain the premium costs of such system at a reasonable level; and
(6) to assure the prudent financing of current funding deficiencies and future obligations of the single-employer pension plan termination insurance system by increasing termination insurance premiums.
(Pub. L. 99272, title XI, § 11002, Apr. 7, 1986, 100 Stat. 237.)
## Notes
Editorial Notes
References in TextThis title, referred to in subsec. (c), is title XI of Pub. L. 99272, Apr. 7, 1986, 100 Stat. 237, known as the Single-Employer Pension Plan Amendments Act of 1986. For complete classification of this Act to the Code, see Short Title of 1986 Amendment note set out under section 1001 of this title and Tables.
Codification Section was enacted as part of the Single-Employer Pension Plan Amendments Act of 1986, and not as part of the Employee Retirement Income Security Act of 1974 which comprises this chapter.
Statutory Notes and Related Subsidiaries
Effective DateSection effective Jan. 1, 1986, with certain exceptions, see section 11019 of Pub. L. 99272, set out as an Effective Date of 1986 Amendment note under section 1341 of this title.
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# 29 U.S.C. § 1003 - Coverage
## Text
(a) In general Except as provided in subsection (b) or (c) and in sections 1051, 1081, and 1101 of this title, this subchapter shall apply to any employee benefit plan if it is established or maintained—
(1) by any employer engaged in commerce or in any industry or activity affecting commerce; or
(2) by any employee organization or organizations representing employees engaged in commerce or in any industry or activity affecting commerce; or
(3) by both.
(b) Exceptions for certain plans The provisions of this subchapter shall not apply to any employee benefit plan if—
(1) such plan is a governmental plan (as defined in section 1002(32) of this title);
(2) such plan is a church plan (as defined in section 1002(33) of this title) with respect to which no election has been made under section 410(d) of title 26;
(3) such plan is maintained solely for the purpose of complying with applicable workmens compensation laws or unemployment compensation or disability insurance laws;
(4) such plan is maintained outside of the United States primarily for the benefit of persons substantially all of whom are nonresident aliens; or
(5) such plan is an excess benefit plan (as defined in section 1002(36) of this title) and is unfunded.
The provisions of part 7 of subtitle B of this subchapter shall not apply to a health insurance issuer (as defined in section 1191b(b)(2) of this title) solely by reason of health insurance coverage (as defined in section 1191b(b)(1) of this title) provided by such issuer in connection with a group health plan (as defined in section 1191b(a)(1) of this title) if the provisions of this subchapter do not apply to such group health plan.
(c) Voluntary employee contributions to accounts and annuities If a pension plan allows an employee to elect to make voluntary employee contributions to accounts and annuities as provided in section 408(q) of title 26, such accounts and annuities (and contributions thereto) shall not be treated as part of such plan (or as a separate pension plan) for purposes of any provision of this subchapter other than section 1103(c), 1104, or 1105 of this title (relating to exclusive benefit, and fiduciary and co-fiduciary responsibilities) and part 5 of subtitle B of this subchapter 11 See References in Text note below. (relating to administration and enforcement). Such provisions shall apply to such accounts and annuities in a manner similar to their application to a simplified employee pension under section 408(k) of title 26.
(Pub. L. 93406, title I, § 4, Sept. 2, 1974, 88 Stat. 839; Pub. L. 101239, title VII, § 7891(a)(1), Dec. 19, 1989, 103 Stat. 2445; Pub. L. 104191, title I, § 101(d), Aug. 21, 1996, 110 Stat. 1952; Pub. L. 104204, title VI, § 603(b)(3)(A), Sept. 26, 1996, 110 Stat. 2938; Pub. L. 10716, title VI, § 602(b), June 7, 2001, 115 Stat. 96; Pub. L. 107147, title IV, § 411(i)(2), Mar. 9, 2002, 116 Stat. 47.)
## Notes
Editorial Notes
References in TextPart 5 of subtitle B of this subchapter, referred to in subsec. (c), was in the original a reference to “part 5” and was translated as meaning part 5 of subtitle B of title I of Pub. L. 93406, to reflect the probable intent of Congress.
Amendments2002—Subsec. (c). Pub. L. 107147 inserted “and part 5 of subtitle B of this subchapter (relating to administration and enforcement)” after “co-fiduciary responsibilities)” and “Such provisions shall apply to such accounts and annuities in a manner similar to their application to a simplified employee pension under section 408(k) of title 26.” at end. 2001—Subsec. (a). Pub. L. 10716, § 602(b)(2), inserted “or (c)” after “subsection (b)” in introductory provisions. Subsec. (c). Pub. L. 10716, § 602(b)(1), added subsec. (c). 1996—Subsec. (b). Pub. L. 104204, in concluding provisions, made technical amendment to references in original act which appear in text as references to section 1191b of this title. Pub. L. 104191 inserted at end “The provisions of part 7 of subtitle B of this subchapter shall not apply to a health insurance issuer (as defined in section 1191b(b)(2) of this title) solely by reason of health insurance coverage (as defined in section 1191b(b)(1) of this title) provided by such issuer in connection with a group health plan (as defined in section 1191b(a)(1) of this title) if the provisions of this subchapter do not apply to such group health plan.” 1989—Subsec. (b)(2). Pub. L. 101239 substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text.
Statutory Notes and Related Subsidiaries
Effective Date of 2002 AmendmentAmendment by Pub. L. 107147 effective as if included in the provisions of the Economic Growth and Tax Relief Reconciliation Act of 2001, Pub. L. 10716, to which such amendment relates, see section 411(x) of Pub. L. 107147, set out as a note under section 25B of Title 26, Internal Revenue Code.
Effective Date of 2001 AmendmentAmendment by Pub. L. 10716 applicable to plan years beginning after Dec. 31, 2002, see section 602(c) of Pub. L. 10716, set out as a note under section 408 of Title 26, Internal Revenue Code.
Effective Date of 1996 AmendmentsPub. L. 104204, title VI, § 603(c), Sept. 26, 1996, 110 Stat. 2938, provided that: “The amendments made by this section [enacting section 1185 of this title and amending this section and sections 1021, 1022, 1024, 1132, 1136, 1144, 1181, 1191, and 1191a of this title] shall apply with respect to group health plans for plan years beginning on or after January 1, 1998.” Amendment by Pub. L. 104191 applicable with respect to group health plans for plan years beginning after June 30, 1997, except as otherwise provided, see section 101(g) of Pub. L. 104191, set out as an Effective Date note under section 1181 of this title.
Effective Date of 1989 AmendmentAmendment by Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title.
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# 29 U.S.C. § 1022 - Summary plan description
## Text
(a) A summary plan description of any employee benefit plan shall be furnished to participants and beneficiaries as provided in section 1024(b) of this title. The summary plan description shall include the information described in subsection (b), shall be written in a manner calculated to be understood by the average plan participant, and shall be sufficiently accurate and comprehensive to reasonably apprise such participants and beneficiaries of their rights and obligations under the plan. A summary of any material modification in the terms of the plan and any change in the information required under subsection (b) shall be written in a manner calculated to be understood by the average plan participant and shall be furnished in accordance with section 1024(b)(1) of this title.
(b) The summary plan description shall contain the following information: The name and type of administration of the plan; in the case of a group health plan (as defined in section 1191b(a)(1) of this title), whether a health insurance issuer (as defined in section 1191b(b)(2) of this title) is responsible for the financing or administration (including payment of claims) of the plan and (if so) the name and address of such issuer; the name and address of the person designated as agent for the service of legal process, if such person is not the administrator; the name and address of the administrator; names, titles, and addresses of any trustee or trustees (if they are persons different from the administrator); a description of the relevant provisions of any applicable collective bargaining agreement; the plans requirements respecting eligibility for participation and benefits; a description of the provisions providing for nonforfeitable pension benefits; circumstances which may result in disqualification, ineligibility, or denial or loss of benefits; the source of financing of the plan and the identity of any organization through which benefits are provided; the date of the end of the plan year and whether the records of the plan are kept on a calendar, policy, or fiscal year basis; the procedures to be followed in presenting claims for benefits under the plan including the office at the Department of Labor through which participants and beneficiaries may seek assistance or information regarding their rights under this chapter and the Health Insurance Portability and Accountability Act of 1996 with respect to health benefits that are offered through a group health plan (as defined in section 1191b(a)(1) of this title), the remedies available under the plan for the redress of claims which are denied in whole or in part (including procedures required under section 1133 of this title), and if the employer so elects for purposes of complying with section 1181(f)(3)(B)(i) of this title, the model notice applicable to the State in which the participants and beneficiaries reside.
(Pub. L. 93406, title I, § 102, Sept. 2, 1974, 88 Stat. 841; Pub. L. 104191, title I, § 101(c)(2), Aug. 21, 1996, 110 Stat. 1951; Pub. L. 104204, title VI, § 603(b)(3)(C), Sept. 26, 1996, 110 Stat. 2938; Pub. L. 10534, title XV, § 1503(b), Aug. 5, 1997, 111 Stat. 1061; Pub. L. 1113, title III, § 311(b)(1)(B), Feb. 4, 2009, 123 Stat. 67.)
## Notes
Editorial Notes
References in TextThis chapter, referred to in subsec. (b), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables. The Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (b), is Pub. L. 104191, Aug. 21, 1996, 110 Stat. 1936. For complete classification of this Act to the Code, see Short Title of 1996 Amendment note set out under section 201 of Title 42, The Public Health and Welfare, and Tables.
Amendments2009—Subsec. (b). Pub. L. 1113 substituted “, the remedies” for “and the remedies” and inserted “, and if the employer so elects for purposes of complying with section 1181(f)(3)(B)(i) of this title, the model notice applicable to the State in which the participants and beneficiaries reside” before the period at end. 1997—Pub. L. 10534, § 1503(b)(2)(B), substituted “Summary plan description” for “Plan description and summary plan description” in section catchline. Subsec. (a). Pub. L. 10534, § 1503(b)(1), struck out “(1)” after subsec. designation and struck out par. (2) which read as follows: “A plan description (containing the information required by subsection (b)) of any employee benefit plan shall be prepared on forms prescribed by the Secretary, and shall be filed with the Secretary as required by section 1024(a)(1) of this title. Any material modification in the terms of the plan and any change in the information described in subsection (b) shall be filed in accordance with section 1024(a)(1)(D) of this title.” Subsec. (b). Pub. L. 10534, § 1503(b)(2)(A), substituted “The summary plan description shall contain” for “The plan description and summary plan description shall contain”. 1996—Subsec. (b). Pub. L. 104204 made technical amendment to references in original act which appear in text as references to section 1191b of this title. Pub. L. 104191 inserted “in the case of a group health plan (as defined in section 1191b(a)(1) of this title), whether a health insurance issuer (as defined in section 1191b(b)(2) of this title) is responsible for the financing or administration (including payment of claims) of the plan and (if so) the name and address of such issuer;” after “type of administration of the plan;” and “including the office at the Department of Labor through which participants and beneficiaries may seek assistance or information regarding their rights under this chapter and the Health Insurance Portability and Accountability Act of 1996 with respect to health benefits that are offered through a group health plan (as defined in section 1191b(a)(1) of this title)” after “presenting claims for benefits under the plan”.
Statutory Notes and Related Subsidiaries
Effective Date of 2009 AmendmentAmendment by Pub. L. 1113 effective Apr. 1, 2009, and applicable to child health assistance and medical assistance provided on or after that date, with certain exceptions, see section 3 of Pub. L. 1113, set out as an Effective Date note under section 1396 of Title 42, The Public Health and Welfare.
Effective Date of 1996 AmendmentsAmendment by Pub. L. 104204 applicable with respect to group health plans for plan years beginning on or after Jan. 1, 1998, see section 603(c) of Pub. L. 104204 set out as a note under section 1003 of this title. Amendment by Pub. L. 104191 applicable with respect to group health plans for plan years beginning after June 30, 1997, except as otherwise provided, see section 101(g) of Pub. L. 104191, set out as an Effective Date note under section 1181 of this title.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1023 - Annual reports
## Text
(a) Publication and filing (1) (A) An annual report shall be published with respect to every employee benefit plan to which this part applies. Such report shall be filed with the Secretary in accordance with section 1024(a) of this title, and shall be made available and furnished to participants in accordance with section 1024(b) of this title.
(B) The annual report shall include the information described in subsections (b) and (c) and where applicable subsections (d), (e), (f), and (g) and shall also include—
(i) a financial statement and opinion, as required by paragraph (3) of this subsection, and
(ii) an actuarial statement and opinion, as required by paragraph (4) of this subsection.
(2) If some or all of the information necessary to enable the administrator to comply with the requirements of this subchapter is maintained by—
(A) an insurance carrier or other organization which provides some or all of the benefits under the plan, or holds assets of the plan in a separate account,
(B) a bank or similar institution which holds some or all of the assets of the plan in a common or collective trust or a separate trust, or custodial account, or
(C) a plan sponsor as defined in section 1002(16)(B) of this title,
such carrier, organization, bank, institution, or plan sponsor shall transmit and certify the accuracy of such information to the administrator within 120 days after the end of the plan year (or such other date as may be prescribed under regulations of the Secretary).
(3) (A) Except as provided in subparagraph (C), the administrator of an employee benefit plan shall engage, on behalf of all plan participants, an independent qualified public accountant, who shall conduct such an examination of any financial statements of the plan, and of other books and records of the plan, as the accountant may deem necessary to enable the accountant to form an opinion as to whether the financial statements and schedules required to be included in the annual reports by subsection (b) of this section are presented fairly in conformity with generally accepted accounting principles applied on a basis consistent with that of the preceding year. Such examination shall be conducted in accordance with generally accepted auditing standards, and shall involve such tests of the books and records of the plan as are considered necessary by the independent qualified public accountant. The independent qualified public accountant shall also offer his opinion as to whether the separate schedules specified in subsection (b)(3) of this section and the summary material required under section 1024(b)(3) of this title present fairly, and in all material respects the information contained therein when considered in conjunction with the financial statements taken as a whole. The opinion by the independent qualified public accountant shall be made a part of the annual report. In a case where a plan is not required to file an annual report, the requirements of this paragraph shall not apply. In a case where by reason of section 1024(a)(2) of this title a plan is required only to file a simplified annual report, the Secretary may waive the requirements of this paragraph.
(B) In offering his opinion under this section the accountant may rely on the correctness of any actuarial matter certified to by an enrolled actuary, if he so states his reliance.
(C) The opinion required by subparagraph (A) need not be expressed as to any statements required by subsection (b)(3)(G) prepared by a bank or similar institution or insurance carrier regulated and supervised and subject to periodic examination by a State or Federal agency if such statements are certified by the bank, similar institution, or insurance carrier as accurate and are made a part of the annual report.
(D) For purposes of this subchapter, the term “qualified public accountant” means—
(i) a person who is a certified public accountant, certified by a regulatory authority of a State;
(ii) a person who is a licensed public accountant licensed by a regulatory authority of a State; or
(iii) a person certified by the Secretary as a qualified public accountant in accordance with regulations published by him for a person who practices in States where there is no certification or licensing procedure for accountants.
(4) (A) The administrator of an employee pension benefit plan subject to the reporting requirement of subsection (d) of this section shall engage, on behalf of all plan participants, an enrolled actuary who shall be responsible for the preparation of the materials comprising the actuarial statement required under subsection (d) of this section. In a case where a plan is not required to file an annual report, the requirement of this paragraph shall not apply, and, in a case where by reason of section 1024(a)(2) of this title, a plan is required only to file a simplified report, the Secretary may waive the requirement of this paragraph.
(B) The enrolled actuary shall utilize such assumptions and techniques as are necessary to enable him to form an opinion as to whether the contents of the matters reported under subsection (d) of this section—
(i) are in the aggregate reasonably related to the experience of the plan and to reasonable expectations; and
(ii) represent his best estimate of anticipated experience under the plan.
The opinion by the enrolled actuary shall be made with respect to, and shall be made a part of, each annual report.
(C) For purposes of this subchapter, the term “enrolled actuary” means an actuary enrolled under subtitle C of subchapter II of this chapter.
(D) In making a certification under this section the enrolled actuary may rely on the correctness of any accounting matter under subsection (b) to which any qualified public accountant has expressed an opinion, if he so states his reliance.
(b) Financial statement An annual report under this section shall include a financial statement containing the following information:
(1) With respect to an employee welfare benefit plan: a statement of assets and liabilities; a statement of changes in fund balance; and a statement of changes in financial position. In the notes to financial statements, disclosures concerning the following items shall be considered by the accountant: a description of the plan including any significant changes in the plan made during the period and the impact of such changes on benefits; a description of material lease commitments, other commitments, and contingent liabilities; a description of agreements and transactions with persons known to be parties in interest; a general description of priorities upon termination of the plan; information concerning whether or not a tax ruling or determination letter has been obtained; and any other matters necessary to fully and fairly present the financial statements of the plan.
(2) With respect to an employee pension benefit plan: a statement of assets and liabilities, and a statement of changes in net assets available for plan benefits which shall include details of revenues and expenses and other changes aggregated by general source and application. In the notes to financial statements, disclosures concerning the following items shall be considered by the accountant: a description of the plan including any significant changes in the plan made during the period and the impact of such changes on benefits; the funding policy (including policy with respect to prior service cost), and any changes in such policies during the year; a description of any significant changes in plan benefits made during the period; a description of material lease commitments, other commitments, and contingent liabilities; a description of agreements and transactions with persons known to be parties in interest; a general description of priorities upon termination of the plan; information concerning whether or not a tax ruling or determination letter has been obtained; and any other matters necessary to fully and fairly present the financial statements of such pension plan.
(3) With respect to all employee benefit plans, the statement required under paragraph (1) or (2) shall have attached the following information in separate schedules:
(A) a statement of the assets and liabilities of the plan aggregated by categories and valued at their current value, and the same data displayed in comparative form for the end of the previous fiscal year of the plan;
(B) a statement of receipts and disbursements during the preceding twelve-month period aggregated by general sources and applications;
(C) a schedule of all assets held for investment purposes aggregated and identified by issuer, borrower, or lessor, or similar party to the transaction (including a notation as to whether such party is known to be a party in interest), maturity date, rate of interest, collateral, par or maturity value, cost, and current value;
(D) a schedule of each transaction involving a person known to be party in interest, the identity of such party in interest and his relationship or that of any other party in interest to the plan, a description of each asset to which the transaction relates; the purchase or selling price in case of a sale or purchase, the rental in case of a lease, or the interest rate and maturity date in case of a loan; expense incurred in connection with the transaction; the cost of the asset, the current value of the asset, and the net gain (or loss) on each transaction;
(E) a schedule of all loans or fixed income obligations which were in default as of the close of the plans fiscal year or were classified during the year as uncollectable and the following information with respect to each loan on such schedule (including a notation as to whether parties involved are known to be parties in interest): the original principal amount of the loan, the amount of principal and interest received during the reporting year, the unpaid balance, the identity and address of the obligor, a detailed description of the loan (including date of making and maturity, interest rate, the type and value of collateral, and other material terms), the amount of principal and interest overdue (if any) and an explanation thereof;
(F) a list of all leases which were in default or were classified during the year as uncollectable; and the following information with respect to each lease on such schedule (including a notation as to whether parties involved are known to be parties in interest): the type of property leased (and, in the case of fixed assets such as land, buildings, leasehold, and so forth, the location of the property), the identity of the lessor or lessee from or to whom the plan is leasing, the relationship of such lessors and lessees, if any, to the plan, the employer, employee organization, or any other party in interest, the terms of the lease regarding rent, taxes, insurance, repairs, expenses, and renewal options; the date the leased property was purchased and its cost, the date the property was leased and its approximate value at such date, the gross rental receipts during the reporting period, expenses paid for the leased property during the reporting period, the net receipts from the lease, the amounts in arrears, and a statement as to what steps have been taken to collect amounts due or otherwise remedy the default;
(G) if some or all of the assets of a plan or plans are held in a common or collective trust maintained by a bank or similar institution or in a separate account maintained by an insurance carrier or a separate trust maintained by a bank as trustee, the report shall include the most recent annual statement of assets and liabilities of such common or collective trust, and in the case of a separate account or a separate trust, such other information as is required by the administrator in order to comply with this subsection; and
(H) a schedule of each reportable transaction, the name of each party to the transaction (except that, in the case of an acquisition or sale of a security on the market, the report need not identify the person from whom the security was acquired or to whom it was sold) and a description of each asset to which the transaction applies; the purchase or selling price in case of a sale or purchase, the rental in case of a lease, or the interest rate and maturity date in case of a loan; expenses incurred in connection with the transaction; the cost of the asset, the current value of the asset, and the net gain (or loss) on each transaction. For purposes of the preceding sentence, the term “reportable transaction” means a transaction to which the plan is a party if such transaction is—
(i) a transaction involving an amount in excess of 3 percent of the current value of the assets of the plan;
(ii) any transaction (other than a transaction respecting a security) which is part of a series of transactions with or in conjunction with a person in a plan year, if the aggregate amount of such transactions exceeds 3 percent of the current value of the assets of the plan;
(iii) a transaction which is part of a series of transactions respecting one or more securities of the same issuer, if the aggregate amount of such transactions in the plan year exceeds 3 percent of the current value of the assets of the plan; or
(iv) a transaction with or in conjunction with a person respecting a security, if any other transaction with or in conjunction with such person in the plan year respecting a security is required to be reported by reason of clause (i).
(4) The Secretary may, by regulation, relieve any plan from filing a copy of a statement of assets and liabilities (or other information) described in paragraph (3)(G) if such statement and other information is filed with the Secretary by the bank or insurance carrier which maintains the common or collective trust or separate account.
(c) Information to be furnished by administrator The administrator shall furnish as a part of a report under this section the following information:
(1) The number of employees covered by the plan.
(2) The name and address of each fiduciary.
(3) Except in the case of a person whose compensation is minimal (determined under regulations of the Secretary) and who performs solely ministerial duties (determined under such regulations), the name of each person (including but not limited to, any consultant, broker, trustee, accountant, insurance carrier, actuary, administrator, investment manager, or custodian who rendered services to the plan or who had transactions with the plan) who received directly or indirectly compensation from the plan during the preceding year for services rendered to the plan or its participants, the amount of such compensation, the nature of his services to the plan or its participants, his relationship to the employer of the employees covered by the plan, or the employee organization, and any other office, position, or employment he holds with any party in interest.
(4) An explanation of the reason for any change in appointment of trustee, accountant, insurance carrier, enrolled actuary, administrator, investment manager, or custodian.
(5) Such financial and actuarial information including but not limited to the material described in subsections (b) and (d) of this section as the Secretary may find necessary or appropriate.
(d) Actuarial statement With respect to an employee pension benefit plan (other than (A) a profit sharing, savings, or other plan, which is an individual account plan, (B) a plan described in section 1081(b) of this title, or (C) a plan described both in section 1321(b) of this title and in paragraph (1), (2), (3), (4), (5), (6), or (7) of section 1081(a) of this title) an annual report under this section for a plan year shall include a complete actuarial statement applicable to the plan year which shall include the following:
(1) The date of the plan year, and the date of the actuarial valuation applicable to the plan year for which the report is filed.
(2) The date and amount of the contribution (or contributions) received by the plan for the plan year for which the report is filed and contributions for prior plan years not previously reported.
(3) The following information applicable to the plan year for which the report is filed: the normal costs or target normal costs, the accrued liabilities or funding target, an identification of benefits not included in the calculation; a statement of the other facts and actuarial assumptions and methods used to determine costs, and a justification for any change in actuarial assumptions or cost methods; and the minimum contribution required under section 1082 of this title.
(4) The number of participants and beneficiaries, both retired and nonretired, covered by the plan.
(5) The current value of the assets accumulated in the plan, and the present value of the assets of the plan used by the actuary in any computation of the amount of contributions to the plan required under section 1082 of this title and a statement explaining the basis of such valuation of present value of assets.
(6) Information required in regulations of the Pension Benefit Guaranty Corporation with respect to:
(A) the current value of the assets of the plan,
(B) the present value of all nonforfeitable benefits for participants and beneficiaries receiving payments under the plan,
(C) the present value of all nonforfeitable benefits for all other participants and beneficiaries,
(D) the present value of all accrued benefits which are not nonforfeitable (including a separate accounting of such benefits which are benefit commitments, as defined in section 1301(a)(16) of this title), and
(E) the actuarial assumptions and techniques used in determining the values described in subparagraphs (A) through (D).
(7) A certification of the contribution necessary to reduce the minimum required contribution determined under section 1083 of this title, or the accumulated funding deficiency determined under section 1084 of this title, to zero.
(8) A statement by the enrolled actuary—
(A) that to the best of his knowledge the report is complete and accurate, and
(B) the applicable requirements of sections 1083(h), 1084(c)(3), and 1085a(c)(3) of this title (relating to reasonable actuarial assumptions and methods) have been complied with.
(9) A copy of the opinion required by subsection (a)(4).
(10) A statement by the actuary which discloses—
(A) any event which the actuary has not taken into account, and
(B) any trend which, for purposes of the actuarial assumptions used, was not assumed to continue in the future,
but only if, to the best of the actuarys knowledge, such event or trend may require a material increase in plan costs or required contribution rates.
(11) If the current value of the assets of the plan is less than 70 percent of—
(A) in the case of a single-employer plan, the funding target (as defined in section 1083(d)(1) of this title) of the plan, or
(B) in the case of a multiemployer plan, the current liability (as defined in section 1084(c)(6)(D) of this title) under the plan,
the percentage which such value is of the amount described in subparagraph (A) or (B).
(12) A statement explaining the actuarial assumptions and methods used in projecting future retirements and forms of benefit distributions under the plan.
(13) Such other information regarding the plan as the Secretary may by regulation require.
(14) Such other information as may be necessary to fully and fairly disclose the actuarial position of the plan.
Such actuary shall make an actuarial valuation of the plan for every third plan year, unless he determines that a more frequent valuation is necessary to support his opinion under subsection (a)(4) of this section.
(e) Statement from insurance company, insurance service, or other similar organizations which sell or guarantee plan benefits If some or all of the benefits under the plan are purchased from and guaranteed by an insurance company, insurance service, or other similar organization, a report under this section shall include a statement from such insurance company, service, or other similar organization covering the plan year and enumerating—
(1) the premium rate or subscription charge and the total premium or subscription charges paid to each such carrier, insurance service, or other similar organization and the approximate number of persons covered by each class of such benefits; and
(2) the total amount of premiums received, the approximate number of persons covered by each class of benefits, and the total claims paid by such company, service, or other organization; dividends or retroactive rate adjustments, commissions, and administrative service or other fees or other specific acquisition costs paid by such company, service, or other organization; any amounts held to provide benefits after retirement; the remainder of such premiums; and the names and addresses of the brokers, agents, or other persons to whom commissions or fees were paid, the amount paid to each, and for what purpose. If any such company, service, or other organization does not maintain separate experience records covering the specific groups it serves, the report shall include in lieu of the information required by the foregoing provisions of this paragraph (A) a statement as to the basis of its premium rate or subscription charge, the total amount of premiums or subscription charges received from the plan, and a copy of the financial report of the company, service, or other organization and (B) if such company, service, or organization incurs specific costs in connection with the acquisition or retention of any particular plan or plans, a detailed statement of such costs.
(f) Additional information with respect to defined benefit plans (1) Liabilities under 2 or more plans (A) In general In any case in which any liabilities to participants or their beneficiaries under a defined benefit plan as of the end of a plan year consist (in whole or in part) of liabilities to such participants and beneficiaries under 2 or more pension plans as of immediately before such plan year, an annual report under this section for such plan year shall include the funded percentage of each of such 2 or more pension plans as of the last day of such plan year and the funded percentage of the plan with respect to which the annual report is filed as of the last day of such plan year.
(B) Funded percentage For purposes of this paragraph, the term “funded percentage”—
(i) in the case of a single-employer plan, means the funding target attainment percentage, as defined in section 1083(d)(2) of this title, and
(ii) in the case of a multiemployer plan, has the meaning given such term in section 1085(i)(2) of this title.
(2) Additional information for multiemployer plans With respect to any defined benefit plan which is a multiemployer plan, an annual report under this section for a plan year shall include, in addition to the information required under paragraph (1), the following, as of the end of the plan year to which the report relates:
(A) The number of employers obligated to contribute to the plan.
(B) A list of the employers that contributed more than 5 percent of the total contributions to the plan during such plan year.
(C) The number of participants under the plan on whose behalf no contributions were made by an employer as an employer of the participant for such plan year and for each of the 2 preceding plan years.
(D) The ratios of—
(i) the number of participants under the plan on whose behalf no employer had an obligation to make an employer contribution during the plan year, to
(ii) the number of participants under the plan on whose behalf no employer had an obligation to make an employer contribution during each of the 2 preceding plan years.
(E) Whether the plan received an amortization extension under section 1084(d) of this title or section 431(d) of title 26 for such plan year and, if so, the amount of the difference between the minimum required contribution for the year and the minimum required contribution which would have been required without regard to the extension, and the period of such extension.
(F) Whether the plan used the shortfall funding method (as such term is used in section 1085 of this title) for such plan year and, if so, the amount of the difference between the minimum required contribution for the year and the minimum required contribution which would have been required without regard to the use of such method, and the period of use of such method.
(G) Whether the plan was in critical or endangered status under section 1085 of this title for such plan year, and if so, a summary of any funding improvement or rehabilitation plan (or modification thereto) adopted during the plan year, and the funded percentage of the plan.
(H) The number of employers that withdrew from the plan during the preceding plan year and the aggregate amount of withdrawal liability assessed, or estimated to be assessed, against such withdrawn employers.
(I) In the case of a multiemployer plan that has merged with another plan or to which assets and liabilities have been transferred, the actuarial valuation of the assets and liabilities of each affected plan during the year preceding the effective date of the merger or transfer, based upon the most recent data available as of the day before the first day of the plan year, or other valuation method performed under standards and procedures as the Secretary may prescribe by regulation.
(g) Additional information with respect to pooled employer and multiple employer plans An annual report under this section for a plan year shall include—
(1) with respect to any plan to which section 1060(a) of this title applies (including a pooled employer plan), a list of employers in the plan and a good faith estimate of the percentage of total contributions made by such employers during the plan year and the aggregate account balances attributable to each employer in the plan (determined as the sum of the account balances of the employees of such employer (and the beneficiaries of such employees)); and
(2) with respect to a pooled employer plan, the identifying information for the person designated under the terms of the plan as the pooled plan provider.
(Pub. L. 93406, title I, § 103, Sept. 2, 1974, 88 Stat. 841; Pub. L. 96364, title III, § 307, Sept. 26, 1980, 94 Stat. 1295; Pub. L. 99272, title XI, § 11016(b)(1), Apr. 7, 1986, 100 Stat. 272; Pub. L. 100203, title IX, § 9342(a)(1), Dec. 22, 1987, 101 Stat. 1330371; Pub. L. 101239, title VII, § 7881(j)(1), Dec. 19, 1989, 103 Stat. 2442; Pub. L. 109280, title I, § 108(a)(2), (3), formerly § 107(a)(2), (3), title V, § 503(a)(1), (b), Aug. 17, 2006, 120 Stat. 818, 942, 943, renumbered Pub. L. 111192, title II, § 202(a), June 25, 2010, 124 Stat. 1297; Pub. L. 110458, title I, § 101(d)(1)(A), Dec. 23, 2008, 122 Stat. 5098; Pub. L. 11397, title I, §§ 102(b)(5), 104(c), Apr. 7, 2014, 128 Stat. 1116, 1121; Pub. L. 11694, div. O, title I, § 101(d)(1), Dec. 20, 2019, 133 Stat. 3145.)
## Notes
Editorial Notes
Amendments2019—Subsec. (a)(1)(B). Pub. L. 11694, § 101(d)(1)(A), substituted “applicable subsections (d), (e), (f), and (g)” for “applicable subsections (d), (e), and (f)” in introductory provisions. Subsec. (g). Pub. L. 11694, § 101(d)(1)(B), amended subsec. (g) generally. Prior to amendment, text read as follows: “With respect to any multiple employer plan, an annual report under this section for a plan year shall include a list of participating employers and a good faith estimate of the percentage of total contributions made by such participating employers during the plan year.” 2014—Subsec. (d)(8)(B). Pub. L. 11397, § 102(b)(5), substituted “sections 1083(h), 1084(c)(3), and 1085a(c)(3) of this title” for “sections 1083(h) and 1084(c)(3) of this title”. Subsec. (g). Pub. L. 11397, § 104(c), added subsec. (g). 2008—Subsec. (d)(3). Pub. L. 110458, § 101(d)(1)(A)(i), substituted “the normal costs or target normal costs, the accrued liabilities or funding target” for “the normal costs, the accrued liabilities”. Subsec. (d)(7). Pub. L. 110458, § 101(d)(1)(A)(ii), added par. (7) and struck out former par. (7) which read as follows: “A certification of the contribution necessary to reduce the accumulated funding deficiency to zero.” 2006—Subsec. (a)(1)(B). Pub. L. 109280, § 503(a)(1)(A), substituted “subsections (d), (e), and (f)” for “subsections (d) and (e)” in introductory provisions. Subsec. (d)(8)(B). Pub. L. 109280, § 108(a)(2), formerly § 107(a)(2), as renumbered by Pub. L. 111192, substituted “the applicable requirements of sections 1083(h) and 1084(c)(3)” for “the requirements of section 1082(c)(3)”. Subsec. (d)(11). Pub. L. 109280, § 108(a)(3), formerly § 107(a)(3), as renumbered by Pub. L. 111192, added par. (11) and struck out former par. (11) which read as follows: “If the current value of the assets of the plan is less than 70 percent of the current liability under the plan (within the meaning of section 1082(d)(7) of this title), the percentage which such value is of such liability..” Subsec. (d)(12) to (14). Pub. L. 109280, § 503(b), added par. (12) and redesignated former pars. (12) and (13) as (13) and (14), respectively. Subsec. (f). Pub. L. 109280, § 503(a)(1)(B), added subsec. (f). 1989—Subsec. (d)(11). Pub. L. 101239 substituted “70 percent” for “60 percent” and “the percentage which such value is of such liability.” for “such percentage”. 1987—Subsec. (d)(11) to (13). Pub. L. 100203 added par. (11) and redesignated former pars. (11) and (12) as (12) and (13), respectively. 1986—Subsec. (d)(6). Pub. L. 99272 amended par. (6) generally. Prior to amendment, par. (6) read as follows: “The present value of all of the plans liabilities for nonforfeitable pension benefits allocated by the termination priority categories as set forth in section 1344 of this title, and the actuarial assumptions used in these computations. The Secretary shall establish regulations defining (for purposes of this section) termination priority categories and acceptable methods, including approximate methods, for allocating the plans liabilities to such termination priority categories.” 1980—Subsec. (d)(10) to (12). Pub. L. 96364 added par. (10) and redesignated former pars. (10) and (11) as (11) and (12), respectively.
Statutory Notes and Related Subsidiaries
Effective Date of 2019 AmendmentAmendment by Pub. L. 11694 applicable to plan years beginning after Dec. 31, 2020, see section 101(e) of Pub. L. 11694, set out as a note under section 408 of Title 26, Internal Revenue Code.
Effective Date of 2014 AmendmentAmendment by Pub. L. 11397 applicable to years beginning after Dec. 31, 2013, see section 3 of Pub. L. 11397, set out as a note under section 401 of Title 26, Internal Revenue Code.
Effective Date of 2008 AmendmentAmendment by Pub. L. 110458 effective as if included in the provisions of Pub. L. 109280 to which the amendment relates, except as otherwise provided, see section 112 of Pub. L. 110458, set out as a note under section 72 of Title 26, Internal Revenue Code.
Effective Date of 2006 AmendmentAmendment by section 108(a)(2), (3) of Pub. L. 109280 applicable to plan years beginning after 2007, see section 108(e) of Pub. L. 109280, set out as a note under section 1021 of this title. Amendment by section 503(a)(1), (b) of Pub. L. 109280 applicable to plan years beginning after Dec. 31, 2007, see section 503(f) of Pub. L. 109280, set out as a note under section 1021 of this title.
Effective Date of 1989 AmendmentAmendment by Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Pension Protection Act, Pub. L. 100203, §§ 93029346, to which such amendment relates, see section 7882 of Pub. L. 101239, set out as a note under section 401 of Title 26, Internal Revenue Code.
Effective Date of 1987 AmendmentAmendment by Pub. L. 100203 applicable with respect to reports required to be filed after Dec. 31, 1987, see section 9342(d)(1) of Pub. L. 100203, set out as a note under section 1132 of this title.
Effective Date of 1986 AmendmentAmendment by Pub. L. 99272 effective Jan. 1, 1986, with certain exceptions, see section 11019 of Pub. L. 99272, set out as a note under section 1341 of this title.
Effective Date of 1980 AmendmentAmendment by Pub. L. 96364 effective Sept. 26, 1980, except as specifically provided, see section 1461(e) of this title.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
Report on Pooled Employer PlansPub. L. 117328, div. T, title III, § 344, Dec. 29, 2022, 136 Stat. 5380, provided that: “The Secretary of Labor shall— “(1) conduct a study on the pooled employer plan (as such term is defined in section 3(43) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1002(43))) industry, including on—“(A) the legal name and number of pooled employer plans; “(B) the number of participants in such plans; “(C) the range of investment options provided in such plans; “(D) the fees assessed in such plans; “(E) the manner in which employers select and monitor such plans; “(F) the disclosures provided to participants in such plans; “(G) the number and nature of any enforcement actions by the Secretary of Labor on such plans; “(H) the extent to which such plans have increased retirement savings coverage in the United States; and “(I) any additional information as the Secretary determines is necessary; and “(2) not later than 5 years after the date of enactment of this Act [Dec. 29, 2022], and every 5 years thereafter, submit to Congress and make available on a publicly accessible website of the Department of Labor, a report on the findings of the study under paragraph (1), including recommendations on how pooled employer plans can be improved, through legislation, to serve and protect retirement plan participants.”
Applicability of Amendments by Subtitles A and B of Title I of Pub. L. 109280For special rules on applicability of amendments by subtitles A (§§ 101108) and B (§§ 111116) of title I of Pub. L. 109280 to certain eligible cooperative plans, PBGC settlement plans, and eligible government contractor plans, see sections 104, 105, and 106 of Pub. L. 109280, set out as notes under section 401 of Title 26, Internal Revenue Code.
Guidance by Secretary of LaborPub. L. 109280, title V, § 503(a)(2), Aug. 17, 2006, 120 Stat. 943, provided that: “Not later than 1 year after the date of enactment of this Act [Aug. 17, 2006], the Secretary of Labor shall publish guidance to assist multiemployer defined benefit plans to— “(A) identify and enumerate plan participants for whom there is no employer with an obligation to make an employer contribution under the plan; and “(B) report such information under section 103(f)(2)(D) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1023(f)(2)(D)] (as added by this section).”
Transition RulesPub. L. 99272, title XI, § 11016(b)(3), Apr. 7, 1986, 100 Stat. 273, provided that: “Any regulations, modifications, or waivers which have been issued by the Secretary of Labor with respect to section 103(d)(6) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1023(d)(6)] (as in effect immediately before the date of the enactment of this Act [Apr. 7, 1986]) shall remain in full force and effect until modified by any regulations with respect to such section 103(d)(6) prescribed by the Pension Benefit Guaranty Corporation.”
Consolidation of Actuarial ReportsSecretary of the Treasury and Secretary of Labor to take such steps as may be necessary to assure coordination to the maximum extent feasible between the actuarial reports required by subsec. (d) of this section and section 6059 of Title 26, Internal Revenue Code, see section 1033(c) of Pub. L. 93406, set out as a note under section 6059 of Title 26.
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# 29 U.S.C. § 1024 - Filing with Secretary and furnishing information to participants and certain employers
## Text
(a) Filing of annual report with Secretary (1) The administrator of any employee benefit plan subject to this part shall file with the Secretary the annual report for a plan year within 210 days after the close of such year (or within such time as may be required by regulations promulgated by the Secretary in order to reduce duplicative filing). The Secretary shall make copies of such annual reports available for inspection in the public document room of the Department of Labor.
(2) (A) With respect to annual reports required to be filed with the Secretary under this part, the Secretary may by regulation prescribe simplified annual reports for any pension plan that—
(i) covers fewer than 100 participants; or
(ii) is a plan described in section 1060(a) of this title that covers fewer than 1,000 participants, but only if no single employer in the plan has 100 or more participants covered by the plan.
(B) Nothing contained in this paragraph shall preclude the Secretary from requiring any information or data from any such plan to which this part applies where he finds such data or information is necessary to carry out the purposes of this subchapter nor shall the Secretary be precluded from revoking provisions for simplified reports for any such plan if he finds it necessary to do so in order to carry out the objectives of this subchapter.
(3) The Secretary may by regulation exempt any welfare benefit plan from all or part of the reporting and disclosure requirements of this subchapter, or may provide for simplified reporting and disclosure if he finds that such requirements are inappropriate as applied to welfare benefit plans.
(4) The Secretary may reject any filing under this section—
(A) if he determines that such filing is incomplete for purposes of this part; or
(B) if he determines that there is any material qualification by an accountant or actuary contained in an opinion submitted pursuant to section 1023(a)(3)(A) or section 1023(a)(4)(B) of this title.
(5) If the Secretary rejects a filing of a report under paragraph (4) and if a revised filing satisfactory to the Secretary is not submitted within 45 days after the Secretary makes his determination under paragraph (4) to reject the filing, and if the Secretary deems it in the best interest of the participants, he may take any one or more of the following actions—
(A) retain an independent qualified public accountant (as defined in section 1023(a)(3)(D) of this title) on behalf of the participants to perform an audit,
(B) retain an enrolled actuary (as defined in section 1023(a)(4)(C) of this title) on behalf of the plan participants, to prepare an actuarial statement,
(C) bring a civil action for such legal or equitable relief as may be appropriate to enforce the provisions of this part, or
(D) take any other action authorized by this subchapter.
The administrator shall permit such accountant or actuary to inspect whatever books and records of the plan are necessary for such audit. The plan shall be liable to the Secretary for the expenses for such audit or report, and the Secretary may bring an action against the plan in any court of competent jurisdiction to recover such expenses.
(6) The administrator of any employee benefit plan subject to this part shall furnish to the Secretary, upon request, any documents relating to the employee benefit plan, including but not limited to, the latest summary plan description (including any summaries of plan changes not contained in the summary plan description), and the bargaining agreement, trust agreement, contract, or other instrument under which the plan is established or operated.
(b) Publication of summary plan description and annual report to participants and beneficiaries of plan Publication of the summary plan descriptions and annual reports shall be made to participants and beneficiaries of the particular plan as follows:
(1) The administrator shall furnish to each participant, and each beneficiary receiving benefits under the plan, a copy of the summary plan description, and all modifications and changes referred to in section 1022(a) of this title—
(A) within 90 days after he becomes a participant, or (in the case of a beneficiary) within 90 days after he first receives benefits, or
(B) if later, within 120 days after the plan becomes subject to this part.
The administrator shall furnish to each participant, and each beneficiary receiving benefits under the plan, every fifth year after the plan becomes subject to this part an updated summary plan description described in section 1022 of this title which integrates all plan amendments made within such five-year period, except that in a case where no amendments have been made to a plan during such five-year period this sentence shall not apply. Notwithstanding the foregoing, the administrator shall furnish to each participant, and to each beneficiary receiving benefits under the plan, the summary plan description described in section 1022 of this title every tenth year after the plan becomes subject to this part. If there is a modification or change described in section 1022(a) of this title (other than a material reduction in covered services or benefits provided in the case of a group health plan (as defined in section 1191b(a)(1) of this title)), a summary description of such modification or change shall be furnished not later than 210 days after the end of the plan year in which the change is adopted to each participant, and to each beneficiary who is receiving benefits under the plan. If there is a modification or change described in section 1022(a) of this title that is a material reduction in covered services or benefits provided under a group health plan (as defined in section 1191b(a)(1) of this title), a summary description of such modification or change shall be furnished to participants and beneficiaries not later than 60 days after the date of the adoption of the modification or change. In the alternative, the plan sponsors may provide such description at regular intervals of not more than 90 days. The Secretary shall issue regulations within 180 days after August 21, 1996, providing alternative mechanisms to delivery by mail through which group health plans (as so defined) may notify participants and beneficiaries of material reductions in covered services or benefits.
(2) The administrator shall make copies of the latest updated summary plan description and the latest annual report and the bargaining agreement, trust agreement, contract, or other instruments under which the plan was established or is operated available for examination by any plan participant or beneficiary in the principal office of the administrator and in such other places as may be necessary to make available all pertinent information to all participants (including such places as the Secretary may prescribe by regulations).
(3) Within 210 days after the close of the fiscal year of the plan, the administrator (other than an administrator of a defined benefit plan to which the requirements of section 1021(f) of this title applies) 11 So in original. Probably should be “apply)”. shall furnish to each participant, and to each beneficiary receiving benefits under the plan, a copy of the statements and schedules, for such fiscal year, described in subparagraphs (A) and (B) of section 1023(b)(3) of this title and such other material (including the percentage determined under section 1023(d)(11) of this title) as is necessary to fairly summarize the latest annual report.
(4) The administrator shall, upon written request of any participant or beneficiary, furnish a copy of the latest updated summary,22 So in original. Comma probably should not appear. plan description, and the latest annual report, any terminal report, the bargaining agreement, trust agreement, contract, or other instruments under which the plan is established or operated. The administrator may make a reasonable charge to cover the cost of furnishing such complete copies. The Secretary may by regulation prescribe the maximum amount which will constitute a reasonable charge under the preceding sentence.
(5) Identification and basic plan information and actuarial information included in the annual report for any plan year shall be filed with the Secretary in an electronic format which accommodates display on the Internet, in accordance with regulations which shall be prescribed by the Secretary. The Secretary shall provide for display of such information included in the annual report, within 90 days after the date of the filing of the annual report, on an Internet website maintained by the Secretary and other appropriate media. Such information shall also be displayed on any Intranet website maintained by the plan sponsor (or by the plan administrator on behalf of the plan sponsor) for the purpose of communicating with employees and not the public, in accordance with regulations which shall be prescribed by the Secretary.
(c) Statement of rights The Secretary may by regulation require that the administrator of any employee benefit plan furnish to each participant and to each beneficiary receiving benefits under the plan a statement of the rights of participants and beneficiaries under this subchapter.
(d) Furnishing summary plan information to employers and employee representatives of multiemployer plans (1) In general With respect to a multiemployer plan subject to this section, within 30 days after the due date under subsection (a)(1) for the filing of the annual report for the fiscal year of the plan, the administrators shall furnish to each employee organization and to each employer with an obligation to contribute to the plan a report that contains—
(A) a description of the contribution schedules and benefit formulas under the plan, and any modification to such schedules and formulas, during such plan year;
(B) the number of employers obligated to contribute to the plan;
(C) a list of the employers that contributed more than 5 percent of the total contributions to the plan during such plan year;
(D) the number of participants under the plan on whose behalf no contributions were made by an employer as an employer of the participant for such plan year and for each of the 2 preceding plan years;
(E) whether the plan was in critical or endangered status under section 1085 of this title for such plan year and, if so, include—
(i) a list of the actions taken by the plan to improve its funding status; and
(ii) a statement describing how a person may obtain a copy of the plans funding improvement or rehabilitation plan, as applicable, adopted under section 1085 of this title and the actuarial and financial data that demonstrate any action taken by the plan toward fiscal improvement;
(F) the number of employers that withdrew from the plan during the preceding plan year and the aggregate amount of withdrawal liability assessed, or estimated to be assessed, against such withdrawn employers, as reported on the annual report for the plan year to which the report under this subsection relates;
(G) in the case of a multiemployer plan that has merged with another plan or to which assets and liabilities have been transferred, the actuarial valuation of the assets and liabilities of each affected plan during the year preceding the effective date of the merger or transfer, based upon the most recent data available as of the day before the first day of the plan year, or other valuation method performed under standards and procedures as the Secretary may prescribe by regulation;
(H) a description as to whether the plan—
(i) sought or received an amortization extension under section 1084(d) of this title or section 431(d) of title 26 for such plan year; or
(ii) used the shortfall funding method (as such term is used in section 1085 of this title) for such plan year; and
(I) notification of the right under this section of the recipient to a copy of the annual report filed with the Secretary under subsection (a), summary plan description, summary of any material modification of the plan, upon written request, but that—
(i) in no case shall a recipient be entitled to receive more than one copy of any such document described during any one 12-month period; and
(ii) the administrator may make a reasonable charge to cover copying, mailing, and other costs of furnishing copies of information pursuant to this subparagraph.
(2) Effect of subsection Nothing in this subsection waives any other provision under this subchapter requiring plan administrators to provide, upon request, information to employers that have an obligation to contribute under the plan.
(e) Cross references For regulations respecting coordination of reports to the Secretaries of Labor and the Treasury, see section 1204 of this title.
(Pub. L. 93406, title I, § 104, Sept. 2, 1974, 88 Stat. 847; Pub. L. 99272, title XI, § 11016(b)(2), Apr. 7, 1986, 100 Stat. 273; Pub. L. 100203, title IX, § 9342(a)(2), Dec. 22, 1987, 101 Stat. 1330371; Pub. L. 101239, title VII, § 7894(b)(3), (4), Dec. 19, 1989, 103 Stat. 2448; Pub. L. 104191, title I, § 101(c)(1), Aug. 21, 1996, 110 Stat. 1951; Pub. L. 104204, title VI, § 603(b)(3)(D), Sept. 26, 1996, 110 Stat. 2938; Pub. L. 10534, title XV, § 1503(c)(1), (2)(A), (d)(1)(3), Aug. 5, 1997, 111 Stat. 1062; Pub. L. 109280, title V, §§ 503(c)(1), (d), 504(a), Aug. 17, 2006, 120 Stat. 943945; Pub. L. 110458, title I, § 105(c)(1), Dec. 23, 2008, 122 Stat. 5105; Pub. L. 11694, div. O, title I, § 101(d)(2), Dec. 20, 2019, 133 Stat. 3145.)
## Notes
Editorial Notes
Amendments2019—Subsec. (a)(2)(A). Pub. L. 11694 added subpar. (A) and struck out former subpar. (A) which read as follows: “With respect to annual reports required to be filed with the Secretary under this part, he may by regulation prescribe simplified annual reports for any pension plan which covers less than 100 participants.” 2008—Subsec. (b)(3). Pub. L. 110458, § 105(c)(1)(A)(ii), which directed substitution of “the administrator” for “the administrators” in par. (3), could not be executed because the words “the administrators” did not appear. Pub. L. 110458, § 105(c)(1)(A)(i), substituted “section 1021(f)” for “section 1023(f)”. Subsec. (d)(1)(E)(ii). Pub. L. 110458, § 105(c)(1)(B), inserted “funding” after “plans”. 2006—Pub. L. 109280, § 503(d)(1), substituted “participants and certain employers” for “participants” in section catchline. Subsec. (b)(3). Pub. L. 109280, § 503(c)(1), which directed amendment of par. (3) by inserting “(other than an administrator of a defined benefit plan to which the requirements of section 1023(f) of this title applies)” after “the administrators”, was executed by making the insertion after “the administrator”, to reflect the probable intent of Congress. Subsec. (b)(5). Pub. L. 109280, § 504(a), added par. (5). Subsecs. (d), (e). Pub. L. 109280, § 503(d)(2), (3), added subsec. (d) and redesignated former subsec. (d) as (e). 1997—Subsec. (a)(1). Pub. L. 10534, § 1503(c)(1), amended par. (1) generally, substituting present provisions for provisions requiring filing of annual report, plan description, summary plan description, as well as modifications and changes in plan descriptions. Subsec. (a)(6). Pub. L. 10534, § 1503(c)(2)(A), added par. (6). Subsec. (b)(1). Pub. L. 10534, § 1503(d)(1), substituted “section 1022(a) of this title” for “section 1022(a)(1) of this title” wherever appearing. Subsec. (b)(2). Pub. L. 10534, § 1503(d)(2), substituted “the latest updated summary plan description and” for “the plan description and”. Subsec. (b)(4). Pub. L. 10534, § 1503(d)(3), struck out “plan description” before “, plan description, and the latest annual report”. 1996—Subsec. (b)(1). Pub. L. 104204 made technical amendment to references in original act which appear in text as references to section 1191b of this title. Pub. L. 104191, in closing provisions, substituted “1022(a)(1) of this title (other than a material reduction in covered services or benefits provided in the case of a group health plan (as defined in section 1191b(a)(1) of this title)),” for “1022(a)(1) of this title,” and inserted at end “If there is a modification or change described in section 1022(a)(1) of this title that is a material reduction in covered services or benefits provided under a group health plan (as defined in section 1191b(a)(1) of this title), a summary description of such modification or change shall be furnished to participants and beneficiaries not later than 60 days after the date of the adoption of the modification or change. In the alternative, the plan sponsors may provide such description at regular intervals of not more than 90 days. The Secretary shall issue regulations within 180 days after August 21, 1996, providing alternative mechanisms to delivery by mail through which group health plans (as so defined) may notify participants and beneficiaries of material reductions in covered services or benefits.” 1989—Subsec. (a)(5)(B). Pub. L. 101239, § 7894(b)(3), substituted a comma for period at end. Subsec. (b)(1). Pub. L. 101239, § 7894(b)(4), struck out comma after “summary”. 1987—Subsec. (b)(3). Pub. L. 100203 inserted “(including the percentage determined under section 1023(d)(11) of this title)” after “material”. 1986—Subsec. (a)(2)(A). Pub. L. 99272 struck out provision permitting the Secretary to waive or modify the requirements of section 1023(d)(6) of this title if he found that the interests of the plan participants were not harmed and the expense of compliance was not justified by the needs of the participants, the Pension Benefit Guaranty Corporation, and the Department of Labor for some portion or all of the information otherwise required under section 1023(d)(6) of this title.
Statutory Notes and Related Subsidiaries
Effective Date of 2019 AmendmentAmendment by Pub. L. 11694 applicable to plan years beginning after Dec. 31, 2020, see section 101(e) of Pub. L. 11694, set out as a note under section 408 of Title 26, Internal Revenue Code.
Effective Date of 2008 AmendmentAmendment by Pub. L. 110458 effective as if included in the provisions of Pub. L. 109280 to which the amendment relates, except as otherwise provided, see section 112 of Pub. L. 110458, set out as a note under section 72 of Title 26, Internal Revenue Code.
Effective Date of 2006 AmendmentAmendment by section 503(c)(1), (d) of Pub. L. 109280 applicable to plan years beginning after Dec. 31, 2007, see section 503(f) of Pub. L. 109280, set out as a note under section 1021 of this title. Pub. L. 109280, title V, § 504(b), Aug. 17, 2006, 120 Stat. 945, provided that: “The amendment made by this section [amending this section] shall apply to plan years beginning after December 31, 2007.”
Effective Date of 1996 AmendmentsAmendment by Pub. L. 104204 applicable with respect to group health plans for plan years beginning on or after Jan. 1, 1998, see section 603(c) of Pub. L. 104204 set out as a note under section 1003 of this title. Amendment by Pub. L. 104191 applicable with respect to group health plans for plan years beginning after June 30, 1997, except as otherwise provided, see section 101(g) of Pub. L. 104191, set out as an Effective Date note under section 1181 of this title.
Effective Date of 1989 AmendmentAmendment by Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
Effective Date of 1987 AmendmentAmendment by Pub. L. 100203 applicable with respect to reports required to be filed after Dec. 31, 1987, see section 9342(d)(1) of Pub. L. 100203, set out as a note under section 1132 of this title.
Effective Date of 1986 AmendmentAmendment by Pub. L. 99272 effective Jan. 1, 1986, with certain exceptions, see section 11019 of Pub. L. 99272, set out as a note under section 1341 of this title.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
Model Notices and FormsFor provisions requiring the Secretary of Labor to publish a model form for providing the statements, schedules, and other material required to be provided under subsec. (d) of this section, see section 503(e) of Pub. L. 109280, set out as a note under section 1021 of this title.
@@ -0,0 +1,151 @@
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# 29 U.S.C. § 1025 - Reporting of participants benefit rights
## Text
(a) Requirements to provide pension benefit statements (1) Requirements (A) Individual account plan The administrator of an individual account plan (other than a one-participant retirement plan described in section 1021(i)(8)(B) of this title) shall furnish a pension benefit statement—
(i) at least once each calendar quarter to a participant or beneficiary who has the right to direct the investment of assets in his or her account under the plan,
(ii) at least once each calendar year to a participant or beneficiary who has his or her own account under the plan but does not have the right to direct the investment of assets in that account, and
(iii) upon written request to a plan beneficiary not described in clause (i) or (ii).
(B) Defined benefit plan The administrator of a defined benefit plan (other than a one-participant retirement plan described in section 1021(i)(8)(B) of this title) shall furnish a pension benefit statement—
(i) at least once every 3 years to each participant with a nonforfeitable accrued benefit and who is employed by the employer maintaining the plan at the time the statement is to be furnished, and
(ii) to a participant or beneficiary of the plan upon written request.
Information furnished under clause (i) to a participant may be based on reasonable estimates determined under regulations prescribed by the Secretary, in consultation with the Pension Benefit Guaranty Corporation.
(2) Statements (A) In general A pension benefit statement under paragraph (1)—
(i) shall indicate, on the basis of the latest available information—
(I) the total benefits accrued, and
(II) the nonforfeitable pension benefits, if any, which have accrued, or the earliest date on which benefits will become nonforfeitable,
(ii) shall include an explanation of any permitted disparity under section 401(l) of title 26 or any floor-offset arrangement that may be applied in determining any accrued benefits described in clause (i),
(iii) shall be written in a manner calculated to be understood by the average plan participant, and
(iv) may be delivered in written, electronic, or other appropriate form to the extent such form is reasonably accessible to the participant or beneficiary.
(B) Additional information In the case of an individual account plan, any pension benefit statement under clause (i) or (ii) of paragraph (1)(A) shall include—
(i) the value of each investment to which assets in the individual account have been allocated, determined as of the most recent valuation date under the plan, including the value of any assets held in the form of employer securities, without regard to whether such securities were contributed by the plan sponsor or acquired at the direction of the plan or of the participant or beneficiary,
(ii) in the case of a pension benefit statement under paragraph (1)(A)(i)—
(I) an explanation of any limitations or restrictions on any right of the participant or beneficiary under the plan to direct an investment,
(II) an explanation, written in a manner calculated to be understood by the average plan participant, of the importance, for the long-term retirement security of participants and beneficiaries, of a well-balanced and diversified investment portfolio, including a statement of the risk that holding more than 20 percent of a portfolio in the security of one entity (such as employer securities) may not be adequately diversified, and
(III) a notice directing the participant or beneficiary to the Internet website of the Department of Labor for sources of information on individual investing and diversification, and
(iii) the lifetime income disclosure described in subparagraph (D)(i).
In the case of pension benefit statements described in clause (i) of paragraph (1)(A), a lifetime income disclosure under clause (iii) of this subparagraph shall be required to be included in only one pension benefit statement during any one 12-month period.
(C) Alternative notice The requirements of subparagraph (A)(i)(II) are met if, at least annually and in accordance with requirements of the Secretary, the plan—
(i) updates the information described in such paragraph which is provided in the pension benefit statement, or
(ii) provides in a separate statement such information as is necessary to enable a participant or beneficiary to determine their nonforfeitable vested benefits.
(D) Lifetime income disclosure (i) In general (I) Disclosure A lifetime income disclosure shall set forth the lifetime income stream equivalent of the total benefits accrued with respect to the participant or beneficiary.
(II) Lifetime income stream equivalent of the total benefits accrued For purposes of this subparagraph, the term “lifetime income stream equivalent of the total benefits accrued” means the amount of monthly payments the participant or beneficiary would receive if the total accrued benefits of such participant or beneficiary were used to provide lifetime income streams described in subclause (III), based on assumptions specified in rules prescribed by the Secretary.
(III) Lifetime income streams The lifetime income streams described in this subclause are a qualified joint and survivor annuity (as defined in section 1055(d) of this title), based on assumptions specified in rules prescribed by the Secretary, including the assumption that the participant or beneficiary has a spouse of equal age, and a single life annuity. Such lifetime income streams may have a term certain or other features to the extent permitted under rules prescribed by the Secretary.
(ii) Model disclosure Not later than 1 year after December 20, 2019, the Secretary shall issue a model lifetime income disclosure, written in a manner so as to be understood by the average plan participant, which—
(I) explains that the lifetime income stream equivalent is only provided as an illustration;
(II) explains that the actual payments under the lifetime income stream described in clause (i)(III) which may be purchased with the total benefits accrued will depend on numerous factors and may vary substantially from the lifetime income stream equivalent in the disclosures;
(III) explains the assumptions upon which the lifetime income stream equivalent was determined; and
(IV) provides such other similar explanations as the Secretary considers appropriate.
(iii) Assumptions and rules Not later than 1 year after December 20, 2019, the Secretary shall—
(I) prescribe assumptions which administrators of individual account plans may use in converting total accrued benefits into lifetime income stream equivalents for purposes of this subparagraph; and
(II) issue interim final rules under clause (i).
In prescribing assumptions under subclause (I), the Secretary may prescribe a single set of specific assumptions (in which case the Secretary may issue tables or factors which facilitate such conversions), or ranges of permissible assumptions. To the extent that an accrued benefit is or may be invested in a lifetime income stream described in clause (i)(III), the assumptions prescribed under subclause (I) shall, to the extent appropriate, permit administrators of individual account plans to use the amounts payable under such lifetime income stream as a lifetime income stream equivalent.
(iv) Limitation on liability No plan fiduciary, plan sponsor, or other person shall have any liability under this subchapter solely by reason of the provision of lifetime income stream equivalents which are derived in accordance with the assumptions and rules described in clause (iii) and which include the explanations contained in the model lifetime income disclosure described in clause (ii). This clause shall apply without regard to whether the provision of such lifetime income stream equivalent is required by subparagraph (B)(iii).
(v) Effective date The requirement in subparagraph (B)(iii) shall apply to pension benefit statements furnished more than 12 months after the latest of the issuance by the Secretary of—
(I) interim final rules under clause (i);
(II) the model disclosure under clause (ii); or
(III) the assumptions under clause (iii).
(3) Defined benefit plans (A) Alternative notice In the case of a defined benefit plan, the requirements of paragraph (1)(B)(i) shall be treated as met with respect to a participant if at least once each year the administrator provides to the participant notice of the availability of the pension benefit statement and the ways in which the participant may obtain such statement. Such notice may be delivered in written, electronic, or other appropriate form to the extent such form is reasonably accessible to the participant.
(B) Years in which no benefits accrue The Secretary may provide that years in which no employee or former employee benefits (within the meaning of section 410(b) of title 26) under the plan need not be taken into account in determining the 3-year period under paragraph (1)(B)(i).
(b) Limitation on number of statements In no case shall a participant or beneficiary of a plan be entitled to more than 1 statement described in subparagraph (A)(iii) or (B)(ii) of subsection (a)(1), whichever is applicable, in any 12-month period.
(c) Individual statement furnished by administrator to participants setting forth information in administrators Internal Revenue registration statement and notification of forfeitable benefits Each administrator required to register under section 6057 of title 26 shall, before the expiration of the time prescribed for such registration, furnish to each participant described in subsection (a)(2)(C) of such section, an individual statement setting forth the information with respect to such participant required to be contained in the registration statement required by section 6057(a)(2) of title 26. Such statement shall also include a notice to the participant of any benefits which are forfeitable if the participant dies before a certain date.
(Pub. L. 93406, title I, § 105, Sept. 2, 1974, 88 Stat. 849; Pub. L. 98397, title I, § 106, Aug. 23, 1984, 98 Stat. 1436; Pub. L. 101239, title VII, §§ 7891(a)(1), 7894(b)(5), Dec. 19, 1989, 103 Stat. 2445, 2448; Pub. L. 109280, title V, § 508(a)(1)(2)(B), Aug. 17, 2006, 120 Stat. 949, 951; Pub. L. 11694, div. O, title II, § 203, Dec. 20, 2019, 133 Stat. 3163; Pub. L. 117328, div. T, title III, § 338(a), Dec. 29, 2022, 136 Stat. 5373.)
## Notes
Amendment of Subsection (a)(2)Pub. L. 117328, div. T, title III, § 338(a), (c), Dec. 29, 2022, 136 Stat. 5373, 5374, provided that, applicable with respect to plan years beginning after Dec. 31, 2025, subsection (a)(2) of this section is amended: (1) in subparagraph (A)(iv), by inserting “subject to subparagraph (E),” before “may be delivered”; and (2) by adding at the end the following: “(E) Provision of paper statements “With respect to at least 1 pension benefit statement furnished for a calendar year with respect to an individual account plan under paragraph (1)(A), and with respect to at least 1 pension benefit statement furnished every 3 calendar years with respect to a defined benefit plan under paragraph (1)(B), such statement shall be furnished on paper in written form except— “(i) in the case of a plan that furnishes such statement in accordance with section 2520.104b-1(c) of title 29, Code of Federal Regulations; or “(ii) in the case of a plan that permits a participant or beneficiary to request that the statements referred to in the matter preceding clause (i) be furnished by electronic delivery, if the participant or beneficiary requests that such statements be delivered electronically and the statements are so delivered.” See 2022 Amendment notes below.
Editorial Notes
Amendments2022—Subsec. (a)(2)(A)(iv). Pub. L. 117328, § 338(a)(1), inserted “subject to subparagraph (E),” before “may be delivered”. Subsec. (a)(2)(E). Pub. L. 117328, § 338(a)(2), added subpar. (E). 2019—Subsec. (a)(2)(B). Pub. L. 11694, § 203(a), added cl. (iii) and concluding provisions. Subsec. (a)(2)(D). Pub. L. 11694, § 203(b), added subpar. (D). 2006—Subsec. (a). Pub. L. 109280, § 508(a)(1), amended heading and text of subsec. (a) generally. Prior to amendment, text read as follows: “Each administrator of an employee pension benefit plan shall furnish to any plan participant or beneficiary who so requests in writing, a statement indicating, on the basis of the latest available information— “(1) the total benefits accrued, and “(2) the nonforfeitable pension benefits, if any, which have accrued, or the earliest date on which benefits will become nonforfeitable.” Subsec. (b). Pub. L. 109280, § 508(a)(2)(B), amended heading and text of subsec. (b) generally. Prior to amendment, text read as follows: “In no case shall a participant or beneficiary be entitled under this section to receive more than one report described in subsection (a) during any one 12-month period.” Subsec. (d). Pub. L. 109280, § 508(a)(2)(A), struck out heading and text of subsec. (d). Text read as follows: “Subsection (a) of this section shall apply to a plan to which more than one unaffiliated employer is required to contribute only to the extent provided in regulations prescribed by the Secretary in coordination with the Secretary of the Treasury.” 1989—Subsec. (b). Pub. L. 101239, § 7894(b)(5), substituted “12-month” for “12 month”. Subsec. (c). Pub. L. 101239, § 7891(a)(1), substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text. 1984—Subsec. (c). Pub. L. 98397 inserted at end “Such statement shall also include a notice to the participant of any benefits which are forfeitable if the participant dies before a certain date.”
Statutory Notes and Related Subsidiaries
Effective Date of 2022 AmendmentPub. L. 117328, div. T, title III, § 338(c), Dec. 29, 2022, 136 Stat. 5374, provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to plan years beginning after December 31, 2025.”
Effective Date of 2006 AmendmentPub. L. 109280, title V, § 508(c), Aug. 17, 2006, 120 Stat. 952, provided that: “(1) In general.—The amendments made by this section [amending this section and section 1132 of this title] shall apply to plan years beginning after December 31, 2006. “(2) Special rule for collectively bargained agreements.—In the case of a plan maintained pursuant to 1 or more collective bargaining agreements between employee representatives and 1 or more employers ratified on or before the date of the enactment of this Act [Aug. 17, 2006], paragraph (1) shall be applied to benefits pursuant to, and individuals covered by, any such agreement by substituting for December 31, 2006 the earlier of—“(A) the later of—“(i) December 31, 2007, or “(ii) the date on which the last of such collective bargaining agreements terminates (determined without regard to any extension thereof after such date of enactment), or “(B) December 31, 2008.”
Effective Date of 1989 AmendmentAmendment by section 7891(a)(1) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title. Amendment by section 7894(b)(5) of Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
Effective Date of 1984 AmendmentAmendment by Pub. L. 98397 applicable to plan years beginning after Dec. 31, 1984, except as otherwise provided, see sections 302 and 303 of Pub. L. 98397, set out as a note under section 1001 of this title.
Implementation of 2022 AmendmentPub. L. 117328, div. T, title III, § 338(b), Dec. 29, 2022, 136 Stat. 5373, provided that: “(1) In general.—The Secretary of Labor shall, not later than December 31, 2024, update section 2520.104b-1(c) of title 29, Code of Federal Regulations, to provide that a plan may furnish the statements referred to in subparagraph (E) of section 105(a)(2) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1025(a)(2)(E)] by electronic delivery only if, with respect to participants who first become eligible to participate, and beneficiaries who first become eligible for benefits, after December 31, 2025, in addition to meeting the other requirements under the regulations such plan furnishes each participant or beneficiary a one-time initial notice on paper in written form, prior to the electronic delivery of any pension benefit statement, of their right to request that all documents required to be disclosed under title I of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1001 et seq.] be furnished on paper in written form. “(2) Other guidance.—In implementing the amendment made by subsection (a) with respect to a plan that discloses required documents or statements electronically, in accordance with applicable guidance governing electronic disclosure by the Department of Labor (with the exception of section 2520.104b-1(c) of title 29, Code of Federal Regulations), the Secretary of Labor shall, not later than December 31, 2024, update such guidance to the extent necessary to ensure that—“(A) a participant or beneficiary under such a plan is permitted the opportunity to request that any disclosure required to be delivered on paper under applicable guidance by the Department of Labor shall be furnished by electronic delivery; “(B) each paper statement furnished under such a plan pursuant to the amendment shall include—“(i) an explanation of how to request that all such statements, and any other document required to be disclosed under title I of the Employee Retirement Income Security Act of 1974, be furnished by electronic delivery; and “(ii) contact information for the plan sponsor, including a telephone number; “(C) the plan may not charge any fee to a participant or beneficiary for the delivery of any paper statements; “(D) each document required to be disclosed that is furnished by electronic delivery under such a plan shall include an explanation of how to request that all such documents be furnished on paper in written form; and “(E) a plan is permitted to furnish a duplicate electronic statement in any case in which the plan furnishes a paper pension benefit statement.”
RegulationsSecretary of Labor authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations by him, see section 1031 of this title.
Model StatementsPub. L. 109280, title V, § 508(b), Aug. 17, 2006, 120 Stat. 951, provided that: “(1) In general.—The Secretary of Labor shall, within 1 year after the date of the enactment of this section [Aug. 17, 2006], develop 1 or more model benefit statements that are written in a manner calculated to be understood by the average plan participant and that may be used by plan administrators in complying with the requirements of section 105 of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1025]. “(2) Interim final rules.—The Secretary of Labor may promulgate any interim final rules as the Secretary determines appropriate to carry out the provisions of this subsection.”
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# 29 U.S.C. § 1026 - Reports made public information
## Text
(a) Except as provided in subsection (b), the contents of the annual reports, statements, and other documents filed with the Secretary pursuant to this part shall be public information and the Secretary shall make any such information and data available for inspection in the public document room of the Department of Labor. The Secretary may use the information and data for statistical and research purposes, and compile and publish such studies, analyses, reports, and surveys based thereon as he may deem appropriate.
(b) Information described in sections 1025(a) and 1025(c) of this title with respect to a participant may be disclosed only to the extent that information respecting that participants benefits under title II of the Social Security Act [42 U.S.C. 401 et seq.] may be disclosed under such Act.
(Pub. L. 93406, title I, § 106, Sept. 2, 1974, 88 Stat. 850; Pub. L. 101239, title VII, § 7894(b)(6), Dec. 19, 1989, 103 Stat. 2448; Pub. L. 10534, title XV, § 1503(d)(4), Aug. 5, 1997, 111 Stat. 1062.)
## Notes
Editorial Notes
References in TextThe Social Security Act, referred to in subsec. (b), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title II of the Social Security Act is classified generally to subchapter II (§ 401 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.
Amendments1997—Subsec. (a). Pub. L. 10534 struck out “descriptions,” before “annual reports,”. 1989—Subsec. (b). Pub. L. 101239 substituted “sections” for “section”.
Statutory Notes and Related Subsidiaries
Effective Date of 1989 AmendmentAmendment by Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
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# 29 U.S.C. § 1027 - Retention of records
## Text
Every person subject to a requirement to file any report (including the documents described in subparagraphs (E) through (I) of section 1021(k) of this title) or to certify any information therefor under this subchapter or who would be subject to such a requirement but for an exemption or simplified reporting requirement under section 1024(a)(2) or (3) of this title shall maintain a copy of such report and records on the matters of which disclosure is required which will provide in sufficient detail the necessary basic information and data from which the documents thus required may be verified, explained, or clarified, and checked for accuracy and completeness, and shall include vouchers, worksheets, receipts, and applicable resolutions, and shall keep such records available for examination for a period of not less than six years after the filing date of the documents based on the information which they contain, or six years after the date on which such documents would have been filed but for an exemption or simplified reporting requirement under section 1024(a)(2) or (3) of this title.
(Pub. L. 93406, title I, § 107, Sept. 2, 1974, 88 Stat. 850; Pub. L. 10534, title XV, § 1503(d)(5), Aug. 5, 1997, 111 Stat. 1062; Pub. L. 113235, div. O, title I, § 111(c), Dec. 16, 2014, 128 Stat. 2793.)
## Notes
Editorial Notes
Amendments2014—Pub. L. 113235 inserted “(including the documents described in subparagraphs (E) through (I) of section 1021(k) of this title)” after “file any report” and “a copy of such report and” after “shall maintain”. 1997—Pub. L. 10534 struck out “description or” after “requirement to file any”.
Statutory Notes and Related Subsidiaries
Effective Date of 2014 AmendmentAmendment by Pub. L. 113235 applicable with respect to plan years beginning after Dec. 31, 2014, see section 111(e) of Pub. L. 113235, set out as a note under section 1021 of this title.
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# 29 U.S.C. § 1028 - Reliance on administrative interpretations
## Text
In any criminal proceeding under section 1131 of this title, based on any act or omission in alleged violation of this part or section 1112 of this title, no person shall be subject to any liability or punishment for or on account of the failure of such person to (1) comply with this part or section 1112 of this title, if he pleads and proves that the act or omission complained of was in good faith, in conformity with, and in reliance on any regulation or written ruling of the Secretary, or (2) publish and file any information required by any provision of this part if he pleads and proves that he published and filed such information in good faith, and in conformity with any regulation or written ruling of the Secretary issued under this part regarding the filing of such reports. Such a defense, if established, shall be a bar to the action or proceeding, notwithstanding that (A) after such act or omission, such interpretation or opinion is modified or rescinded or is determined by judicial authority to be invalid or of no legal effect, or (B) after publishing or filing the annual reports and other reports required by this subchapter, such publication or filing is determined by judicial authority not to be in conformity with the requirements of this part.
(Pub. L. 93406, title I, § 108, Sept. 2, 1974, 88 Stat. 850; Pub. L. 101239, title VII, § 7894(b)(7), Dec. 19, 1989, 103 Stat. 2448; Pub. L. 10534, title XV, § 1503(d)(6), Aug. 5, 1997, 111 Stat. 1062.)
## Notes
Editorial Notes
Amendments1997—Pub. L. 10534, which directed the amendment of cl. (2)(B) by substituting “annual reports” for “plan descriptions, annual reports,”, was executed by making the substitution for “plan description, annual reports,” to reflect the probable intent of Congress. 1989—Pub. L. 101239 substituted “act or omission” for “act of omission” before “complained of”.
Statutory Notes and Related Subsidiaries
Effective Date of 1989 AmendmentAmendment by Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1029 - Forms
## Text
(a) Information required on forms Except as provided in subsection (b) of this section, the Secretary may require that any information required under this subchapter to be submitted to him, including but not limited to the information required to be filed by the administrator pursuant to section 1023(b)(3) and (c) of this title, must be submitted on such forms as he may prescribe.
(b) Information not required on forms The financial statement and opinion required to be prepared by an independent qualified public accountant pursuant to section 1023(a)(3)(A) of this title, the actuarial statement required to be prepared by an enrolled actuary pursuant to section 1023(a)(4)(A) of this title and the summary plan description required by section 1022(a) of this title shall not be required to be submitted on forms.
(c) Format and content of summary plan description, annual report, etc., required to be furnished to plan participants and beneficiaries The Secretary may prescribe the format and content of the summary plan description, the summary of the annual report described in section 1024(b)(3) of this title and any other report, statements or documents (other than the bargaining agreement, trust agreement, contract, or other instrument under which the plan is established or operated), which are required to be furnished or made available to plan participants and beneficiaries receiving benefits under the plan.
(Pub. L. 93406, title I, § 109, Sept. 2, 1974, 88 Stat. 850.)
## Notes
Statutory Notes and Related Subsidiaries
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1030 - Alternative methods of compliance
## Text
(a) The Secretary on his own motion or after having received the petition of an administrator may prescribe an alternative method for satisfying any requirement of this part with respect to any pension plan, or class of pension plans (including pension-linked emergency savings account features within a pension plan), subject to such requirement if he determines—
(1) that the use of such alternative method is consistent with the purposes of this subchapter and that it provides adequate disclosure to the participants and beneficiaries in the plan, and adequate reporting to the Secretary,
(2) that the application of such requirement of this part would—
(A) increase the costs to the plan, or
(B) impose unreasonable administrative burdens with respect to the operation of the plan, having regard to the particular characteristics of the plan or the type of plan involved; and
(3) that the application of this part would be adverse to the interests of plan participants in the aggregate.
(b) An alternative method may be prescribed under subsection (a) by regulation or otherwise. If an alternative method is prescribed other than by regulation, the Secretary shall provide notice and an opportunity for interested persons to present their views, and shall publish in the Federal Register the provisions of such alternative method.
(Pub. L. 93406, title I, § 110, Sept. 2, 1974, 88 Stat. 851; Pub. L. 117328, div. T, title I, § 127(c)(1), Dec. 29, 2022, 136 Stat. 5324.)
## Notes
Editorial Notes
Amendments2022—Subsec. (a). Pub. L. 117328 inserted “(including pension-linked emergency savings account features within a pension plan)” after “class of pension plans” in introductory provisions.
Statutory Notes and Related Subsidiaries
Effective Date of 2022 AmendmentAmendment by Pub. L. 117328 applicable to plan years beginning after Dec. 31, 2023, see section 127(g) of Pub. L. 117328, set out as a note under section 72 of Title 26, Internal Revenue Code.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1030a - Eliminating unnecessary plan requirements related to unenrolled participants
## Text
(a) In general Notwithstanding any other provision of this subchapter, with respect to any individual account plan, no disclosure, notice, or other plan document (other than the notices and documents described in paragraphs (1) and (2)) shall be required to be furnished under this subchapter to any unenrolled participant if the unenrolled participant is furnished—
(1) an annual reminder notice of such participants eligibility to participate in such plan and any applicable election deadlines under the plan; and
(2) any document requested by such participant that the participant would be entitled to receive notwithstanding this section.
(b) Unenrolled participant For purposes of this section, the term “unenrolled participant” means an employee who—
(1) is eligible to participate in an individual account plan;
(2) has been furnished—
(A) the summary plan description pursuant to section 1024(b) of this title, and
(B) any other notices related to eligibility under the plan required to be furnished under this subchapter, or the Internal Revenue Code of 1986, in connection with such participants initial eligibility to participate in such plan;
(3) is not participating in such plan; and
(4) satisfies such other criteria as the Secretary of Labor may determine appropriate, as prescribed in guidance issued in consultation with the Secretary of Treasury.
For purposes of this section, any eligibility to participate in the plan following any period for which such employee was not eligible to participate shall be treated as initial eligibility.
(c) Annual reminder notice For purposes of this section, the term “annual reminder notice” means a notice provided in accordance with section 2520.104b1 of title 29, Code of Federal Regulations (or any successor regulation), which—
(1) is furnished in connection with the annual open season election period with respect to the plan or, if there is no such period, is furnished within a reasonable period prior to the beginning of each plan year;
(2) notifies the unenrolled participant of—
(A) the unenrolled participants eligibility to participate in the plan; and
(B) the key benefits and rights under the plan, with a focus on employer contributions and vesting provisions; and
(3) provides such information in a prominent manner calculated to be understood by the average participant.
(Pub. L. 93406, title I, § 111, as added Pub. L. 117328, div. T, title III, § 320(a)(1), Dec. 29, 2022, 136 Stat. 5354.)
## Notes
Editorial Notes
References in TextThe Internal Revenue Code of 1986, referred to in subsec. (b)(2)(B), is classified generally to Title 26, Internal Revenue Code.
Prior ProvisionsA prior section 111 of Pub. L. 93406 was renumbered section 112 and is classified to section 1031 of this title.
Statutory Notes and Related Subsidiaries
Effective DateSection applicable to plan years beginning after Dec. 31, 2022, see section 320(c) of Pub. L. 117328, set out as an Effective Date of 2022 Amendment note under section 414 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1031 - Repeal and effective date
## Text
(a) (1) The Welfare and Pension Plans Disclosure Act [29 U.S.C. 301 et seq.] is repealed except that such Act shall continue to apply to any conduct and events which occurred before the effective date of this part.
(2) (A) Section 664 of title 18 is amended by striking out “any such plan subject to the provisions of the Welfare and Pension Plans Disclosure Act” and inserting in lieu thereof “any employee benefit plan subject to any provisions of title I of the Employee Retirement Income Security Act of 1974”.
(B) (i) Section 1027 of such title 18 is amended by striking out “Welfare and Pension Plans Disclosure Act” and inserting in lieu thereof “title I of the Employee Retirement Income Security Act of 1974”, and by striking out “Act” each place it appears and inserting in lieu thereof “title”.
(ii) The heading for such section is amended by striking out “welfare and pension plans disclosure act” and inserting in lieu thereof “employee retirement income security act of 1974”.
(iii) The table of sections of chapter 47 of such title 18 is amended by striking out “Welfare and Pension Plans Disclosure Act” in the item relating to section 1027 and inserting in lieu thereof “Employee Retirement Income Security Act of 1974”.
(C) Section 1954 of such title 18 is amended by striking out “any plan subject to the provisions of the Welfare and Pension Plans Disclosure Act as amended” and inserting in lieu thereof “any employee welfare benefit plan or employee pension benefit plan, respectively, subject to any provision of title I of the Employee Retirement Income Security Act of 1974”; and by striking out “sections 3(3) and 5(b)(1) and (2) of the Welfare and Pension Plans Disclosure Act, as amended” and inserting in lieu thereof “sections 3(4) and (3)(16) 11 So in original. Probably should be “3(16)”. of the Employee Retirement Income Security Act of 1974”.
(D) Section 211 of the Labor-Management Reporting and Disclosure Act of 1959 (29 U.S.C. 441) is amended by striking out “Welfare and Pension Plans Disclosure Act” and inserting in lieu thereof “Employee Retirement Income Security Act of 1974”.
(b) (1) Except as provided in paragraph (2), this part (including the amendments and repeals made by subsection (a)) shall take effect on January 1, 1975.
(2) In the case of a plan which has a plan year which begins before January 1, 1975, and ends after December 31, 1974, the Secretary may postpone by regulation the effective date of the repeal of any provision of the Welfare and Pension Plans Disclosure Act (and of any amendment made by subsection (a)(2)) and the effective date of any provision of this part, until the beginning of the first plan year of such plan which begins after January 1, 1975.
(c) The provisions of this subchapter authorizing the Secretary to promulgate regulations shall take effect on September 2, 1974.
(d) Subsections (b) and (c) shall not apply with respect to amendments made to this part in provisions enacted after September 2, 1974.
(Pub. L. 93406, title I, § 112, formerly § 111, Sept. 2, 1974, 88 Stat. 851; Pub. L. 101239, title VII, § 7894(h)(1), Dec. 19, 1989, 103 Stat. 2451; renumbered § 112, Pub. L. 117328, div. T, title III, § 320(a)(1), Dec. 29, 2022, 136 Stat. 5354.)
## Notes
Editorial Notes
References in TextThe Welfare and Pension Plans Disclosure Act, referred to in subsecs. (a) and (b)(2), is Pub. L. 85836, Aug. 28, 1958, 72 Stat. 997, which was classified generally to chapter 10 (§ 301 et seq.) of this title. For complete classification of this Act to the Code, see Short Title note set out under section 301 of this title and Tables. Title I of the Employee Retirement Income Security Act of 1974, referred to in subsec. (a)(2)(A) to (C), means title I of Pub. L. 93406, which enacted this subchapter, amended section 441 of this title, section 5108 of Title 5, Government Organization and Employees, and sections 664, 1027, and 1954 of Title 18, Crimes and Criminal Procedure, and repealed sections 301 to 309 of this title. The Employee Retirement Income Security Act of 1974, referred to in subsec. (a)(2)(B)(ii), (iii), (D), is Pub. L. 93406, Sept. 2, 1974, 88 Stat. 829. Titles I, III, and IV of such act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
Amendments1989—Subsec. (d). Pub. L. 101239 added subsec. (d).
Statutory Notes and Related Subsidiaries
Effective Date of 2022 AmendmentAmendment by Pub. L. 117328 applicable to plan years beginning after Dec. 31, 2022, see section 320(c) of Pub. L. 117328, set out as a note under section 414 of Title 26, Internal Revenue Code.
Effective Date of 1989 AmendmentAmendment by Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
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# 29 U.S.C. § 1032 - Notice and disclosure requirements with respect to lump sums
## Text
(a) In general A plan administrator of a pension plan that amends the plan to provide a period of time during which a participant or beneficiary may elect to receive a lump sum, instead of future monthly payments, shall furnish notice—
(1) to each participant or beneficiary offered such lump sum amount, in the manner in which the participant and beneficiary receives the lump sum offer from the plan sponsor, not later than 90 days prior to the first day on which the participant or beneficiary may make an election with respect to such lump sum; and
(2) to the Secretary and the Pension Benefit Guaranty Corporation, not later than 30 days prior to the first day on which participants and beneficiaries may make an election with respect to such lump sum.
(b) Notice to participants and beneficiaries (1) Content The notice required under subsection (a)(1) shall include the following:
(A) Available benefit options, including the estimated monthly benefit that the participant or beneficiary would receive at normal retirement age, whether there is a subsidized early retirement option or qualified joint and survivor annuity that is fully subsidized (in accordance with section 417(a)(5) of title 26,11 So in original. A closing parenthesis probably should precede the comma. the monthly benefit amount if payments begin immediately, and the lump sum amount available if the participant or beneficiary takes the option.
(B) An explanation of how the lump sum was calculated, including the interest rate, mortality assumptions, and whether any additional plan benefits were included in the lump sum, such as early retirement subsidies.
(C) In a manner consistent with the manner in which a written explanation is required to be given under 417(a)(3) of title 26, the relative value of the lump sum option for a terminated vested participant compared to the value of—
(i) the single life annuity, (or other standard form of benefit); and
(ii) the qualified joint and survivor annuity (as defined in section 1055(d)(1) of this title);
(D) A statement that—
(i) a commercial annuity comparable to the annuity available from the plan may cost more than the amount of the lump sum amount, and
(ii) it may be advisable to consult an advisor regarding this point if the participant or beneficiary is considering purchasing a commercial annuity.
(E) The potential ramifications of accepting the lump sum, including longevity risks, loss of protections guaranteed by the Pension Benefit Guaranty Corporation (with an explanation of the monthly benefit amount that would be protected by the Pension Benefit Guaranty Corporation if the plan is terminated with insufficient assets to pay benefits), loss of protection from creditors, loss of spousal protections, and other protections under this Act that would be lost.
(F) General tax rules related to accepting a lump sum, including rollover options and early distribution penalties with a disclaimer that the plan does not provide tax, legal, or accounting advice, and a suggestion that participants and beneficiaries consult with their own tax, legal, and accounting advisors before determining whether to accept the offer.
(G) How to accept or reject the offer, the deadline for response, and whether a spouse is required to consent to the election.
(H) Contact information for the point of contact at the plan administrator for participants and beneficiaries to get more information or ask questions about the options.
(2) Plain language The notice under this subsection shall be written in a manner calculated to be understood by the average plan participant.
(3) Model notice The Secretary shall issue a model notice for purposes of the notice under subsection (a)(1), including for information required under subparagraphs (C) through (F) of paragraph (1).
(c) Notice to the Secretary and Pension Benefit Guaranty Corporation The notice required under subsection (a)(2) shall include the following:
(1) The total number of participants and beneficiaries eligible for such lump sum option.
(2) The length of the limited period during which the lump sum is offered.
(3) An explanation of how the lump sum was calculated, including the interest rate, mortality assumptions, and whether any additional plan benefits were included in the lump sum, such as early retirement subsidies.
(4) A sample of the notice provided to participants and beneficiaries under subsection (a)(1), if otherwise required.
(d) Post-offer report to the Secretary and Pension Benefit Guaranty Corporation Not later than 90 days after the conclusion of the limited period during which participants and beneficiaries in a plan may accept a plans offer of a lump sum, a plan sponsor shall submit a report to the Secretary and the Director of the Pension Benefit Guaranty Corporation that includes the number of participants and beneficiaries who accepted the lump sum offer and such other information as the Secretary may require.
(e) Public availability The Secretary shall make the information provided in the notice to the Secretary required under subsection (a)(2) and in the post-offer reports submitted under subsection (d) publicly available in a form that protects the confidentiality of the information provided.
(f) Biennial report Not later than the last day of the second calendar year after the calendar year including the applicability date of the final rules under section 342(e) of the SECURE 2.0 Act of 2022, and every 2 years thereafter, so long as the Secretary has received notices and post-offer reports under subsections (c) and (d) of this section, the Secretary shall submit to Congress a report that summarizes such notices and post-offer reports during the applicable reporting period. The applicable reporting period begins on the first day of the second calendar year preceding the calendar year that the report is submitted to Congress and ends on the last day of the calendar year preceding the calendar year the report is due.
(Pub. L. 93406, title I, § 113, as added Pub. L. 117328, div. T, title III, § 342(a), Dec. 29, 2022, 136 Stat. 5376.)
## Notes
Editorial Notes
References in TextSection 342(e) of the SECURE 2.0 Act of 2022, referred to in subsec. (f), is section 342(e) of div. T of Pub. L. 117328, which is set out as a note below.
Statutory Notes and Related Subsidiaries
Effective Date of 2022 AmendmentPub. L. 117328, div. T, title III, § 342(d), Dec. 29, 2022, 136 Stat. 5378, provided that: “The requirements of section 113 of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1032], as added by subsection (b) [probably means subsec. (a) of section 342 of Pub. L. 117328, which enacted this section], shall apply beginning on the applicable effective date specified in the final regulations promulgated pursuant to subsection (e) [set out below].”
RegulationsPub. L. 117328, div. T, title III, § 342(e), Dec. 29, 2022, 136 Stat. 5378, provided that: “Not earlier than 1 year after the date of enactment of this Act [Dec. 29, 2022], the Secretary of Labor, in consultation with the Secretary of the Treasury, shall issue regulations to implement section 113 of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1032], as added by subsection (a). Such regulations shall be applicable not earlier than the issuance of a final rule and not later than 1 year after issuance of a final rule.”
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# 29 U.S.C. § 1051 - Coverage
## Text
This part shall apply to any employee benefit plan described in section 1003(a) of this title (and not exempted under section 1003(b) of this title) other than—
(1) an employee welfare benefit plan;
(2) a plan which is unfunded and is maintained by an employer primarily for the purpose of providing deferred compensation for a select group of management or highly compensated employees;
(3) (A) a plan established and maintained by a society, order, or association described in section 501(c)(8) or (9) of title 26, if no part of the contributions to or under such plan are made by employers of participants in such plan, or
(B) a trust described in section 501(c)(18) of title 26;
(4) a plan which is established and maintained by a labor organization described in section 501(c)(5) of title 26 and which does not at any time after September 2, 1974, provide for employer contributions;
(5) any agreement providing payments to a retired partner or a deceased partners successor in interest, as described in section 736 of title 26;
(6) an individual retirement account or annuity described in section 408 of title 26, or a retirement bond described in section 409 of title 26 (as effective for obligations issued before January 1, 1984);
(7) an excess benefit plan; or
(8) any plan, fund or program under which an employer, all of whose stock is directly or indirectly owned by employees, former employees or their beneficiaries, proposes through an unfunded arrangement to compensate retired employees for benefits which were forfeited by such employees under a pension plan maintained by a former employer prior to the date such pension plan became subject to this chapter.
(Pub. L. 93406, title I, § 201, Sept. 2, 1974, 88 Stat. 852; Pub. L. 96364, title IV, § 411(a), Sept. 26, 1980, 94 Stat. 1308; Pub. L. 101239, title VII, §§ 7891(a)(1), 7894(c)(1)(A), (11)(A), Dec. 19, 1989, 103 Stat. 2445, 2448, 2449.)
## Notes
Editorial Notes
References in TextSection 409 of title 26, referred to in par. (6), means section 409 of Title 26, Internal Revenue Code, prior to its repeal by Pub. L. 98369, div. A, title IV, § 491(b), July 18, 1984, 98 Stat. 848, applicable to obligations issued after Dec. 31, 1983. This chapter, referred to in par. (8), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
Amendments1989—Pars. (3)(A), (4), (5). Pub. L. 101239, § 7891(a)(1), substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text. Par. (6). Pub. L. 101239, § 7891(a)(1), substituted “section 408 of the Internal Revenue Code of 1986” for “section 408 of the Internal Revenue Code of 1954”, which for purposes of codification was translated as “section 408 of title 26” thus requiring no change in text. Pub. L. 101239, § 7894(c)(11)(A), substituted “section 409 of title 26 (as effective for obligations issued before January 1, 1984)” for “section 409 of title 26”. Pub. L. 101239, § 7894(c)(1)(A)(i), struck out “or” after semicolon at end. Par. (7). Pub. L. 101239, § 7894(c)(1)(A)(ii), substituted “plan; or” for “plan.” Par. (8). Pub. L. 101239, § 7894(c)(1)(A)(iii), substituted “any plan” for “Any plan”. 1980—Par. (8). Pub. L. 96364 added par. (8).
Statutory Notes and Related Subsidiaries
Effective Date of 1989 AmendmentAmendment by section 7891(a)(1) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title. Pub. L. 101239, title VII, § 7894(c)(1)(B), Dec. 19, 1989, 103 Stat. 2449, provided that: “The amendments made by subparagraph (A) [amending this section] shall take effect as if included in section 411 of the Multiemployer Pension Plan Amendments Act of 1980 [Pub. L. 96364].” Pub. L. 101239, title VII, § 7894(c)(11)(B), Dec. 19, 1989, 103 Stat. 2449, provided that: “The amendment made by subparagraph (A) [amending this section] shall take effect as if originally included in section 491(b) of Public Law 98369.”
Effective Date of 1980 AmendmentAmendment by Pub. L. 96364 effective Sept. 26, 1980, except as specifically provided, see section 1461(e) of this title.
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# 29 U.S.C. § 1052 - Minimum participation standards
## Text
(a) (1) (A) No pension plan may require, as a condition of participation in the plan, that an employee complete a period of service with the employer or employers maintaining the plan extending beyond the later of the following dates—
(i) the date on which the employee attains the age of 21; or
(ii) the date on which he completes 1 year of service.
(B) (i) In the case of any plan which provides that after not more than 2 years of service each participant has a right to 100 percent of his accrued benefit under the plan which is nonforfeitable at the time such benefit accrues, clause (ii) of subparagraph (A) shall be applied by substituting “2 years of service” for “1 year of service”.
(ii) In the case of any plan maintained exclusively for employees of an educational organization (as defined in section 170(b)(1)(A)(ii) of title 26) by an employer which is exempt from tax under section 501(a) of title 26, which provides that each participant having at least 1 year of service has a right to 100 percent of his accrued benefit under the plan which is nonforfeitable at the time such benefit accrues, clause (i) of subparagraph (A) shall be applied by substituting “26” for “21”. This clause shall not apply to any plan to which clause (i) applies.
(2) No pension plan may exclude from participation (on the basis of age) employees who have attained a specified age.
(3) (A) For purposes of this section, the term “year of service” means a 12-month period during which the employee has not less than 1,000 hours of service. For purposes of this paragraph, computation of any 12-month period shall be made with reference to the date on which the employees employment commenced, except that, in accordance with regulations prescribed by the Secretary, such computation may be made by reference to the first day of a plan year in the case of an employee who does not complete 1,000 hours of service during the 12-month period beginning on the date his employment commenced.
(B) In the case of any seasonal industry where the customary period of employment is less than 1,000 hours during a calendar year, the term “year of service” shall be such period as may be determined under regulations prescribed by the Secretary.
(C) For purposes of this section, the term “hour of service” means a time of service determined under regulations prescribed by the Secretary.
(D) For purposes of this section, in the case of any maritime industry, 125 days of service shall be treated as 1,000 hours of service. The Secretary may prescribe regulations to carry out the purposes of this subparagraph.
(4) A plan shall be treated as not meeting the requirements of paragraph (1) unless it provides that any employee who has satisfied the minimum age and service requirements specified in such paragraph, and who is otherwise entitled to participate in the plan, commences participation in the plan no later than the earlier of—
(A) the first day of the first plan year beginning after the date on which such employee satisfied such requirements, or
(B) the date 6 months after the date on which he satisfied such requirements,
unless such employee was separated from the service before the date referred to in subparagraph (A) or (B), whichever is applicable.
(b) (1) Except as otherwise provided in paragraphs (2), (3), and (4), all years of service with the employer or employers maintaining the plan shall be taken into account in computing the period of service for purposes of subsection (a)(1).
(2) In the case of any employee who has any 1-year break in service (as defined in section 1053(b)(3)(A) of this title) under a plan to which the service requirements of clause (i) of subsection (a)(1)(B) apply, if such employee has not satisfied such requirements, service before such break shall not be required to be taken into account.
(3) In computing an employees period of service for purposes of subsection (a)(1) in the case of any participant who has any 1-year break in service (as defined in section 1053(b)(3)(A) of this title), service before such break shall not be required to be taken into account under the plan until he has completed a year of service (as defined in subsection (a)(3)) after his return.
(4) (A) For purposes of paragraph (1), in the case of a nonvested participant, years of service with the employer or employers maintaining the plan before any period of consecutive 1-year breaks in service shall not be required to be taken into account in computing the period of service if the number of consecutive 1-year breaks in service within such period equals or exceeds the greater of—
(i) 5, or
(ii) the aggregate number of years of service before such period.
(B) If any years of service are not required to be taken into account by reason of a period of breaks in service to which subparagraph (A) applies, such years of service shall not be taken into account in applying subparagraph (A) to a subsequent period of breaks in service.
(C) For purposes of subparagraph (A), the term “nonvested participant” means a participant who does not have any nonforfeitable right under the plan to an accrued benefit derived from employer contributions.
(5) (A) In the case of each individual who is absent from work for any period—
(i) by reason of the pregnancy of the individual,
(ii) by reason of the birth of a child of the individual,
(iii) by reason of the placement of a child with the individual in connection with the adoption of such child by such individual, or
(iv) for purposes of caring for such child for a period beginning immediately following such birth or placement,
the plan shall treat as hours of service, solely for purposes of determining under this subsection whether a 1-year break in service (as defined in section 1053(b)(3)(A) of this title) has occurred, the hours described in subparagraph (B).
(B) The hours described in this subparagraph are—
(i) the hours of service which otherwise would normally have been credited to such individual but for such absence, or
(ii) in any case in which the plan is unable to determine the hours described in clause (i), 8 hours of service per day of such absence,
except that the total number of hours treated as hours of service under this subparagraph by reason of any such pregnancy or placement shall not exceed 501 hours.
(C) The hours described in subparagraph (B) shall be treated as hours of service as provided in this paragraph—
(i) only in the year in which the absence from work begins, if a participant would be prevented from incurring a 1-year break in service in such year solely because the period of absence is treated as hours of service as provided in subparagraph (A); or
(ii) in any other case, in the immediately following year.
(D) For purposes of this paragraph, the term “year” means the period used in computations pursuant to subsection (a)(3)(A).
(E) A plan may provide that no credit will be given pursuant to this paragraph unless the individual furnishes to the plan administrator such timely information as the plan may reasonably require to establish—
(i) that the absence from work is for reasons referred to in subparagraph (A), and
(ii) the number of days for which there was such an absence.
(c) Special Rule for Certain Part-time Employees.— (1) In general.— A pension plan that includes either a qualified cash or deferred arrangement (as defined in section 401(k) of title 26) or a salary reduction agreement (as described in section 403(b) of title 26) shall not require, as a condition of participation in the arrangement or agreement, that an employee complete a period of service with the employer (or employers) maintaining the plan extending beyond the close of the earlier of—
(A) the period permitted under subsection (a)(1) (determined without regard to subparagraph (B)(i) thereof); or
(B) the first 24-month period—
(i) consisting of 2 consecutive 12-month periods during each of which the employee has at least 500 hours of service; and
(ii) by the close of which the employee has met the requirement of subsection (a)(1)(A)(i).
(2) Exception.— Paragraph (1)(B) shall not apply to any employee described in section 410(b)(3) of title 26.
(3) Coordination with time of participation rules.— In the case of employees who are eligible to participate in the arrangement or agreement solely by reason of paragraph (1)(B), or by reason of such paragraph and section 401(k)(2)(D)(ii) of title 26, the rules of subsection (a)(4) shall apply to such employees.
(4) 12-month period.— For purposes of this subsection, 12-month periods shall be determined in the same manner as under the last sentence of subsection (a)(3)(A), except that 12-month periods beginning before January 1, 2023, shall not be taken into account.
(Pub. L. 93406, title I, § 202, Sept. 2, 1974, 88 Stat. 853; Pub. L. 98397, title I, § 102(a), (d)(1), (e)(1), Aug. 23, 1984, 98 Stat. 1426, 1427; Pub. L. 99509, title IX, § 9203(a)(1), Oct. 21, 1986, 100 Stat. 1979; Pub. L. 99514, title XI, § 1113(e)(3), Oct. 22, 1986, 100 Stat. 2448; Pub. L. 101239, title VII, §§ 7861(a)(2), 7891(a)(1), 7892(a), 7894(c)(2), Dec. 19, 1989, 103 Stat. 2430, 2445, 2447, 2449; Pub. L. 117328, div. T, title I, § 125(a)(1), Dec. 29, 2022, 136 Stat. 5314.)
## Notes
Editorial Notes
Amendments2022—Subsec. (c). Pub. L. 117328 added subsec. (c). 1989—Subsec. (a)(1)(B)(i). Pub. L. 101239, § 7861(a)(2), made technical correction to directory language of Pub. L. 99514. See 1986 Amendment note below. Subsec. (a)(1)(B)(ii). Pub. L. 101239, § 7894(c)(2)(A), substituted “educational organization” for “educational institution”. Pub. L. 101239, § 7891(a)(1), substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text. Subsec. (a)(2). Pub. L. 101239, § 7892(a), struck out comma after “specified age”. Subsec. (b)(2). Pub. L. 101239, § 7894(c)(2)(B), substituted “a plan” for “the plan”. 1986—Subsec. (a)(1)(B)(i). Pub. L. 99514, as amended by Pub. L. 101239, § 7861(a)(2), substituted “2 years of service” for “3 years of service” in two places. Subsec. (a)(2). Pub. L. 99509 substituted a period for “unless— “(A) the plan is a— “(i) defined benefit plan, or “(ii) target benefit plan (as defined under regulations prescribed by the Secretary of the Treasury), and “(B) such employees begin employment with the employer after they have attained a specified age which is not more than 5 years before the normal retirement age under the plan.” 1984—Subsec. (a)(1). Pub. L. 98397, § 102(a), substituted “21” for “25” in subpar. (A)(i) and “ 26 for 21 ” for “ 30 for 25 ” in subpar. (B)(ii). Subsec. (b)(4). Pub. L. 98397, § 102(d)(1), amended par. (4) generally. Prior to amendment, par. (4) read as follows: “In the case of an employee who does not have any nonforfeitable right to an accrued benefit derived from employer contributions, years of service with the employer or employers maintaining the plan before a break in service shall not be required to be taken into account in computing the period of service for purposes of subsection (a)(1) if the number of consecutive 1-year breaks in service equals or exceeds the aggregate number of such years of service before such break. Such aggregate number of years of service before such break shall be deemed not to include any years of service not required to be taken into account under this paragraph by reason of any prior break in service.” Subsec. (b)(5). Pub. L. 98397, § 102(e)(1), added par. (5).
Statutory Notes and Related Subsidiaries
Effective Date of 2022 AmendmentAmendment by Pub. L. 117328 applicable to plan years beginning after Dec. 31, 2024, see section 125(f)(1) of Pub. L. 117328, set out as a note under section 401 of Title 26, Internal Revenue Code.
Effective Date of 1989 AmendmentAmendment by section 7861(a)(2) of Pub. L. 101239 effective as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7863 of Pub. L. 101239, set out as a note under section 106 of Title 26, Internal Revenue Code. Amendment by section 7891(a)(1) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title. Pub. L. 101239, title VII, § 7892(c), Dec. 19, 1989, 103 Stat. 2447, provided that: “Any amendment made by this section [amending this section and section 1082 of this title] shall take effect as if included in the provision of the Omnibus Budget Reconciliation Act of 1987 [Pub. L. 100203, probably should refer to Omnibus Budget Reconciliation Act of 1986, Pub. L. 99509] or Pension Protection Act [Pub. L. 100203, §§ 93029346, probably should refer to Omnibus Budget Reconciliation Act of 1987, Pub. L. 100203] to which such amendment relates.” Amendment by section 7894(c)(2) of Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
Effective Date of 1986 AmendmentsAmendment by section 1113(e)(3) of Pub. L. 99514 applicable to plan years beginning after Dec. 31, 1988, with special rule for plans maintained pursuant to collective bargaining agreements ratified before Mar. 1, 1986, and not applicable to employees who do not have 1 hour of service in any plan year to which the amendment applies, see section 1113(f) of Pub. L. 99514, as amended, set out as a note under section 411 of Title 26, Internal Revenue Code. Amendment by Pub. L. 99509 applicable only with respect to plan years beginning on or after Jan. 1, 1988, and only with respect to service performed on or after such date, see section 9204 of Pub. L. 99509, set out as an Effective and Termination Dates of 1986 Amendments note under section 623 of this title.
Effective Date of 1984 AmendmentAmendment by Pub. L. 98397 applicable to plan years beginning after Dec. 31, 1984, except as otherwise provided, see sections 302 and 303 of Pub. L. 98397, set out as a note under section 1001 of this title.
RegulationsSecretary of Labor, Secretary of the Treasury, and Equal Employment Opportunity Commission each to issue before Feb. 1, 1988, final regulations to carry out amendments made by Pub. L. 99509, see section 9204 of Pub. L. 99509, set out as an Effective and Termination Dates of 1986 Amendment note under section 623 of this title. Secretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
Plan Amendments Not Required Until January 1, 1989For provisions directing that if any amendments made by subtitle A or subtitle C of title XI [§§ 11011147 and 11711177] or title XVIII [§§ 18001899A] of Pub. L. 99514 require an amendment to any plan, such plan amendment shall not be required to be made before the first plan year beginning on or after Jan. 1, 1989, see section 1140 of Pub. L. 99514, as amended, set out as a note under section 401 of Title 26, Internal Revenue Code. For provisions directing that if any amendments made by Pub. L. 99509 require an amendment to any plan, such plan amendment shall not be required to be made before the first plan year beginning on or after Jan. 1, 1989, see section 9204 of Pub. L. 99509, set out as an Effective and Termination Dates of 1986 Amendment note under section 623 of this title.
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# 29 U.S.C. § 1057 - Repealed. Pub. L. 109280, title I, § 108(d), formerly § 107(d), Aug. 17, 2006, 120 Stat. 820, renumbered Pub. L. 111192, title II, § 202(a), June 25, 2010, 124 Stat. 1297
## Notes
Section, Pub. L. 93406, title I, § 207, Sept. 2, 1974, 88 Stat. 865, related to temporary variances from certain vesting requirements.
Statutory Notes and Related Subsidiaries
Effective Date of RepealRepeal applicable to plan years beginning after 2007, see section 108(e) of Pub. L. 109280, set out as an Effective Date of 2006 Amendment note under section 1021 of this title.
@@ -0,0 +1,45 @@
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# 29 U.S.C. § 1058 - Mergers and consolidations of plans or transfers of plan assets
## Text
A pension plan may not merge or consolidate with, or transfer its assets or liabilities to, any other plan after September 2, 1974, unless each participant in the plan would (if the plan then terminated) receive a benefit immediately after the merger, consolidation, or transfer which is equal to or greater than the benefit he would have been entitled to receive immediately before the merger, consolidation, or transfer (if the plan had then terminated). The preceding sentence shall not apply to any transaction to the extent that participants either before or after the transaction are covered under a multiemployer plan to which subchapter III of this chapter applies.
(Pub. L. 93406, title I, § 208, Sept. 2, 1974, 88 Stat. 865; Pub. L. 96364, title IV, § 402(b)(1), Sept. 26, 1980, 94 Stat. 1299.)
## Notes
Editorial Notes
Amendments1980—Pub. L. 96364 substituted provisions respecting applicability of preceding sentence to transactions under a covered multiemployer plan to which subchapter III applies, for provisions relating to applicability of paragraph to a multiemployer plan only to extent determined by Corporation.
Statutory Notes and Related Subsidiaries
Effective Date of 1980 AmendmentAmendment by Pub. L. 96364 effective Sept. 26, 1980, except as specifically provided, see section 1461(e) of this title.
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# 29 U.S.C. § 1059 - Recordkeeping and reporting requirements
## Text
(a) (1) Except as provided by paragraph (2) every employer shall, in accordance with such regulations as the Secretary may prescribe, maintain records with respect to each of his employees sufficient to determine the benefits due or which may become due to such employees. The plan administrator shall make a report, in such manner and at such time as may be provided in regulations prescribed by the Secretary, to each employee who is a participant under the plan and who—
(A) requests such report, in such manner and at such time as may be provided in such regulations,
(B) terminates his service with the employer, or
(C) has a 1-year break in service (as defined in section 1053(b)(3)(A) of this title).
The employer shall furnish to the plan administrator the information necessary for the administrator to make the reports required by the preceding sentence. Not more than one report shall be required under subparagraph (A) in any 12-month period. Not more than one report shall be required under subparagraph (C) with respect to consecutive 1-year breaks in service. The report required under this paragraph shall be in the same form, and contain the same information, as periodic benefit statements under section 1025(a) of this title.
(2) If more than one employer adopts a plan, each such employer shall furnish to the plan administrator the information necessary for the administrator to maintain the records, and make the reports, required by paragraph (1). Such administrator shall maintain the records, and make the reports, required by paragraph (1).
(b) If any person who is required, under subsection (a), to furnish information or maintain records for any plan year fails to comply with such requirement, he shall pay to the Secretary a civil penalty of $10 for each employee with respect to whom such failure occurs, unless it is shown that such failure is due to reasonable cause.
(Pub. L. 93406, title I, § 209, Sept. 2, 1974, 88 Stat. 865; Pub. L. 110458, title I, § 105(f), Dec. 23, 2008, 122 Stat. 5105.)
## Notes
Editorial Notes
Amendments2008—Subsec. (a)(1). Pub. L. 110458, § 105(f)(1), in introductory provisions, substituted “such regulations as the Secretary may prescribe” for “regulations prescribed by the Secretary” and, in concluding provisions, inserted last sentence and struck out former last sentence which read as follows: “The report required under this paragraph shall be sufficient to inform the employee of his accrued benefits under the plan and the percentage of such benefits which are nonforfeitable under the plan.” Subsec. (a)(2). Pub. L. 110458, § 105(f)(2), added par. (2) and struck out former par. (2) which read as follows: “If more than one employer adopts a plan, each such employer shall, in accordance with regulations prescribed by the Secretary, furnish to the plan administrator the information necessary for the administrator to maintain the records and make the reports required by paragraph (1). Such administrator shall maintain the records and, to the extent provided under regulations prescribed by the Secretary, make the reports, required by paragraph (1).”
Statutory Notes and Related Subsidiaries
Effective Date of 2008 AmendmentAmendment by Pub. L. 110458 effective as if included in the provisions of Pub. L. 109280 to which the amendment relates, except as otherwise provided, see section 112 of Pub. L. 110458, set out as a note under section 72 of Title 26, Internal Revenue Code.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1060 - Multiple employer plans and other special rules
## Text
(a) Plan maintained by more than one employer Notwithstanding any other provision of this part or part 3, the following provisions of this subsection shall apply to a plan maintained by more than one employer:
(1) Section 1052 of this title shall be applied as if all employees of each of the employers were employed by a single employer.
(2) Sections 1053 and 1054 of this title shall be applied as if all such employers constituted a single employer, except that the application of any rules with respect to breaks in service shall be made under regulations prescribed by the Secretary.
(3) The minimum funding standard provided by section 1082 of this title shall be determined as if all participants in the plan were employed by a single employer.
(b) Maintenance of plan of predecessor employer For purposes of this part and part 3—
(1) in any case in which the employer maintains a plan of a predecessor employer, service for such predecessor shall be treated as service for the employer, and
(2) in any case in which the employer maintains a plan which is not the plan maintained by a predecessor employer, service for such predecessor shall, to the extent provided in regulations prescribed by the Secretary of the Treasury, be treated as service for the employer.
(c) Plan maintained by controlled group of corporations For purposes of sections 1052, 1053, and 1054 of this title, all employees of all corporations which are members of a controlled group of corporations (within the meaning of section 1563(a) of title 26, determined without regard to section 1563(a)(4) and (e)(3)(C) of title 26) shall be treated as employed by a single employer. With respect to a plan adopted by more than one such corporation, the minimum funding standard of section 1082 of this title shall be determined as if all such employers were a single employer, and allocated to each employer in accordance with regulations prescribed by the Secretary of the Treasury.
(d) Plan of trades or businesses under common control For purposes of sections 1052, 1053, and 1054 of this title, under regulations prescribed by the Secretary of the Treasury, all employees of trades or businesses (whether or not incorporated) which are under common control shall be treated as employed by a single employer. The regulations prescribed under this subsection shall be based on principles similar to the principles which apply in the case of subsection (c).
(e) Special rules for eligible combined defined benefit plans and qualified cash or deferred arrangements (1) General rule Except as provided in this subsection, this chapter shall be applied to any defined benefit plan or applicable individual account plan which are 11 So in original. Probably should be “is”. part of an eligible combined plan in the same manner as if each such plan were not a part of the eligible combined plan. In the case of a termination of the defined benefit plan and the applicable defined contribution plan forming part of an eligible combined plan, the plan administrator shall terminate each such plan separately.
(2) Eligible combined plan For purposes of this subsection—
(A) In general The term “eligible combined plan” means a plan—
(i) which is maintained by an employer which, at the time the plan is established, is a small employer,
(ii) which consists of a defined benefit plan and an applicable individual account plan each of which qualifies under section 401(a) of title 26,
(iii) the assets of which are held in a single trust forming part of the plan and are clearly identified and allocated to the defined benefit plan and the applicable individual account plan to the extent necessary for the separate application of this chapter under paragraph (1), and
(iv) with respect to which the benefit, contribution, vesting, and nondiscrimination requirements of subparagraphs (B), (C), (D), (E), and (F) are met.
For purposes of this subparagraph, the term “small employer” has the meaning given such term by section 4980D(d)(2) of title 26, except that such section shall be applied by substituting “500” for “50” each place it appears.
(B) Benefit requirements (i) In general The benefit requirements of this subparagraph are met with respect to the defined benefit plan forming part of the eligible combined plan if the accrued benefit of each participant derived from employer contributions, when expressed as an annual retirement benefit, is not less than the applicable percentage of the participants final average pay. For purposes of this clause, final average pay shall be determined using the period of consecutive years (not exceeding 5) during which the participant had the greatest aggregate compensation from the employer.
(ii) Applicable percentage For purposes of clause (i), the applicable percentage is the lesser of—
(I) 1 percent multiplied by the number of years of service with the employer, or
(II) 20 percent.
(iii) Special rule for applicable defined benefit plans If the defined benefit plan under clause (i) is an applicable defined benefit plan as defined in section 1053(f)(3)(B) of this title which meets the interest credit requirements of section 1054(b)(5)(B)(i) of this title, the plan shall be treated as meeting the requirements of clause (i) with respect to any plan year if each participant receives pay credit for the year which is not less than the percentage of compensation determined in accordance with the following table: If the participants age as of thebeginning of the year is—The percentage is— 30 or less2 Over 30 but less than 404 40 or over but less than 506 50 or over8.
(iv) Years of service For purposes of this subparagraph, years of service shall be determined under the rules of paragraphs (1), (2), and (3) of section 1053(b) of this title, except that the plan may not disregard any year of service because of a participant making, or failing to make, any elective deferral with respect to the qualified cash or deferred arrangement to which subparagraph (C) applies.
(C) Contribution requirements (i) In general The contribution requirements of this subparagraph with respect to any applicable individual account plan forming part of an eligible combined plan are met if—
(I) the qualified cash or deferred arrangement included in such plan constitutes an automatic contribution arrangement, and
(II) the employer is required to make matching contributions on behalf of each employee eligible to participate in the arrangement in an amount equal to 50 percent of the elective contributions of the employee to the extent such elective contributions do not exceed 4 percent of compensation.
Rules similar to the rules of clauses (ii) and (iii) of section 401(k)(12)(B) of title 26 shall apply for purposes of this clause.
(ii) Nonelective contributions An applicable individual account plan shall not be treated as failing to meet the requirements of clause (i) because the employer makes nonelective contributions under the plan but such contributions shall not be taken into account in determining whether the requirements of clause (i)(II) are met.
(D) Vesting requirements The vesting requirements of this subparagraph are met if—
(i) in the case of a defined benefit plan forming part of an eligible combined plan an employee who has completed at least 3 years of service has a nonforfeitable right to 100 percent of the employees accrued benefit under the plan derived from employer contributions, and
(ii) in the case of an applicable individual account plan forming part of eligible combined plan—
(I) an employee has a nonforfeitable right to any matching contribution made under the qualified cash or deferred arrangement included in such plan by an employer with respect to any elective contribution, including matching contributions in excess of the contributions required under subparagraph (C)(i)(II), and
(II) an employee who has completed at least 3 years of service has a nonforfeitable right to 100 percent of the employees accrued benefit derived under the arrangement from nonelective contributions of the employer.
For purposes of this subparagraph, the rules of section 1053 of this title shall apply to the extent not inconsistent with this subparagraph.
(E) Uniform provision of contributions and benefits In the case of a defined benefit plan or applicable individual account plan forming part of an eligible combined plan, the requirements of this subparagraph are met if all contributions and benefits under each such plan, and all rights and features under each such plan, must be provided uniformly to all participants.
(F) Requirements must be met without taking into account social security and similar contributions and benefits or other plans (i) In general The requirements of this subparagraph are met if the requirements of clauses (ii) and (iii) are met.
(ii) Social security and similar contributions The requirements of this clause are met if—
(I) the requirements of subparagraphs (B) and (C) are met without regard to section 401(l) of title 26, and
(II) the requirements of sections 401(a)(4) and 410(b) of title 26 are met with respect to both the applicable defined contribution plan and defined benefit plan forming part of an eligible combined plan without regard to section 401(l) of title 26.
(iii) Other plans and arrangements The requirements of this clause are met if the applicable defined contribution plan and defined benefit plan forming part of an eligible combined plan meet the requirements of sections 401(a)(4) and 410(b) of title 26 without being combined with any other plan.
(3) Automatic contribution arrangement For purposes of this subsection—
(A) In general A qualified cash or deferred arrangement shall be treated as an automatic contribution arrangement if the arrangement—
(i) provides that each employee eligible to participate in the arrangement is treated as having elected to have the employer make elective contributions in an amount equal to 4 percent of the employees compensation unless the employee specifically elects not to have such contributions made or to have such contributions made at a different rate, and
(ii) meets the notice requirements under subparagraph (B).
(B) Notice requirements (i) In general The requirements of this subparagraph are met if the requirements of clauses (ii) and (iii) are met.
(ii) Reasonable period to make election The requirements of this clause are met if each employee to whom subparagraph (A)(i) applies—
(I) receives a notice explaining the employees right under the arrangement to elect not to have elective contributions made on the employees behalf or to have the contributions made at a different rate, and
(II) has a reasonable period of time after receipt of such notice and before the first elective contribution is made to make such election.
(iii) Annual notice of rights and obligations The requirements of this clause are met if each employee eligible to participate in the arrangement is, within a reasonable period before any year, given notice of the employees rights and obligations under the arrangement.
The requirements of this subparagraph shall not be treated as met unless the requirements of clauses (i) and (ii) of section 401(k)(12)(D) of title 26 are met with respect to the notices described in clauses (ii) and (iii) of this subparagraph.
(4) Coordination with other requirements (A) Treatment of separate plans The except clause in section 1002(35) of this title shall not apply to an eligible combined plan.
(B) Reporting An eligible combined plan shall be treated as a single plan for purposes of section 1023 of this title.
(5) Applicable individual account plan For purposes of this subsection—
(A) In general The term “applicable individual account plan” means an individual account plan which includes a qualified cash or deferred arrangement.
(B) Qualified cash or deferred arrangement The term “qualified cash or deferred arrangement” has the meaning given such term by section 401(k)(2) of title 26.
(f) Cooperative and small employer charity pension plans (1) In general For purposes of this subchapter, except as provided in this subsection, a CSEC plan is an employee pension benefit plan (other than a multiemployer plan) that is a defined benefit plan—
(A) to which section 104 of the Pension Protection Act of 2006 applies, without regard to—
(i) section 104(a)(2) of such Act;
(ii) the amendments to such section 104 by section 202(b) of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010; and
(iii) paragraph (3)(B);
(B) that, as of June 25, 2010, was maintained by more than one employer and all of the employers were organizations described in section 501(c)(3) of title 26;
(C) that, as of June 25, 2010, was maintained by an employer—
(i) described in section 501(c)(3) of such title,
(ii) chartered under part B of subtitle II of title 36,
(iii) with employees in at least 40 States, and
(iv) whose primary exempt purpose is to provide services with respect to children; or
(D) that, as of January 1, 2000, was maintained by an employer—
(i) described in section 501(c)(3) of title 26,
(ii) who has been in existence since at least 1938,
(iii) who conducts medical research directly or indirectly through grant making, and
(iv) whose primary exempt purpose is to provide services with respect to mothers and children.
(2) Aggregation All employers that are treated as a single employer under subsection (b) or (c) of section 414 of title 26 shall be treated as a single employer for purposes of determining if a plan was maintained by more than one employer under subparagraph 22 So in original. Probably should be “subparagraphs”. (B) and (C) of paragraph (1).
(3) Election (A) In general If a plan falls within the definition of a CSEC plan under this subsection (without regard to this paragraph), such plan shall be a CSEC plan unless the plan sponsor elects not later than the close of the first plan year of the plan beginning after December 31, 2013, not to be treated as a CSEC plan. An election under the preceding sentence shall take effect for such plan year and, once made, may be revoked only with the consent of the Secretary of the Treasury.
(B) Special rule If a plan described in subparagraph (A) is treated as a CSEC plan, section 104 of the Pension Protection Act of 2006, as amended by the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, shall cease to apply to such plan as of the first date as of which such plan is treated as a CSEC plan.
(Pub. L. 93406, title I, § 210, Sept. 2, 1974, 88 Stat. 866; Pub. L. 101239, title VII, §§ 7891(a)(1), 7894(c)(10), Dec. 19, 1989, 103 Stat. 2445, 2449; Pub. L. 109280, title IX, § 903(b)(1), (2)(A), Aug. 17, 2006, 120 Stat. 1044, 1048; Pub. L. 110458, title I, § 109(c)(2), Dec. 23, 2008, 122 Stat. 5111; Pub. L. 11397, title I, §§ 101, 103(a), Apr. 7, 2014, 128 Stat. 1102, 1117; Pub. L. 113235, div. P, § 3(a), Dec. 16, 2014, 128 Stat. 2829; Pub. L. 116136, div. A, title III, § 3609(a), Mar. 27, 2020, 134 Stat. 413.)
## Notes
Editorial Notes
References in TextThis chapter, referred to in subsec. (e)(1), (2)(A)(iii), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables. Section 104 of the Pension Protection Act of 2006, referred to in subsec. (f)(1)(A), (3)(B), is section 104 of Pub. L. 109280, which is set out as a note under section 401 of Title 26, Internal Revenue Code. The Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010, referred to in subsec. (f)(3)(B), is Pub. L. 111192, June 25, 2010, 124 Stat. 1280. For complete classification of this Act to the Code, see Short Title of 2010 Amendment note set out under section 1001 of this title and Tables.
Amendments2020—Subsec. (f)(1)(D). Pub. L. 116136 added subpar. (D). 2014—Subsec. (f). Pub. L. 11397, § 101, added subsec. (f). Subsec. (f)(1)(C). Pub. L. 113235, § 3(a)(1), added subpar. (C). Subsec. (f)(2). Pub. L. 113235, § 3(a)(2), substituted “subparagraph (B) and (C) of paragraph (1)” for “paragraph (1)(B)”. Subsec. (f)(3). Pub. L. 11397, § 103(a), added par. (3). 2008—Subsec. (e)(1). Pub. L. 110458, § 109(c)(2)(A), inserted at end “In the case of a termination of the defined benefit plan and the applicable defined contribution plan forming part of an eligible combined plan, the plan administrator shall terminate each such plan separately.” Subsec. (e)(3) to (6). Pub. L. 110458, § 109(c)(2)(B), struck out par. (3) and redesignated pars. (4) to (6) as (3) to (5), respectively. Former par. (3) related to nondiscrimination requirements for qualified cash or deferred arrangement. 2006—Pub. L. 109280, § 903(b)(2)(A), inserted “and other special rules” after “plans” in section catchline. Subsec. (e). Pub. L. 109280, § 903(b)(1), added subsec. (e). 1989—Subsec. (c). Pub. L. 101239, § 7894(c)(10), substituted “and (e)(3)(C) of such Code” for “and (e)(3)(C) of such code”, which for purposes of codification was translated as “and (e)(3)(C) of title 26” thus requiring no change in text. Pub. L. 101239, § 7891(a)(1), substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text.
Statutory Notes and Related Subsidiaries
Effective Date of 2020 AmendmentAmendment by Pub. L. 116136 applicable to plan years beginning after Dec. 31, 2018, see section 3609(c) of Pub. L. 116136, set out as a note under section 414 of Title 26, Internal Revenue Code.
Effective Date of 2014 AmendmentAmendments by Pub. L. 113235 effective as if included in the amendments made by the Cooperative and Small Employer Charity Pension Flexibility Act, Pub. L. 11397, see section 3(c) of Pub. L. 113235, set out as a note under section 414 of Title 26, Internal Revenue Code. Amendment by section 101 of Pub. L. 11397 applicable to years beginning after Dec. 31, 2013, see section 3 of Pub. L. 11397, set out as a note under section 401 of Title 26, Internal Revenue Code. Pub. L. 11397, title I, § 103(d), Apr. 7, 2014, 128 Stat. 1120, provided that: “The amendments made by this section [amending this section and provisions set out as a note under section 401 of Title 26, Internal Revenue Code] shall apply as of the date of enactment of this Act [Apr. 7, 2014].”
Effective Date of 2008 AmendmentAmendment by Pub. L. 110458 effective as if included in the provisions of Pub. L. 109280 to which the amendment relates, except as otherwise provided, see section 112 of Pub. L. 110458, set out as a note under section 72 of Title 26, Internal Revenue Code.
Effective Date of 2006 AmendmentAmendment by Pub. L. 109280 applicable to plan years beginning after Dec. 31, 2009, see section 903(c) of Pub. L. 109280, set out as a note under section 414 of Title 26, Internal Revenue Code.
Effective Date of 1989 AmendmentAmendment by section 7891(a)(1) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title. Amendment by section 7894(c)(10) of Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1061 - Effective dates
## Text
(a) Except as otherwise provided in this section, this part shall apply in the case of plan years beginning after September 2, 1974.
(b) (1) Except as otherwise provided in subsection (d), sections 1055, 1056(d) and 1058 of this title shall apply with respect to plan years beginning after December 31, 1975.
(2) Except as otherwise provided in subsections (c) and (d) in the case of a plan in existence on January 1, 1974, this part shall apply in the case of plan years beginning after December 31, 1975.
(c) (1) In the case of a plan maintained on January 1, 1974, pursuant to one or more agreements which the Secretary finds to be collective bargaining agreements between employee organizations and one or more employers, no plan shall be treated as not meeting the requirements of sections 1054 and 1055 of this title by reason of a supplementary or special plan provision (within the meaning of paragraph (2)) for any plan year before the year which begins after the earlier of—
(A) the date on which the last of such agreements relating to the plan terminates (determined without regard to any extension thereof agreed to after September 2, 1974), or
(B) December 31, 1980.
For purposes of subparagraph (A) and section 1086(c) 11 See References in Text note below. of this title, any plan amendment made pursuant to a collective bargaining agreement relating to the plan which amends the plan solely to conform to any requirement contained in this chapter or title 26 shall not be treated as a termination of such collective bargaining agreement. This paragraph shall not apply unless the Secretary determines that the participation and vesting rules in effect on September 2, 1974, are not less favorable to participants, in the aggregate, than the rules provided under sections 1052, 1053, and 1054 of this title.
(2) For purposes of paragraph (1), the term “supplementary or special plan provision” means any plan provision which—
(A) provides supplementary benefits, not in excess of one-third of the basic benefit, in the form of an annuity for the life of the participant, or
(B) provides that, under a contractual agreement based on medical evidence as to the effects of working in an adverse environment for an extended period of time, a participant having 25 years of service is to be treated as having 30 years of service.
(3) This subsection shall apply with respect to a plan if (and only if) the application of this subsection results in a later effective date for this part than the effective date required by subsection (b).
(d) If the administrator of a plan elects under section 1017(d) of this Act to make applicable to a plan year and to all subsequent plan years the provisions of title 26 relating to participation, vesting, funding, and form of benefit, this part shall apply to the first plan year to which such election applies and to all subsequent plan years.
(e) (1) No pension plan to which section 1052 of this title applies may make effective any plan amendment with respect to breaks in service (which amendment is made or becomes effective after January 1, 1974, and before the date on which section 1052 of this title first becomes effective with respect to such plan) which provides that any employees participation in the plan would commence at any date later than the later of—
(A) the date on which his participation would commence under the break in service rules of section 1052(b) of this title, or
(B) the date on which his participation would commence under the plan as in effect on January 1, 1974.
(2) No pension plan to which section 1053 of this title applies may make effective any plan amendment with respect to breaks in service (which amendment is made or becomes effective after January 1, 1974, and before the date on which section 1053 of this title first becomes effective with respect to such plan) if such amendment provides that the nonforfeitable benefit derived from employer contributions to which any employee would be entitled is less than the lesser of the nonforfeitable benefit derived from employer contributions to which he would be entitled under—
(A) the break in service rules of section 1052(b)(3) of this title, or
(B) the plan as in effect on January 1, 1974.
Subparagraph (B) shall not apply if the break in service rules under the plan would have been in violation of any law or rule of law in effect on January 1, 1974.
(f) The preceding provisions of this section shall not apply with respect to amendments made to this part in provisions enacted after September 2, 1974.
(Pub. L. 93406, title I, § 211, Sept. 2, 1974, 88 Stat. 867; Pub. L. 99272, title XI, § 11015(a)(1)(B), Apr. 7, 1986, 100 Stat. 265; Pub. L. 101239, title VII, §§ 7891(a)(1), 7894(h)(2), Dec. 19, 1989, 103 Stat. 2445, 2451.)
## Notes
Editorial Notes
References in TextSection 1086(c) of this title, referred to in subsec. (c)(1), was in the original “section 307(c)”, meaning section 307(c) of Pub. L. 93406, the Employee Retirement Income Security Act of 1974. Section 307(c) was renumbered section 308(c) by Pub. L. 100203, title IX, § 9341(b)(1), Dec. 22, 1987, 101 Stat. 1330370 and subsequently was repealed by Pub. L. 109280, title I, § 101(a), Aug. 17, 2006, 120 Stat. 784. This chapter, referred to in subsec. (c)(1), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables. Section 1017(d) of this Act, referred to in subsec. (d), is section 1017 of Pub. L. 93406, which is set out as an Effective Date; Transitional Rules note under section 410 of Title 26.
Amendments1989—Subsecs. (c)(1), (d). Pub. L. 101239, § 7891(a)(1), substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26”. Subsec. (f). Pub. L. 101239, § 7894(h)(2), added subsec. (f). 1986—Subsec. (c)(1). Pub. L. 99272 made a technical amendment to the reference to section 1086(c) of this title to reflect the renumbering of the corresponding section of the original act.
Statutory Notes and Related Subsidiaries
Effective Date of 1989 AmendmentAmendment by section 7891(a)(1) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title. Amendment by section 7894(h)(2) of Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
Effective Date of 1986 AmendmentAmendment by Pub. L. 99272 applicable with respect to applications for waivers, extensions, and modifications filed on or after Apr. 7, 1986, see section 11015(a)(3) of Pub. L. 99272, set out as an Effective Date note under section 412 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1081 - Coverage
## Text
(a) Plans excepted from applicability of this part This part shall apply to any employee pension benefit plan described in section 1003(a) of this title, (and not exempted under section 1003(b) of this title), other than—
(1) an employee welfare benefit plan;
(2) an insurance contract plan described in subsection (b);
(3) a plan which is unfunded and is maintained by an employer primarily for the purpose of providing deferred compensation for a select group of management or highly compensated employees;
(4) (A) a plan which is established and maintained by a society, order, or association described in section 501(c)(8) or (9) of title 26, if no part of the contributions to or under such plan are made by employers of participants in such plan; or
(B) a trust described in section 501(c)(18) of title 26;
(5) a plan which has not at any time after September 2, 1974, provided for employer contributions;
(6) an agreement providing payments to a retired partner or deceased partner or a deceased partners successor in interest as described in section 736 of title 26;
(7) an individual retirement account or annuity as described in section 408(a) of title 26, or a retirement bond described in section 409 of title 26 (as effective for obligations issued before January 1, 1984);
(8) an individual account plan (other than a money purchase plan) and a defined benefit plan to the extent it is treated as an individual account plan (other than a money purchase plan) under section 1002(35)(B) of this title;
(9) an excess benefit plan; or
(10) any plan, fund or program under which an employer, all of whose stock is directly or indirectly owned by employees, former employees or their beneficiaries, proposes through an unfunded arrangement to compensate retired employees for benefits which were forfeited by such employees under a pension plan maintained by a former employer prior to the date such pension plan became subject to this chapter.
(b) “Insurance contract plan” defined For the purposes of paragraph (2) of subsection (a) a plan is an “insurance contract plan” if—
(1) the plan is funded exclusively by the purchase of individual insurance contracts,
(2) such contracts provide for level annual premium payments to be paid extending not later than the retirement age for each individual participating in the plan, and commencing with the date the individual became a participant in the plan (or, in the case of an increase in benefits, commencing at the time such increase became effective),
(3) benefits provided by the plan are equal to the benefits provided under each contract at normal retirement age under the plan and are guaranteed by an insurance carrier (licensed under the laws of a State to do business with the plan) to the extent premiums have been paid,
(4) premiums payable for the plan year, and all prior plan years under such contracts have been paid before lapse or there is reinstatement of the policy,
(5) no rights under such contracts have been subject to a security interest at any time during the plan year, and
(6) no policy loans are outstanding at any time during the plan year.
A plan funded exclusively by the purchase of group insurance contracts which is determined under regulations prescribed by the Secretary of the Treasury to have the same characteristics as contracts described in the preceding sentence shall be treated as a plan described in this subsection.
(c) Applicability of this part to terminated multiemployer plans This part applies, with respect to a terminated multiemployer plan to which section 1321 of this title applies, until the last day of the plan year in which the plan terminates, within the meaning of section 1341a(a)(2) of this title.
(Pub. L. 93406, title I, § 301, Sept. 2, 1974, 88 Stat. 868; Pub. L. 96364, title III, § 304(a), title IV, § 411(b), Sept. 26, 1980, 94 Stat. 1293, 1308; Pub. L. 101239, title VII, §§ 7891(a)(1), 7894(d)(1)(A), (4)(A), Dec. 19, 1989, 103 Stat. 2445, 2449; Pub. L. 109280, title II, § 201(c)(1), Aug. 17, 2006, 120 Stat. 868.)
## Notes
Editorial Notes
References in TextSection 409 of title 26, referred to in subsec. (a)(7), means section 409 of Title 26, Internal Revenue Code, prior to its repeal by Pub. L. 98369, div. A, title IV, § 491(b), July 18, 1984, 98 Stat. 848, applicable to obligations issued after Dec. 31, 1983. This chapter, referred to in subsec. (a)(10), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
Amendments2006—Subsec. (d). Pub. L. 109280 struck out heading and text of subsec. (d). Text read as follows: “Any amount of any financial assistance from the Pension Benefit Guaranty Corporation to any plan, and any repayment of such amount, shall be taken into account under this section in such manner as determined by the Secretary of the Treasury.” 1989—Subsec. (a)(4)(A), (6). Pub. L. 101239, § 7891(a)(1), substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text. Subsec. (a)(7). Pub. L. 101239, § 7894(d)(4)(A), substituted “section 409 of title 26 (as effective for obligations issued before January 1, 1984)” for “section 409 of title 26”. Subsec. (a)(8). Pub. L. 101239, § 7894(d)(1)(A)(i), struck out “or” after semicolon at end. Subsec. (a)(9). Pub. L. 101239, § 7894(d)(1)(A)(ii), substituted “; or” for period at end. Subsec. (a)(10). Pub. L. 101239, § 7894(d)(1)(A)(iii), substituted “any” for “Any”. 1980—Subsec. (a)(10). Pub. L. 96364, § 411(b), added par. (10). Subsecs. (c), (d). Pub. L. 96364, § 304(a), added subsecs. (c) and (d).
Statutory Notes and Related Subsidiaries
Effective Date of 2006 AmendmentPub. L. 109280, title II, § 201(d), Aug. 17, 2006, 120 Stat. 868, provided that: “(1) In general.—The amendments made by this section [enacting section 1084 of this title and amending this section] shall apply to plan years beginning after 2007. “(2) Special rule for certain amortization extensions.—If the Secretary of the Treasury grants an extension under section 304 of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1084] and section 412(e) of the Internal Revenue Code of 1986 [former 26 U.S.C. 412(e)] with respect to any application filed with the Secretary of the Treasury on or before June 30, 2005, the extension (and any modification thereof) shall be applied and administered under the rules of such sections as in effect before the enactment of this Act [Aug. 17, 2006], including the use of the rate of interest determined under section 6621(b) of such Code [26 U.S.C. 6621(b)].”
Effective Date of 1989 AmendmentAmendment by section 7891(a)(1) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title. Section 7894(d)(1)(B) of Pub. L. 101239 provided that: “The amendments made by subparagraph (A) [amending this section] shall take effect as if included in section 411 of the Multiemployer Pension Plan Amendments Act of 1980 [Pub. L. 96364].” Section 7894(d)(4)(B) of Pub. L. 101239 provided that: “The amendment made by subparagraph (A) [amending this section] shall take effect as if originally included in section 491(b) of Public Law 98369.”
Effective Date of 1980 AmendmentAmendment by Pub. L. 96364 effective Sept. 26, 1980, except as specifically provided, see section 1461(e) of this title.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
Special Rule for Certain Benefits Funded Under an Agreement Approved by the Pension Benefit Guaranty CorporationFor applicability of amendment by Pub. L. 109280 to a multiemployer plan that is a party to an agreement that was approved by the Pension Benefit Guaranty Corporation prior to June 30, 2005, and that increases benefits and provides for certain withdrawal liability rules, see section 206 of Pub. L. 109280, set out as a note under section 412 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1082 - Minimum funding standards
## Text
(a) Requirement to meet minimum funding standard (1) In general A plan to which this part applies shall satisfy the minimum funding standard applicable to the plan for any plan year.
(2) Minimum funding standard For purposes of paragraph (1), a plan shall be treated as satisfying the minimum funding standard for a plan year if—
(A) in the case of a defined benefit plan which is a single-employer plan (other than a CSEC plan), the employer makes contributions to or under the plan for the plan year which, in the aggregate, are not less than the minimum required contribution determined under section 1083 of this title for the plan for the plan year,
(B) in the case of a money purchase plan which is a single-employer plan, the employer makes contributions to or under the plan for the plan year which are required under the terms of the plan,
(C) in the case of a multiemployer plan, the employers make contributions to or under the plan for any plan year which, in the aggregate, are sufficient to ensure that the plan does not have an accumulated funding deficiency under section 1084 of this title as of the end of the plan year, and
(D) in the case of a CSEC plan, the employers make contributions to or under the plan for any plan year which, in the aggregate, are sufficient to ensure that the plan does not have an accumulated funding deficiency under section 1085a of this title as of the end of the plan year.
(b) Liability for contributions (1) In general Except as provided in paragraph (2), the amount of any contribution required by this section (including any required installments under paragraphs (3) and (4) of section 1083(j) of this title or under section 1085a(f) of this title) shall be paid by the employer responsible for making contributions to or under the plan.
(2) Joint and several liability where employer member of controlled group If the employer referred to in paragraph (1) is a member of a controlled group, each member of such group shall be jointly and severally liable for payment of such contributions.
(3) Multiemployer plans in critical status Paragraph (1) shall not apply in the case of a multiemployer plan for any plan year in which the plan is in critical status pursuant to section 1085 of this title. This paragraph shall only apply if the plan sponsor adopts a rehabilitation plan in accordance with section 1085(e) of this title and complies with the terms of such rehabilitation plan (and any updates or modifications of the plan).
(c) Variance from minimum funding standards (1) Waiver in case of business hardship (A) In general If—
(i) an employer is (or in the case of a multiemployer plan or a CSEC plan, 10 percent or more of the number of employers contributing to or under the plan are) unable to satisfy the minimum funding standard for a plan year without temporary substantial business hardship (substantial business hardship in the case of a multiemployer plan), and
(ii) application of the standard would be adverse to the interests of plan participants in the aggregate,
the Secretary of the Treasury may, subject to subparagraph (C), waive the requirements of subsection (a) for such year with respect to all or any portion of the minimum funding standard. The Secretary of the Treasury shall not waive the minimum funding standard with respect to a plan for more than 3 of any 15 (5 of any 15 in the case of a multiemployer plan) consecutive plan years.
(B) Effects of waiver If a waiver is granted under subparagraph (A) for any plan year—
(i) in the case of a single-employer plan (other than a CSEC plan), the minimum required contribution under section 1083 of this title for the plan year shall be reduced by the amount of the waived funding deficiency and such amount shall be amortized as required under section 1083(e) of this title,
(ii) in the case of a multiemployer plan, the funding standard account shall be credited under section 1084(b)(3)(C) of this title with the amount of the waived funding deficiency and such amount shall be amortized as required under section 1084(b)(2)(C) of this title, and
(iii) in the case of a CSEC plan, the funding standard account shall be credited under section 1085a(b)(3)(C) of this title with the amount of the waived funding deficiency and such amount shall be amortized as required under section 1085a(b)(2)(C) of this title.
(C) Waiver of amortized portion not allowed The Secretary of the Treasury may not waive under subparagraph (A) any portion of the minimum funding standard under subsection (a) for a plan year which is attributable to any waived funding deficiency for any preceding plan year.
(2) Determination of business hardship For purposes of this subsection, the factors taken into account in determining temporary substantial business hardship (substantial business hardship in the case of a multiemployer plan) shall include (but shall not be limited to) whether or not—
(A) the employer is operating at an economic loss,
(B) there is substantial unemployment or underemployment in the trade or business and in the industry concerned,
(C) the sales and profits of the industry concerned are depressed or declining, and
(D) it is reasonable to expect that the plan will be continued only if the waiver is granted.
(3) Waived funding deficiency For purposes of this part, the term “waived funding deficiency” means the portion of the minimum funding standard under subsection (a) (determined without regard to the waiver) for a plan year waived by the Secretary of the Treasury and not satisfied by employer contributions.
(4) Security for waivers for single-employer plans, consultations (A) Security may be required (i) In general Except as provided in subparagraph (C), the Secretary of the Treasury may require an employer maintaining a defined benefit plan which is a single-employer plan (within the meaning of section 1301(a)(15) of this title) to provide security to such plan as a condition for granting or modifying a waiver under paragraph (1) or for granting an extension under section 1085a(d) of this title.
(ii) Special rules Any security provided under clause (i) may be perfected and enforced only by the Pension Benefit Guaranty Corporation, or at the direction of the Corporation, by a contributing sponsor (within the meaning of section 1301(a)(13) of this title), or a member of such sponsors controlled group (within the meaning of section 1301(a)(14) of this title).
(B) Consultation with the Pension Benefit Guaranty Corporation Except as provided in subparagraph (C), the Secretary of the Treasury shall, before granting or modifying a waiver under this subsection or an extension under 1085a(d) 11 So in original. Probably should be preceded by “section”. of this title with respect to a plan described in subparagraph (A)(i)—
(i) provide the Pension Benefit Guaranty Corporation with—
(I) notice of the completed application for any waiver, modification, or extension, and
(II) an opportunity to comment on such application within 30 days after receipt of such notice, and
(ii) consider—
(I) any comments of the Corporation under clause (i)(II), and
(II) any views of any employee organization (within the meaning of section 1002(4) of this title) representing participants in the plan which are submitted in writing to the Secretary of the Treasury in connection with such application.
Information provided to the Corporation under this subparagraph shall be considered tax return information and subject to the safeguarding and reporting requirements of section 6103(p) of title 26.
(C) Exception for certain waivers or extensions (i) In general The preceding provisions of this paragraph shall not apply to any plan with respect to which the sum of—
(I) the aggregate unpaid minimum required contributions for the plan year and all preceding plan years, or the accumulated funding deficiency under section 1085a of this title, whichever is applicable,
(II) the present value of all waiver amortization installments determined for the plan year and succeeding plan years under section 1083(e)(2) or 1085a(b)(2)(C) of this title, whichever is applicable, and
(III) the total amounts not paid by reason of an extension in effect under section 1085a(d) of this title,
is less than $1,000,000.
(ii) Treatment of waivers or extensions for which applications are pending The amount described in clause (i)(I) shall include any increase in such amount which would result if all applications for waivers or extensions with respect to the minimum funding standard under this subsection which are pending with respect to such plan were denied.
(iii) Unpaid minimum required contribution For purposes of this subparagraph—
(I) In general The term “unpaid minimum required contribution” means, with respect to any plan year, any minimum required contribution under section 1083 of this title for the plan year which is not paid on or before the due date (as determined under section 1083(j)(1) of this title) for the plan year.
(II) Ordering rule For purposes of subclause (I), any payment to or under a plan for any plan year shall be allocated first to unpaid minimum required contributions for all preceding plan years on a first-in, first-out basis and then to the minimum required contribution under section 1083 of this title for the plan year.
(5) Special rules for single-employer plans (A) Application must be submitted before date 2½ months after close of year In the case of a single-employer plan, no waiver may be granted under this subsection with respect to any plan for any plan year unless an application therefor is submitted to the Secretary of the Treasury not later than the 15th day of the 3rd month beginning after the close of such plan year.
(B) Special rule if employer is member of controlled group In the case of a single-employer plan, if an employer is a member of a controlled group, the temporary substantial business hardship requirements of paragraph (1) shall be treated as met only if such requirements are met—
(i) with respect to such employer, and
(ii) with respect to the controlled group of which such employer is a member (determined by treating all members of such group as a single employer).
The Secretary of the Treasury may provide that an analysis of a trade or business or industry of a member need not be conducted if such Secretary determines such analysis is not necessary because the taking into account of such member would not significantly affect the determination under this paragraph.
(6) Advance notice (A) In general The Secretary of the Treasury shall, before granting a waiver under this subsection, require each applicant to provide evidence satisfactory to such Secretary that the applicant has provided notice of the filing of the application for such waiver to each affected party (as defined in section 1301(a)(21) of this title). Such notice shall include a description of the extent to which the plan is funded for benefits which are guaranteed under subchapter III and for benefit liabilities.
(B) Consideration of relevant information The Secretary of the Treasury shall consider any relevant information provided by a person to whom notice was given under subparagraph (A).
(7) Restriction on plan amendments (A) In general No amendment of a plan which increases the liabilities of the plan by reason of any increase in benefits, any change in the accrual of benefits, or any change in the rate at which benefits become nonforfeitable under the plan shall be adopted if a waiver under this subsection or an extension of time under section 1084(d) of this title or section 1085a(d) of this title is in effect with respect to the plan, or if a plan amendment described in subsection (d)(2) which reduces the accrued benefit of any participant has been made at any time in the preceding 12 months (24 months in the case of a multiemployer plan). If a plan is amended in violation of the preceding sentence, any such waiver, or extension of time, shall not apply to any plan year ending on or after the date on which such amendment is adopted.
(B) Exception Subparagraph (A) shall not apply to any plan amendment which—
(i) the Secretary of the Treasury determines to be reasonable and which provides for only de minimis increases in the liabilities of the plan,
(ii) only repeals an amendment described in subsection (d)(2), or
(iii) is required as a condition of qualification under part I of subchapter D of chapter 1 of title 26.
(8) Cross reference For corresponding duties of the Secretary of the Treasury with regard to implementation of title 26, see section 412(c) of title 26.
(d) Miscellaneous rules (1) Change in method or year If the funding method or a plan year for a plan is changed, the change shall take effect only if approved by the Secretary of the Treasury.
(2) Certain retroactive plan amendments For purposes of this section, any amendment applying to a plan year which—
(A) is adopted after the close of such plan year but no later than 2½ months after the close of the plan year (or, in the case of a multiemployer plan, no later than 2 years after the close of such plan year),
(B) does not reduce the accrued benefit of any participant determined as of the beginning of the first plan year to which the amendment applies, and
(C) does not reduce the accrued benefit of any participant determined as of the time of adoption except to the extent required by the circumstances,
shall, at the election of the plan administrator, be deemed to have been made on the first day of such plan year. No amendment described in this paragraph which reduces the accrued benefits of any participant shall take effect unless the plan administrator files a notice with the Secretary of the Treasury notifying him of such amendment and such Secretary has approved such amendment, or within 90 days after the date on which such notice was filed, failed to disapprove such amendment. No amendment described in this subsection shall be approved by the Secretary of the Treasury unless such Secretary determines that such amendment is necessary because of a temporary substantial business hardship (as determined under subsection (c)(2)) or a substantial business hardship (as so determined) in the case of a multiemployer plan and that a waiver under subsection (c) (or, in the case of a multiemployer plan or a CSEC plan, any extension of the amortization period under section 1084(d) of this title or section 1085a(d) of this title) is unavailable or inadequate.
(3) Controlled group For purposes of this section, the term “controlled group” means any group treated as a single employer under subsection (b), (c), (m), or (o) of section 414 of title 26.
(Pub. L. 93406, title I, § 302, as added and amended Pub. L. 109280, title I, § 101(b), title II, § 202(d), Aug. 17, 2006, 120 Stat. 784, 885; Pub. L. 110458, title I, §§ 101(a)(1), 102(b)(1)(A), Dec. 23, 2008, 122 Stat. 5093, 5100; Pub. L. 11397, title I, § 102(b)(1), (2), Apr. 7, 2014, 128 Stat. 1115.)
## Notes
Prior ProvisionsA prior section 1082, Pub. L. 93406, title I, § 302, Sept. 2, 1974, 88 Stat. 869; Pub. L. 96364, title III, § 304(b), Sept. 26, 1980, 94 Stat. 1293; Pub. L. 100203, title IX, §§ 9301(b), 9303(b), (d)(2), 9304(a)(2), (b)(2), (e)(2), 9305(b)(2), 9307(a)(2), (b)(2), (e)(2), Dec. 22, 1987, 101 Stat. 1330332, 1330337, 1330342, 1330344, 1330346, 1330349, 1330352, 1330356 to 1330358; Pub. L. 100647, title II, § 2005(a)(2)(B), (d)(2), Nov. 10, 1988, 102 Stat. 3610, 3612; Pub. L. 101239, title VII, §§ 7881(a)(1)(B), (2)(B), (3)(B), (4)(B), (5)(B), (6)(B), (b)(1)(B), (2)(B), (3)(B), (4)(B), (6)(B)(i), (d)(1)(B), (2), (4), 7891(a)(1), 7892(b), 7894(d)(2), (5), Dec. 19, 1989, 103 Stat. 24352439, 2445, 2447, 2449, 2450; Pub. L. 101508, title XII, § 12012(c), Nov. 5, 1990, 104 Stat. 1388572; Pub. L. 103465, title VII, §§ 761(a)(1)(9)(A), (10), 762(a), 763(a), 764(a), 768(b), Dec. 8, 1994, 108 Stat. 50245031, 50335036, 5041; Pub. L. 10534, title XV, § 1521(b), (c)(2), (3)(B), title XVI, § 1604(b)(2)(B), Aug. 5, 1997, 111 Stat. 1069, 1070, 1097; Pub. L. 10716, title VI, §§ 651(b), 661(b), June 7, 2001, 115 Stat. 129, 142; Pub. L. 107147, title IV, §§ 405(b), 411(v)(2), Mar. 9, 2002, 116 Stat. 42, 52; Pub. L. 108218, title I, §§ 101(a)(1)(3), 102(a), 104(a)(1), Apr. 10, 2004, 118 Stat. 596, 597, 599, 604; Pub. L. 109135, title IV, § 412(x)(2), Dec. 21, 2005, 119 Stat. 2638; Pub. L. 109280, title III, § 301(a)(1), (2), Aug. 17, 2006, 120 Stat. 919, related to minimum funding standards, prior to repeal by Pub. L. 109280, title I, § 101(a), (d), Aug. 17, 2006, 120 Stat. 784, 789, applicable to plan years beginning after 2007.
Editorial Notes
Amendments2014—Subsec. (a)(2)(A). Pub. L. 11397, § 102(b)(2)(M), substituted “single-employer plan (other than a CSEC plan)” for “single-employer plan”. Subsec. (a)(2)(D). Pub. L. 11397, § 102(b)(1), added subpar. (D). Subsec. (b)(1). Pub. L. 11397, § 102(b)(2)(B), substituted “section 1083(j) of this title or under section 1085a(f) of this title” for “section 1083(j) of this title”. Subsec. (c)(1)(A)(i). Pub. L. 11397, § 102(b)(2)(A), substituted “multiemployer plan or a CSEC plan, 10 percent” for “multiemployer plan, 10 percent”. Subsec. (c)(1)(B)(i). Pub. L. 11397, § 102(b)(2)(M), substituted “single-employer plan (other than a CSEC plan)” for “single-employer plan”. Subsec. (c)(1)(B)(iii). Pub. L. 11397, § 102(b)(2)(C), added cl. (iii). Subsec. (c)(4)(A)(i). Pub. L. 11397, § 102(b)(2)(D), substituted “under paragraph (1) or for granting an extension under section 1085a(d) of this title” for “under paragraph (1)”. Subsec. (c)(4)(B). Pub. L. 11397, § 102(b)(2)(E), substituted “waiver under this subsection or an extension under 1085a(d) of this title” for “waiver under this subsection” in introductory provisions. Subsec. (c)(4)(B)(i)(I). Pub. L. 11397, § 102(b)(2)(F), substituted “waiver, modification, or extension” for “waiver or modification”. Subsec. (c)(4)(C). Pub. L. 11397, § 102(b)(2)(G), substituted “waivers or extensions” for “waivers” in heading. Subsec. (c)(4)(C)(i)(I). Pub. L. 11397, § 102(b)(2)(I), substituted “or the accumulated funding deficiency under section 1085a of this title, whichever is applicable,” for “and” at end. Subsec. (c)(4)(C)(i)(II). Pub. L. 11397, § 102(b)(2)(J), substituted “section 1083(e)(2) or 1085a(b)(2)(C) of this title, whichever is applicable, and” for “section 1083(e)(2) of this title,”. Subsec. (c)(4)(C)(i)(III). Pub. L. 11397, § 102(b)(2)(K), added subcl. (III). Subsec. (c)(4)(C)(ii). Pub. L. 11397, § 102(b)(2)(L), substituted “for waivers or extensions with respect to” for “for waivers of”. Pub. L. 11397, § 102(b)(2)(G), substituted “waivers or extensions” for “waivers” in heading. Subsec. (c)(7)(A). Pub. L. 11397, § 102(b)(2)(H), substituted “section 1084(d) of this title or section 1085a(d) of this title” for “section 1084(d) of this title”. Subsec. (d)(2). Pub. L. 11397, § 102(b)(2)(H), substituted “section 1084(d) of this title or section 1085a(d) of this title” for “section 1084(d) of this title” in concluding provisions. Pub. L. 11397, § 102(b)(2)(A), substituted “multiemployer plan or a CSEC plan” for “multiemployer plan” in concluding provisions. 2008—Subsec. (b)(3). Pub. L. 110458, § 102(b)(1)(A), substituted “the plan sponsor adopts” for “the plan adopts”. Subsec. (c)(1)(A)(i). Pub. L. 110458, § 101(a)(1)(A), substituted “the plan are” for “the plan is”. Subsec. (c)(7)(A). Pub. L. 110458, § 101(a)(1)(B), inserted “which reduces the accrued benefit of any participant” after “subsection (d)(2)”. Subsec. (d)(1). Pub. L. 110458, § 101(a)(1)(C), struck out “, the valuation date,” after “funding method”. 2006—Subsec. (b)(3). Pub. L. 109280, § 202(d), added par. (3).
Statutory Notes and Related Subsidiaries
Effective Date of 2014 AmendmentAmendment by Pub. L. 11397 applicable to years beginning after Dec. 31, 2013, see section 3 of Pub. L. 11397, set out as a note under section 401 of Title 26, Internal Revenue Code.
Effective Date of 2008 AmendmentAmendment by Pub. L. 110458 effective as if included in the provisions of Pub. L. 109280 to which the amendment relates, except as otherwise provided, see section 112 of Pub. L. 110458, set out as a note under section 72 of Title 26, Internal Revenue Code.
Effective Date of 2006 AmendmentPub. L. 109280, title II, § 202(f), Aug. 17, 2006, 120 Stat. 885, provided that: “(1) In general.—The amendments made by this section [enacting section 1085 of this title and amending this section and section 1132 of this title] shall apply with respect to plan years beginning after 2007. “(2) Special rule for certain notices.—In any case in which a plans actuary certifies that it is reasonably expected that a multiemployer plan will be in critical status under section 305(b)(3) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1085(b)(3)], as added by this section, with respect to the first plan year beginning after 2007, the notice required under subparagraph (D) of such section may be provided at any time after the date of enactment [Aug. 17, 2006], so long as it is provided on or before the last date for providing the notice under such subparagraph. “(3) Special rule for certain restored benefits.—In the case of a multiemployer plan—“(A) with respect to which benefits were reduced pursuant to a plan amendment adopted on or after January 1, 2002, and before June 30, 2005, and “(B) which, pursuant to the plan document, the trust agreement, or a formal written communication from the plan sponsor to participants provided before June 30, 2005, provided for the restoration of such benefits, the amendments made by this section shall not apply to such benefit restorations to the extent that any restriction on the providing or accrual of such benefits would otherwise apply by reason of such amendments.”
Effective DatePub. L. 109280, title I, § 101(d), Aug. 17, 2006, 120 Stat. 789, provided that: “The amendments made by this section [enacting this section and repealing former section 1082 of this title and sections 1083 to 1085, 1085a, 1085b, and 1086 of this title] shall apply to plan years beginning after 2007.”
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
Applicability of Amendments by Subtitles A and B of Title I of Pub. L. 109280For special rules on applicability of amendments by subtitles A (§§ 101108) and B (§§ 111116) of title I of Pub. L. 109280 to certain eligible cooperative plans, PBGC settlement plans, and eligible government contractor plans, see sections 104, 105, and 106 of Pub. L. 109280, set out as notes under section 401 of Title 26, Internal Revenue Code.
Special Rule for Certain Benefits Funded Under an Agreement Approved by the Pension Benefit Guaranty CorporationFor applicability of amendment by section 202(d) of Pub. L. 109280 to a multiemployer plan that is a party to an agreement that was approved by the Pension Benefit Guaranty Corporation prior to June 30, 2005, and that increases benefits and provides for certain withdrawal liability rules, see section 206 of Pub. L. 109280, set out as a note under section 412 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1084 - Minimum funding standards for multiemployer plans
## Text
(a) In general For purposes of section 1082 of this title, the accumulated funding deficiency of a multiemployer plan for any plan year is the amount, determined as of the end of the plan year, equal to the excess (if any) of the total charges to the funding standard account of the plan for all plan years (beginning with the first plan year for which this part applies to the plan) over the total credits to such account for such years.
(b) Funding standard account (1) Account required Each multiemployer plan to which this part applies shall establish and maintain a funding standard account. Such account shall be credited and charged solely as provided in this section.
(2) Charges to account For a plan year, the funding standard account shall be charged with the sum of—
(A) the normal cost of the plan for the plan year,
(B) the amounts necessary to amortize in equal annual installments (until fully amortized)—
(i) in the case of a plan which comes into existence on or after January 1, 2008, the unfunded past service liability under the plan on the first day of the first plan year to which this section applies, over a period of 15 plan years,
(ii) separately, with respect to each plan year, the net increase (if any) in unfunded past service liability under the plan arising from plan amendments adopted in such year, over a period of 15 plan years,
(iii) separately, with respect to each plan year, the net experience loss (if any) under the plan, over a period of 15 plan years, and
(iv) separately, with respect to each plan year, the net loss (if any) resulting from changes in actuarial assumptions used under the plan, over a period of 15 plan years,
(C) the amount necessary to amortize each waived funding deficiency (within the meaning of section 1082(c)(3) of this title) for each prior plan year in equal annual installments (until fully amortized) over a period of 15 plan years,
(D) the amount necessary to amortize in equal annual installments (until fully amortized) over a period of 5 plan years any amount credited to the funding standard account under section 1082(b)(3)(D) of this title (as in effect on the day before August 17, 2006), and
(E) the amount necessary to amortize in equal annual installments (until fully amortized) over a period of 20 years the contributions which would be required to be made under the plan but for the provisions of section 1082(c)(7)(A)(i)(I) of this title (as in effect on the day before August 17, 2006).
(3) Credits to account For a plan year, the funding standard account shall be credited with the sum of—
(A) the amount considered contributed by the employer to or under the plan for the plan year,
(B) the amount necessary to amortize in equal annual installments (until fully amortized)—
(i) separately, with respect to each plan year, the net decrease (if any) in unfunded past service liability under the plan arising from plan amendments adopted in such year, over a period of 15 plan years,
(ii) separately, with respect to each plan year, the net experience gain (if any) under the plan, over a period of 15 plan years, and
(iii) separately, with respect to each plan year, the net gain (if any) resulting from changes in actuarial assumptions used under the plan, over a period of 15 plan years,
(C) the amount of the waived funding deficiency (within the meaning of section 1082(c)(3) of this title) for the plan year, and
(D) in the case of a plan year for which the accumulated funding deficiency is determined under the funding standard account if such plan year follows a plan year for which such deficiency was determined under the alternative minimum funding standard under section 1085 of this title (as in effect on the day before August 17, 2006), the excess (if any) of any debit balance in the funding standard account (determined without regard to this subparagraph) over any debit balance in the alternative minimum funding standard account.
(4) Special rule for amounts first amortized in plan years before 2008 In the case of any amount amortized under section 1082(b) of this title (as in effect on the day before August 17, 2006) over any period beginning with a plan year beginning before 2008, in lieu of the amortization described in paragraphs (2)(B) and (3)(B), such amount shall continue to be amortized under such section as so in effect.
(5) Combining and offsetting amounts to be amortized Under regulations prescribed by the Secretary of the Treasury, amounts required to be amortized under paragraph (2) or paragraph (3), as the case may be—
(A) may be combined into one amount under such paragraph to be amortized over a period determined on the basis of the remaining amortization period for all items entering into such combined amount, and
(B) may be offset against amounts required to be amortized under the other such paragraph, with the resulting amount to be amortized over a period determined on the basis of the remaining amortization periods for all items entering into whichever of the two amounts being offset is the greater.
(6) Interest The funding standard account (and items therein) shall be charged or credited (as determined under regulations prescribed by the Secretary of the Treasury) with interest at the appropriate rate consistent with the rate or rates of interest used under the plan to determine costs.
(7) Special rules relating to charges and credits to funding standard account For purposes of this part—
(A) Withdrawal liability Any amount received by a multiemployer plan in payment of all or part of an employers withdrawal liability under part 1 of subtitle E of subchapter III shall be considered an amount contributed by the employer to or under the plan. The Secretary of the Treasury may prescribe by regulation additional charges and credits to a multiemployer plans funding standard account to the extent necessary to prevent withdrawal liability payments from being unduly reflected as advance funding for plan liabilities.
(B) Adjustments when a multiemployer plan leaves reorganization If a multiemployer plan is not in reorganization in the plan year but was in reorganization in the immediately preceding plan year, any balance in the funding standard account at the close of such immediately preceding plan year—
(i) shall be eliminated by an offsetting credit or charge (as the case may be), but
(ii) shall be taken into account in subsequent plan years by being amortized in equal annual installments (until fully amortized) over 30 plan years.
The preceding sentence shall not apply to the extent of any accumulated funding deficiency under section 1423(a) 11 See References in Text note below. of this title as of the end of the last plan year that the plan was in reorganization.
(C) Plan payments to supplemental program or withdrawal liability payment fund Any amount paid by a plan during a plan year to the Pension Benefit Guaranty Corporation pursuant to section 1402 of this title or to a fund exempt under section 501(c)(22) of title 26 pursuant to section 1403 of this title shall reduce the amount of contributions considered received by the plan for the plan year.
(D) Interim withdrawal liability payments Any amount paid by an employer pending a final determination of the employers withdrawal liability under part 1 of subtitle E of subchapter III and subsequently refunded to the employer by the plan shall be charged to the funding standard account in accordance with regulations prescribed by the Secretary of the Treasury.
(E) Election for deferral of charge for portion of net experience loss If an election is in effect under section 1082(b)(7)(F) of this title (as in effect on the day before August 17, 2006) for any plan year, the funding standard account shall be charged in the plan year to which the portion of the net experience loss deferred by such election was deferred with the amount so deferred (and paragraph (2)(B)(iii) shall not apply to the amount so charged).
(F) Financial assistance Any amount of any financial assistance from the Pension Benefit Guaranty Corporation to any plan, and any repayment of such amount, shall be taken into account under this section and section 1082 of this title in such manner as is determined by the Secretary of the Treasury.
(G) Short-term benefits To the extent that any plan amendment increases the unfunded past service liability under the plan by reason of an increase in benefits which are not payable as a life annuity but are payable under the terms of the plan for a period that does not exceed 14 years from the effective date of the amendment, paragraph (2)(B)(ii) shall be applied separately with respect to such increase in unfunded past service liability by substituting the number of years of the period during which such benefits are payable for “15”.
(8) Special relief rules Notwithstanding any other provision of this subsection—
(A) Amortization of net investment losses (i) In general A multiemployer plan with respect to which the solvency test under subparagraph (C) is met may treat the portion of any experience loss or gain attributable to net investment losses incurred in either or both of the first two plan years ending after August 31, 2008, as an item separate from other experience losses, to be amortized in equal annual installments (until fully amortized) over the period—
(I) beginning with the plan year in which such portion is first recognized in the actuarial value of assets, and
(II) ending with the last plan year in the 30-plan year period beginning with the plan year in which such net investment loss was incurred.
(ii) Coordination with extensions If this subparagraph applies for any plan year—
(I) no extension of the amortization period under clause (i) shall be allowed under subsection (d), and
(II) if an extension was granted under subsection (d) for any plan year before the election to have this subparagraph apply to the plan year, such extension shall not result in such amortization period exceeding 30 years.
(iii) Net investment losses For purposes of this subparagraph—
(I) In general Net investment losses shall be determined in the manner prescribed by the Secretary of the Treasury on the basis of the difference between actual and expected returns (including any difference attributable to any criminally fraudulent investment arrangement).
(II) Criminally fraudulent investment arrangements The determination as to whether an arrangement is a criminally fraudulent investment arrangement shall be made under rules substantially similar to the rules prescribed by the Secretary of the Treasury for purposes of section 165 of title 26.
(B) Expanded smoothing period (i) In general A multiemployer plan with respect to which the solvency test under subparagraph (C) is met may change its asset valuation method in a manner which—
(I) spreads the difference between expected and actual returns for either or both of the first 2 plan years ending after August 31, 2008, over a period of not more than 10 years,
(II) provides that for either or both of the first 2 plan years beginning after August 31, 2008, the value of plan assets at any time shall not be less than 80 percent or greater than 130 percent of the fair market value of such assets at such time, or
(III) makes both changes described in subclauses (I) and (II) to such method.
(ii) Asset valuation methods If this subparagraph applies for any plan year—
(I) the Secretary of the Treasury shall not treat the asset valuation method of the plan as unreasonable solely because of the changes in such method described in clause (i), and
(II) such changes shall be deemed approved by such Secretary under section 1082(d)(1) of this title and section 412(d)(1) of title 26.
(iii) Amortization of reduction in unfunded accrued liability If this subparagraph and subparagraph (A) both apply for any plan year, the plan shall treat any reduction in unfunded accrued liability resulting from the application of this subparagraph as a separate experience amortization base, to be amortized in equal annual installments (until fully amortized) over a period of 30 plan years rather than the period such liability would otherwise be amortized over.
(C) Solvency test The solvency test under this paragraph is met only if the plan actuary certifies that the plan is projected to have sufficient assets to timely pay expected benefits and anticipated expenditures over the amortization period, taking into account the changes in the funding standard account under this paragraph.
(D) Restriction on benefit increases If subparagraph (A) or (B) apply to a multiemployer plan for any plan year, then, in addition to any other applicable restrictions on benefit increases, a plan amendment increasing benefits may not go into effect during either of the 2 plan years immediately following such plan year unless—
(i) the plan actuary certifies that—
(I) any such increase is paid for out of additional contributions not allocated to the plan immediately before the application of this paragraph to the plan, and
(II) the plans funded percentage and projected credit balances for such 2 plan years are reasonably expected to be at least as high as such percentage and balances would have been if the benefit increase had not been adopted, or
(ii) the amendment is required as a condition of qualification under part I of subchapter D of chapter 1 of title 26 or to comply with other applicable law.
(E) Reporting A plan sponsor of a plan to which this paragraph applies shall—
(i) give notice of such application to participants and beneficiaries of the plan, and
(ii) inform the Pension Benefit Guaranty Corporation of such application in such form and manner as the Director of the Pension Benefit Guaranty Corporation may prescribe.
(F) Relief for 2020 and 2021 A multiemployer plan with respect to which the solvency test under subparagraph (C) is met as of February 29, 2020, may elect to apply this paragraph (without regard to whether such plan previously elected the application of this paragraph)—
(i) by substituting “February 29, 2020” for “August 31, 2008” each place it appears in subparagraphs (A)(i), (B)(i)(I), and (B)(i)(II),
(ii) by inserting “and other losses related to the virus SARSCoV2 or coronavirus disease 2019 (COVID19) (including experience losses related to reductions in contributions, reductions in employment, and deviations from anticipated retirement rates, as determined by the plan sponsor)” after “net investment losses” in subparagraph (A)(i), and
(iii) by substituting “this subparagraph or subparagraph (A)” for “this subparagraph and subparagraph (A) both” in subparagraph (B)(iii).
The preceding sentence shall not apply to a plan to which special financial assistance is granted under section 1432 of this title. For purposes of the application of this subparagraph, the Secretary of the Treasury shall rely on the plan sponsors calculations of plan losses unless such calculations are clearly erroneous.
(c) Additional rules (1) Determinations to be made under funding method For purposes of this part, normal costs, accrued liability, past service liabilities, and experience gains and losses shall be determined under the funding method used to determine costs under the plan.
(2) Valuation of assets (A) In general For purposes of this part, the value of the plans assets shall be determined on the basis of any reasonable actuarial method of valuation which takes into account fair market value and which is permitted under regulations prescribed by the Secretary of the Treasury.
(B) Election with respect to bonds The value of a bond or other evidence of indebtedness which is not in default as to principal or interest may, at the election of the plan administrator, be determined on an amortized basis running from initial cost at purchase to par value at maturity or earliest call date. Any election under this subparagraph shall be made at such time and in such manner as the Secretary of the Treasury shall by regulations provide, shall apply to all such evidences of indebtedness, and may be revoked only with the consent of such Secretary.
(3) Actuarial assumptions must be reasonable For purposes of this section, all costs, liabilities, rates of interest, and other factors under the plan shall be determined on the basis of actuarial assumptions and methods—
(A) each of which is reasonable (taking into account the experience of the plan and reasonable expectations), and
(B) which, in combination, offer the actuarys best estimate of anticipated experience under the plan.
(4) Treatment of certain changes as experience gain or loss For purposes of this section, if—
(A) a change in benefits under the Social Security Act [42 U.S.C. 301 et seq.] or in other retirement benefits created under Federal or State law, or
(B) a change in the definition of the term “wages” under section 3121 of title 26, or a change in the amount of such wages taken into account under regulations prescribed for purposes of section 401(a)(5) of title 26,
results in an increase or decrease in accrued liability under a plan, such increase or decrease shall be treated as an experience loss or gain.
(5) Full funding If, as of the close of a plan year, a plan would (without regard to this paragraph) have an accumulated funding deficiency in excess of the full funding limitation—
(A) the funding standard account shall be credited with the amount of such excess, and
(B) all amounts described in subparagraphs (B), (C), and (D) of subsection (b) (2) and subparagraph (B) of subsection (b)(3) which are required to be amortized shall be considered fully amortized for purposes of such subparagraphs.
(6) Full-funding limitation (A) In general For purposes of paragraph (5), the term “full-funding limitation” means the excess (if any) of—
(i) the accrued liability (including normal cost) under the plan (determined under the entry age normal funding method if such accrued liability cannot be directly calculated under the funding method used for the plan), over
(ii) the lesser of—
(I) the fair market value of the plans assets, or
(II) the value of such assets determined under paragraph (2).
(B) Minimum amount (i) In general In no event shall the full-funding limitation determined under subparagraph (A) be less than the excess (if any) of—
(I) 90 percent of the current liability of the plan (including the expected increase in current liability due to benefits accruing during the plan year), over
(II) the value of the plans assets determined under paragraph (2).
(ii) Assets For purposes of clause (i), assets shall not be reduced by any credit balance in the funding standard account.
(C) Full funding limitation For purposes of this paragraph, unless otherwise provided by the plan, the accrued liability under a multiemployer plan shall not include benefits which are not nonforfeitable under the plan after the termination of the plan (taking into consideration section 411(d)(3) of title 26).
(D) Current liability For purposes of this paragraph—
(i) In general The term “current liability” means all liabilities to employees and their beneficiaries under the plan.
(ii) Treatment of unpredictable contingent event benefits For purposes of clause (i), any benefit contingent on an event other than—
(I) age, service, compensation, death, or disability, or
(II) an event which is reasonably and reliably predictable (as determined by the Secretary of the Treasury),
shall not be taken into account until the event on which the benefit is contingent occurs.
(iii) Interest rate used The rate of interest used to determine current liability under this paragraph shall be the rate of interest determined under subparagraph (E).
(iv) Mortality tables (I) Commissioners standard table In the case of plan years beginning before the first plan year to which the first tables prescribed under subclause (II) apply, the mortality table used in determining current liability under this paragraph shall be the table prescribed by the Secretary of the Treasury which is based on the prevailing commissioners standard table (described in section 807(d)(5)(A) of title 26) 1 used to determine reserves for group annuity contracts issued on January 1, 1993.
(II) Secretarial authority The Secretary of the Treasury may by regulation prescribe for plan years beginning after December 31, 1999, mortality tables to be used in determining current liability under this subsection. Such tables shall be based upon the actual experience of pension plans and projected trends in such experience. In prescribing such tables, such Secretary shall take into account results of available independent studies of mortality of individuals covered by pension plans.
(v) Separate mortality tables for the disabled Notwithstanding clause (iv)—
(I) In general The Secretary of the Treasury shall establish mortality tables which may be used (in lieu of the tables under clause (iv)) to determine current liability under this subsection for individuals who are entitled to benefits under the plan on account of disability. Such Secretary shall establish separate tables for individuals whose disabilities occur in plan years beginning before January 1, 1995, and for individuals whose disabilities occur in plan years beginning on or after such date.
(II) Special rule for disabilities occurring after 1994 In the case of disabilities occurring in plan years beginning after December 31, 1994, the tables under subclause (I) shall apply only with respect to individuals described in such subclause who are disabled within the meaning of title II of the Social Security Act [42 U.S.C. 401 et seq.] and the regulations thereunder.
(vi) Periodic review The Secretary of the Treasury shall periodically (at least every 5 years) review any tables in effect under this subparagraph and shall, to the extent such Secretary determines necessary, by regulation update the tables to reflect the actual experience of pension plans and projected trends in such experience.
(E) Required change of interest rate For purposes of determining a plans current liability for purposes of this paragraph—
(i) In general If any rate of interest used under the plan under subsection (b)(6) to determine cost is not within the permissible range, the plan shall establish a new rate of interest within the permissible range.
(ii) Permissible range For purposes of this subparagraph—
(I) In general Except as provided in subclause (II), the term “permissible range” means a rate of interest which is not more than 5 percent above, and not more than 10 percent below, the weighted average of the rates of interest on 30-year Treasury securities during the 4-year period ending on the last day before the beginning of the plan year.
(II) Secretarial authority If the Secretary of the Treasury finds that the lowest rate of interest permissible under subclause (I) is unreasonably high, such Secretary may prescribe a lower rate of interest, except that such rate may not be less than 80 percent of the average rate determined under such subclause.
(iii) Assumptions Notwithstanding paragraph (3)(A), the interest rate used under the plan shall be—
(I) determined without taking into account the experience of the plan and reasonable expectations, but
(II) consistent with the assumptions which reflect the purchase rates which would be used by insurance companies to satisfy the liabilities under the plan.
(7) Annual valuation (A) In general For purposes of this section, a determination of experience gains and losses and a valuation of the plans liability shall be made not less frequently than once every year, except that such determination shall be made more frequently to the extent required in particular cases under regulations prescribed by the Secretary of the Treasury.
(B) Valuation date (i) Current year Except as provided in clause (ii), the valuation referred to in subparagraph (A) shall be made as of a date within the plan year to which the valuation refers or within one month prior to the beginning of such year.
(ii) Use of prior year valuation The valuation referred to in subparagraph (A) may be made as of a date within the plan year prior to the year to which the valuation refers if, as of such date, the value of the assets of the plan are not less than 100 percent of the plans current liability (as defined in paragraph (6)(D) without regard to clause (iv) thereof).
(iii) Adjustments Information under clause (ii) shall, in accordance with regulations, be actuarially adjusted to reflect significant differences in participants.
(iv) Limitation A change in funding method to use a prior year valuation, as provided in clause (ii), may not be made unless as of the valuation date within the prior plan year, the value of the assets of the plan are not less than 125 percent of the plans current liability (as defined in paragraph (6)(D) without regard to clause (iv) thereof).
(8) Time when certain contributions deemed made For purposes of this section, any contributions for a plan year made by an employer after the last day of such plan year, but not later than two and one-half months after such day, shall be deemed to have been made on such last day. For purposes of this subparagraph, such two and one-half month period may be extended for not more than six months under regulations prescribed by the Secretary of the Treasury.
(d) Extension of amortization periods for multiemployer plans (1) Automatic extension upon application by certain plans (A) In general If the plan sponsor of a multiemployer plan—
(i) submits to the Secretary of the Treasury an application for an extension of the period of years required to amortize any unfunded liability described in any clause of subsection (b)(2)(B) or described in subsection (b)(4), and
(ii) includes with the application a certification by the plans actuary described in subparagraph (B),
the Secretary of the Treasury shall extend the amortization period for the period of time (not in excess of 5 years) specified in the application. Such extension shall be in addition to any extension under paragraph (2).
(B) Criteria A certification with respect to a multiemployer plan is described in this subparagraph if the plans actuary certifies that, based on reasonable assumptions—
(i) absent the extension under subparagraph (A), the plan would have an accumulated funding deficiency in the current plan year or any of the 9 succeeding plan years,
(ii) the plan sponsor has adopted a plan to improve the plans funding status,
(iii) the plan is projected to have sufficient assets to timely pay expected benefits and anticipated expenditures over the amortization period as extended, and
(iv) the notice required under paragraph (3)(A) has been provided.
(2) Alternative extension (A) In general If the plan sponsor of a multiemployer plan submits to the Secretary of the Treasury an application for an extension of the period of years required to amortize any unfunded liability described in any clause of subsection (b)(2)(B) or described in subsection (b)(4), the Secretary of the Treasury may extend the amortization period for a period of time (not in excess of 10 years reduced by the number of years of any extension under paragraph (1) with respect to such unfunded liability) if the Secretary of the Treasury makes the determination described in subparagraph (B). Such extension shall be in addition to any extension under paragraph (1).
(B) Determination The Secretary of the Treasury may grant an extension under subparagraph (A) if such Secretary determines that—
(i) such extension would carry out the purposes of this chapter and would provide adequate protection for participants under the plan and their beneficiaries, and
(ii) the failure to permit such extension would—
(I) result in a substantial risk to the voluntary continuation of the plan, or a substantial curtailment of pension benefit levels or employee compensation, and
(II) be adverse to the interests of plan participants in the aggregate.
(C) Action by Secretary of the Treasury The Secretary of the Treasury shall act upon any application for an extension under this paragraph within 180 days of the submission of such application. If such Secretary rejects the application for an extension under this paragraph, such Secretary shall provide notice to the plan detailing the specific reasons for the rejection, including references to the criteria set forth above.
(3) Advance notice (A) In general The Secretary of the Treasury shall, before granting an extension under this subsection, require each applicant to provide evidence satisfactory to such Secretary that the applicant has provided notice of the filing of the application for such extension to each affected party (as defined in section 1301(a)(21) of this title) with respect to the affected plan. Such notice shall include a description of the extent to which the plan is funded for benefits which are guaranteed under subchapter III and for benefit liabilities.
(B) Consideration of relevant information The Secretary of the Treasury shall consider any relevant information provided by a person to whom notice was given under paragraph (1).
(Pub. L. 93406, title I, § 304, as added Pub. L. 109280, title II, § 201(a), Aug. 17, 2006, 120 Stat. 858; amended Pub. L. 111192, title II, § 211(a)(1), June 25, 2010, 124 Stat. 1302; Pub. L. 113235, div. O, title I, §§ 101(b)(1), 108(a)(3)(B), Dec. 16, 2014, 128 Stat. 2774, 2787; Pub. L. 113295, div. A, title I, § 171(b), Dec. 19, 2014, 128 Stat. 4023; Pub. L. 1172, title IX, § 9703(a)(1), Mar. 11, 2021, 135 Stat. 188.)
## Notes
Editorial Notes
References in TextSection 1423(a) of this title, referred to in subsec. (b)(7)(B), was repealed by Pub. L. 113235, div. O, title I, § 108(a)(1), Dec. 16, 2014, 128 Stat. 2786. The Social Security Act, referred to in subsec. (c)(4)(A), (6)(D)(v)(II), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, which is classified generally to chapter 7 (§ 301 et seq.) of Title 42, The Public Health and Welfare. Title II of the Act is classified generally to subchapter II (§ 401 et seq.) of chapter 7 of Title 42. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables. Section 807(d)(5) of title 26, referred to in subsec. (c)(6)(D)(iv)(I), was repealed by Pub. L. 11597, title I, § 13517(a)(2)(A), Dec. 22, 2017, 131 Stat. 2144. This chapter, referred to in subsec. (d)(2)(B)(i), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
Prior ProvisionsA prior section 1084, Pub. L. 93406, title I, § 304, Sept. 2, 1974, 88 Stat. 873; Pub. L. 99272, title XI, §§ 11015(b)(1)(B), 11016(c)(3), Apr. 7, 1986, 100 Stat. 267, 273; Pub. L. 100203, title IX, § 9306(c)(2)(B), Dec. 22, 1987, 101 Stat. 1330355; Pub. L. 101239, title VII, §§ 7891(a)(1), 7894(d)(3), Dec. 19, 1989, 103 Stat. 2445, 2449, related to extension of amortization periods, prior to repeal by Pub. L. 109280, title I, § 101(a), (d), Aug. 17, 2006, 120 Stat. 784, 789, applicable to plan years beginning after 2007.
Amendments2021—Subsec. (b)(8)(F). Pub. L. 1172 added subpar. (F). 2014—Subsec. (a). Pub. L. 113235, § 108(a)(3)(B), amended subsec. (a) generally. Prior to amendment, subsec. (a) related to accumulated funding deficiencies of multiemployer plans. Subsec. (d)(1)(C). Pub. L. 113295, which directed substitution of “December 31, 2015” for “December 31, 2014”, was not executed in view of the amendment by Pub. L. 113235, § 101(b)(1), which struck out subpar. (C). See note below. Pub. L. 113235, § 101(b)(1), struck out subpar. (C). Text read as follows: “The preceding provisions of this paragraph shall not apply with respect to any application submitted after December 31, 2014.” 2010—Subsec. (b)(8). Pub. L. 111192 added par. (8).
Statutory Notes and Related Subsidiaries
Effective Date of 2021 AmendmentAmendment by Pub. L. 1172 effective as of the first day of the first plan year ending on or after February 29, 2020, with exceptions and restrictions, see section 9703(b) of Pub. L. 1172, set out as an Effective Date note under section 431 of Title 26, Internal Revenue Code.
Effective Date of 2014 AmendmentAmendment by Pub. L. 113295 applicable to applications submitted under subsec. (d)(1)(C) of this section after Dec. 31, 2014, see section 171(c) of Pub. L. 113295, set out as a note under section 431 of Title 26, Internal Revenue Code. Amendment by section 108(a)(3)(B) of Pub. L. 113235 applicable with respect to plan years beginning after Dec. 31, 2014, see section 108(c) of Pub. L. 113235, set out as an Effective Date of Repeal note under section 418 of Title 26, Internal Revenue Code.
Effective Date of 2010 AmendmentAmendment by Pub. L. 111192 effective as of the first day of the first plan year ending after Aug. 31, 2008, with certain exceptions, see section 211(b) of Pub. L. 111192, set out as a note under section 431 of Title 26, Internal Revenue Code.
Effective DateSection applicable to plan years beginning after 2007, with special rule for certain amortization extensions, see section 201(d) of Pub. L. 109280, set out as an Effective Date of 2006 Amendment note under section 1081 of this title.
Shortfall Funding MethodPub. L. 109280, title II, § 201(b), Aug. 17, 2006, 120 Stat. 867, as amended by Pub. L. 110458, title I, § 102(a), Dec. 23, 2008, 122 Stat. 5100, provided that: “(1) In general.—A multiemployer plan meeting the criteria of paragraph (2) may adopt, use, or cease using, the shortfall funding method and such adoption, use, or cessation of use of such method, shall be deemed approved by the Secretary of the Treasury under section 302(d)(1) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1082(d)(1)] and section 412(d)(1) of the Internal Revenue Code of 1986 [26 U.S.C. 412(d)(1)]. “(2) Criteria.—A multiemployer pension plan meets the criteria of this clause if—“(A) the plan has not adopted, or ceased using, the shortfall funding method during the 5-year period ending on the day before the date the plan is to use the method under paragraph (1); and “(B) the plan is not operating under an amortization period extension under section 304(d) of such Act [29 U.S.C. 1084(d)] and did not operate under such an extension during such 5-year period. “(3) Shortfall funding method defined.—For purposes of this subsection, the term shortfall funding method means the shortfall funding method described in Treasury Regulations section 1.412(c)(1)2 (26 CFR 1.412(c)(1)2). “(4) Benefit restrictions to apply.—The benefit restrictions under section 302(c)(7) of such Act [29 U.S.C. 1082(c)(7)] and section 412(c)(7) of such Code [26 U.S.C. 412(c)(7)] shall apply during any period a multiemployer plan is on the shortfall funding method pursuant to this subsection. “(5) Use of shortfall method not to preclude other options.—Nothing in this subsection shall be construed to affect a multiemployer plans ability to adopt the shortfall funding method with the Secretarys permission under otherwise applicable regulations or to affect a multiemployer plans right to change funding methods, with or without the Secretarys consent, as provided in applicable rules and regulations.” [Pub. L. 109280, § 201(b), set out above, applicable to plan years beginning after 2007, with special rule for certain amortization extensions, see section 201(d) of Pub. L. 109280, set out as an Effective Date of 2006 Amendment note under section 1081 of this title.]
Special Rule for Certain Benefits Funded Under an Agreement Approved by the Pension Benefit Guaranty CorporationFor applicability of this section to a multiemployer plan that is a party to an agreement that was approved by the Pension Benefit Guaranty Corporation prior to June 30, 2005, and that increases benefits and provides for certain withdrawal liability rules, see section 206 of Pub. L. 109280, set out as a note under section 412 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1085a - Minimum funding standards
## Text
(a) General rule For purposes of section 1082 of this title, the term “accumulated funding deficiency” for a CSEC plan means the excess of the total charges to the funding standard account for all plan years (beginning with the first plan year to which section 1082 of this title applies) over the total credits to such account for such years or, if less, the excess of the total charges to the alternative minimum funding standard account for such plan years over the total credits to such account for such years.
(b) Funding standard account (1) Account required Each plan to which this section applies shall establish and maintain a funding standard account. Such account shall be credited and charged solely as provided in this section.
(2) Charges to account For a plan year, the funding standard account shall be charged with the sum of—
(A) the normal cost of the plan for the plan year,
(B) the amounts necessary to amortize in equal annual installments (until fully amortized)—
(i) in the case of a plan in existence on January 1, 1974, the unfunded past service liability under the plan on the first day of the first plan year to which section 1082 of this title applies, over a period of 40 plan years,
(ii) in the case of a plan which comes into existence after January 1, 1974, but before the first day of the first plan year beginning after December 31, 2013, the unfunded past service liability under the plan on the first day of the first plan year to which section 1082 of this title applies, over a period of 30 plan years,
(iii) separately, with respect to each plan year, the net increase (if any) in unfunded past service liability under the plan arising from plan amendments adopted in such year, over a period of 15 plan years,
(iv) separately, with respect to each plan year, the net experience loss (if any) under the plan, over a period of 5 plan years, and
(v) separately, with respect to each plan year, the net loss (if any) resulting from changes in actuarial assumptions used under the plan, over a period of 10 plan years,
(C) the amount necessary to amortize each waived funding deficiency (within the meaning of section 1082(c)(3) of this title) for each prior plan year in equal annual installments (until fully amortized) over a period of 5 plan years,
(D) the amount necessary to amortize in equal annual installments (until fully amortized) over a period of 5 plan years any amount credited to the funding standard account under paragraph (3)(D), and
(E) the amount necessary to amortize in equal annual installments (until fully amortized) over a period of 20 years the contributions which would be required to be made under the plan but for the provisions of section 1082(c)(7)(A)(i)(I) of this title (as in effect on the day before August 17, 2006).
(3) Credits to account For a plan year, the funding standard account shall be credited with the sum of—
(A) the amount considered contributed by the employer to or under the plan for the plan year,
(B) the amount necessary to amortize in equal annual installments (until fully amortized)—
(i) separately, with respect to each plan year, the net decrease (if any) in unfunded past service liability under the plan arising from plan amendments adopted in such year, over a period of 15 plan years,
(ii) separately, with respect to each plan year, the net experience gain (if any) under the plan, over a period of 5 plan years, and
(iii) separately, with respect to each plan year, the net gain (if any) resulting from changes in actuarial assumptions used under the plan, over a period of 10 plan years,
(C) the amount of the waived funding deficiency (within the meaning of section 1082(c)(3) of this title) for the plan year, and
(D) in the case of a plan year for which the accumulated funding deficiency is determined under the funding standard account if such plan year follows a plan year for which such deficiency was determined under the alternative minimum funding standard, the excess (if any) of any debit balance in the funding standard account (determined without regard to this subparagraph) over any debit balance in the alternative minimum funding standard account.
(4) Combining and offsetting amounts to be amortized Under regulations prescribed by the Secretary of the Treasury, amounts required to be amortized under paragraph (2) or paragraph (3), as the case may be—
(A) may be combined into one amount under such paragraph to be amortized over a period determined on the basis of the remaining amortization period for all items entering into such combined amount, and
(B) may be offset against amounts required to be amortized under the other such paragraph, with the resulting amount to be amortized over a period determined on the basis of the remaining amortization periods for all items entering into whichever of the two amounts being offset is the greater.
(5) Interest (A) In general Except as provided in subparagraph (B), the funding standard account (and items therein) shall be charged or credited (as determined under regulations prescribed by the Secretary of the Treasury) with interest at the appropriate rate consistent with the rate or rates of interest used under the plan to determine costs.
(B) Exception The interest rate used for purposes of computing the amortization charge described in subsection (b)(2)(C) or for purposes of any arrangement under subsection (d) for any plan year shall be the greater of—
(i) 150 percent of the Federal mid-term rate (as in effect under section 1274 of title 26 for the 1st month of such plan year), or
(ii) the rate of interest determined under subparagraph (A).
(6) Amortization schedules in effect Amortization schedules for amounts described in paragraphs (2) and (3) that are in effect as of the last day of the last plan year beginning before January 1, 2014, by reason of section 104 of the Pension Protection Act of 2006 shall remain in effect pursuant to their terms and this section, except that such amounts shall not be amortized again under this section.
(c) Special rules (1) Determinations to be made under funding method For purposes of this section, normal costs, accrued liability, past service liabilities, and experience gains and losses shall be determined under the funding method used to determine costs under the plan.
(2) Valuation of assets (A) In general For purposes of this section, the value of the plans assets shall be determined on the basis of any reasonable actuarial method of valuation which takes into account fair market value and which is permitted under regulations prescribed by the Secretary of the Treasury.
(B) Dedicated bond portfolio The Secretary of the Treasury may by regulations provide that the value of any dedicated bond portfolio of a plan shall be determined by using the interest rate under section 1082(b)(5) of this title (as in effect on the day before August 17, 2006).
(3) Actuarial assumptions must be reasonable For purposes of this section, all costs, liabilities, rates of interest, and other factors under the plan shall be determined on the basis of actuarial assumptions and methods—
(A) each of which is reasonable (taking into account the experience of the plan and reasonable expectations), and
(B) which, in combination, offer the actuarys best estimate of anticipated experience under the plan.
(4) Treatment of certain changes as experience gain or loss For purposes of this section, if—
(A) a change in benefits under the Social Security Act [42 U.S.C. 301 et seq.] or in other retirement benefits created under Federal or State law, or
(B) a change in the definition of the term “wages” under section 3121 of title 26 or a change in the amount of such wages taken into account under regulations prescribed for purposes of section 401(a)(5) of such title,
results in an increase or decrease in accrued liability under a plan, such increase or decrease shall be treated as an experience loss or gain.
(5) Funding method and plan year (A) Funding methods available All funding methods available to CSEC plans under section 1082 of this title (as in effect on the day before August 17, 2006) shall continue to be available under this section.
(B) Changes If the funding method for a plan is changed, the new funding method shall become the funding method used to determine costs and liabilities under the plan only if the change is approved by the Secretary of the Treasury. If the plan year for a plan is changed, the new plan year shall become the plan year for the plan only if the change is approved by the Secretary of the Treasury.
(C) Approval required for certain changes in assumptions by certain single-employer plans subject to additional funding requirement (i) In general No actuarial assumption (other than the assumptions described in subsection (h)(3)) used to determine the current liability for a plan to which this subparagraph applies may be changed without the approval of the Secretary of the Treasury.
(ii) Plans to which subparagraph applies This subparagraph shall apply to a plan only if—
(I) the plan is a CSEC plan,
(II) the aggregate unfunded vested benefits as of the close of the preceding plan year (as determined under section 1306(a)(3)(E)(iii) of this title) of such plan and all other plans maintained by the contributing sponsors (as defined in section 1301(a)(13) of this title) and members of such sponsors controlled groups (as defined in section 1301(a)(14) of this title) which are covered by subchapter III (disregarding plans with no unfunded vested benefits) exceed $50,000,000, and
(III) the change in assumptions (determined after taking into account any changes in interest rate and mortality table) results in a decrease in the funding shortfall of the plan for the current plan year that exceeds $50,000,000, or that exceeds $5,000,000 and that is 5 percent or more of the current liability of the plan before such change.
(6) Full funding If, as of the close of a plan year, a plan would (without regard to this paragraph) have an accumulated funding deficiency (determined without regard to the alternative minimum funding standard account permitted under subsection (e)) in excess of the full funding limitation—
(A) the funding standard account shall be credited with the amount of such excess, and
(B) all amounts described in paragraphs (2)(B), (C), and (D) and (3)(B) of subsection (b) which are required to be amortized shall be considered fully amortized for purposes of such paragraphs.
(7) Full-funding limitation For purposes of paragraph (6), the term “full-funding limitation” means the excess (if any) of—
(A) the accrued liability (including normal cost) under the plan (determined under the entry age normal funding method if such accrued liability cannot be directly calculated under the funding method used for the plan), over
(B) the lesser of—
(i) the fair market value of the plans assets, or
(ii) the value of such assets determined under paragraph (2).
(C) Minimum amount.— (i) In general.— In no event shall the full-funding limitation determined under subparagraph (A) be less than the excess (if any) of—
(I) 90 percent of the current liability (determined without regard to paragraph (4) of subsection (h)) of the plan (including the expected increase in such current liability due to benefits accruing during the plan year), over
(II) the value of the plans assets determined under paragraph (2).
(ii) Assets.— For purposes of clause (i), assets shall not be reduced by any credit balance in the funding standard account.
(8) Annual valuation (A) In general For purposes of this section, a determination of experience gains and losses and a valuation of the plans liability shall be made not less frequently than once every year, except that such determination shall be made more frequently to the extent required in particular cases under regulations prescribed by the Secretary of the Treasury.
(B) Valuation date (i) Current year Except as provided in clause (ii), the valuation referred to in subparagraph (A) shall be made as of a date within the plan year to which the valuation refers or within one month prior to the beginning of such year.
(ii) Use of prior year valuation The valuation referred to in subparagraph (A) may be made as of a date within the plan year prior to the year to which the valuation refers if, as of such date, the value of the assets of the plan are not less than 100 percent of the plans current liability.
(iii) Adjustments Information under clause (ii) shall, in accordance with regulations, be actuarially adjusted to reflect significant differences in participants.
(iv) Limitation A change in funding method to use a prior year valuation, as provided in clause (ii), may not be made unless as of the valuation date within the prior plan year, the value of the assets of the plan are not less than 125 percent of the plans current liability.
(9) Time when certain contributions deemed made For purposes of this section, any contributions for a plan year made by an employer during the period—
(A) beginning on the day after the last day of such plan year, and
(B) ending on the day which is 8½ months after the close of the plan year,
shall be deemed to have been made on such last day.
(10) Anticipation of benefit increases effective in the future In determining projected benefits, the funding method of a collectively bargained CSEC plan described in section 413(a) of title 26 shall anticipate benefit increases scheduled to take effect during the term of the collective bargaining agreement applicable to the plan.
(d) Extension of amortization periods The period of years required to amortize any unfunded liability (described in any clause of subsection (b)(2)(B)) of any plan may be extended by the Secretary of the Treasury for a period of time (not in excess of 10 years) if such Secretary determines that such extension would carry out the purposes of this chapter and provide adequate protection for participants under the plan and their beneficiaries, and if such Secretary determines that the failure to permit such extension would result in—
(1) a substantial risk to the voluntary continuation of the plan, or
(2) a substantial curtailment of pension benefit levels or employee compensation.
(e) Alternative minimum funding standard (1) In general A CSEC plan which uses a funding method that requires contributions in all years not less than those required under the entry age normal funding method may maintain an alternative minimum funding standard account for any plan year. Such account shall be credited and charged solely as provided in this subsection.
(2) Charges and credits to account For a plan year the alternative minimum funding standard account shall be—
(A) charged with the sum of—
(i) the lesser of normal cost under the funding method used under the plan or normal cost determined under the unit credit method,
(ii) the excess, if any, of the present value of accrued benefits under the plan over the fair market value of the assets, and
(iii) an amount equal to the excess (if any) of credits to the alternative minimum standard account for all prior plan years over charges to such account for all such years, and
(B) credited with the amount considered contributed by the employer to or under the plan for the plan year.
(3) Interest The alternative minimum funding standard account (and items therein) shall be charged or credited with interest in the manner provided under subsection (b)(5) with respect to the funding standard account.
(f) Quarterly contributions required (1) In general If a CSEC plan which has a funded current liability percentage for the preceding plan year of less than 100 percent fails to pay the full amount of a required installment for the plan year, then the rate of interest charged to the funding standard account under subsection (b)(5) with respect to the amount of the underpayment for the period of the underpayment shall be equal to the greater of—
(A) 175 percent of the Federal mid-term rate (as in effect under section 1274 of title 26 for the 1st month of such plan year), or
(B) the rate of interest used under the plan in determining costs.
(2) Amount of underpayment, period of underpayment For purposes of paragraph (1)—
(A) Amount The amount of the underpayment shall be the excess of—
(i) the required installment, over
(ii) the amount (if any) of the installment contributed to or under the plan on or before the due date for the installment.
(B) Period of underpayment The period for which interest is charged under this subsection with regard to any portion of the underpayment shall run from the due date for the installment to the date on which such portion is contributed to or under the plan (determined without regard to subsection (c)(9)).
(C) Order of crediting contributions For purposes of subparagraph (A)(ii), contributions shall be credited against unpaid required installments in the order in which such installments are required to be paid.
(3) Number of required installments; due dates For purposes of this subsection—
(A) Payable in 4 installments There shall be 4 required installments for each plan year.
(B) Time for payment of installments In the case of the following required installments:The due date is: 1stApril 15 2ndJuly 15 3rdOctober 15 4thJanuary 15 of the following year.
(4) Amount of required installment For purposes of this subsection—
(A) In general The amount of any required installment shall be 25 percent of the required annual payment.
(B) Required annual payment For purposes of subparagraph (A), the term “required annual payment” means the lesser of—
(i) 90 percent of the amount required to be contributed to or under the plan by the employer for the plan year under section 1082 of this title (without regard to any waiver under subsection (c) thereof), or
(ii) 100 percent of the amount so required for the preceding plan year.
Clause (ii) shall not apply if the preceding plan year was not a year of 12 months.
(5) Liquidity requirement (A) In general A plan to which this paragraph applies shall be treated as failing to pay the full amount of any required installment to the extent that the value of the liquid assets paid in such installment is less than the liquidity shortfall (whether or not such liquidity shortfall exceeds the amount of such installment required to be paid but for this paragraph).
(B) Plans to which paragraph applies This paragraph shall apply to a CSEC plan other than a plan described in section 1082(d)(6)(A) of this title (as in effect on the day before August 17, 2006) which—
(i) is required to pay installments under this subsection for a plan year, and
(ii) has a liquidity shortfall for any quarter during such plan year.
(C) Period of underpayment For purposes of paragraph (1), any portion of an installment that is treated as not paid under subparagraph (A) shall continue to be treated as unpaid until the close of the quarter in which the due date for such installment occurs.
(D) Limitation on increase If the amount of any required installment is increased by reason of subparagraph (A), in no event shall such increase exceed the amount which, when added to prior installments for the plan year, is necessary to increase the funded current liability percentage (taking into account the expected increase in current liability due to benefits accruing during the plan year) to 100 percent.
(E) Definitions For purposes of this paragraph—
(i) Liquidity shortfall The term “liquidity shortfall” means, with respect to any required installment, an amount equal to the excess (as of the last day of the quarter for which such installment is made) of the base amount with respect to such quarter over the value (as of such last day) of the plans liquid assets.
(ii) Base amount (I) In general The term “base amount” means, with respect to any quarter, an amount equal to 3 times the sum of the adjusted disbursements from the plan for the 12 months ending on the last day of such quarter.
(II) Special rule If the amount determined under subclause (I) exceeds an amount equal to 2 times the sum of the adjusted disbursements from the plan for the 36 months ending on the last day of the quarter and an enrolled actuary certifies to the satisfaction of the Secretary of the Treasury that such excess is the result of nonrecurring circumstances, the base amount with respect to such quarter shall be determined without regard to amounts related to those nonrecurring circumstances.
(iii) Disbursements from the plan The term “disbursements from the plan” means all disbursements from the trust, including purchases of annuities, payments of single sums and other benefits, and administrative expenses.
(iv) Adjusted disbursements The term “adjusted disbursements” means disbursements from the plan reduced by the product of—
(I) the plans funded current liability percentage for the plan year, and
(II) the sum of the purchases of annuities, payments of single sums, and such other disbursements as the Secretary of the Treasury shall provide in regulations.
(v) Liquid assets The term “liquid assets” means cash, marketable securities and such other assets as specified by the Secretary of the Treasury in regulations.
(vi) Quarter The term “quarter” means, with respect to any required installment, the 3-month period preceding the month in which the due date for such installment occurs.
(F) Regulations The Secretary of the Treasury may prescribe such regulations as are necessary to carry out this paragraph.
(6) Fiscal years and short years (A) Fiscal years In applying this subsection to a plan year beginning on any date other than January 1, there shall be substituted for the months specified in this subsection, the months which correspond thereto.
(B) Short plan year This subsection shall be applied to plan years of less than 12 months in accordance with regulations prescribed by the Secretary of the Treasury.
(g) Imposition of lien where failure to make required contributions (1) In general In the case of a plan to which this section applies, if—
(A) any person fails to make a required installment under subsection (f) or any other payment required under this section before the due date for such installment or other payment, and
(B) the unpaid balance of such installment or other payment (including interest), when added to the aggregate unpaid balance of all preceding such installments or other payments for which payment was not made before the due date (including interest), exceeds $1,000,000,
then there shall be a lien in favor of the plan in the amount determined under paragraph (3) upon all property and rights to property, whether real or personal, belonging to such person and any other person who is a member of the same controlled group of which such person is a member.
(2) Plans to which subsection applies This subsection shall apply to a CSEC plan for any plan year for which the funded current liability percentage of such plan is less than 100 percent. This subsection shall not apply to any plan to which section 1321 of this title does not apply (as such section is in effect on December 8, 1994).
(3) Amount of lien For purposes of paragraph (1), the amount of the lien shall be equal to the aggregate unpaid balance of required installments and other payments required under this section (including interest)—
(A) for plan years beginning after 1987, and
(B) for which payment has not been made before the due date.
(4) Notice of failure; lien (A) Notice of failure A person committing a failure described in paragraph (1) shall notify the Pension Benefit Guaranty Corporation of such failure within 10 days of the due date for the required installment or other payment.
(B) Period of lien The lien imposed by paragraph (1) shall arise on the due date for the required installment or other payment and shall continue until the last day of the first plan year in which the plan ceases to be described in paragraph (1)(B). Such lien shall continue to run without regard to whether such plan continues to be described in paragraph (2) during the period referred to in the preceding sentence.
(C) Certain rules to apply Any amount with respect to which a lien is imposed under paragraph (1) shall be treated as taxes due and owing the United States and rules similar to the rules of subsections (c), (d), and (e) of section 1368 of this title shall apply with respect to a lien imposed by subsection (a) 11 So in original. Probably should be “paragraph (1)”. and the amount with respect to such lien.
(5) Enforcement Any lien created under paragraph (1) may be perfected and enforced only by the Pension Benefit Guaranty Corporation, or at the direction of the Pension Benefit Guaranty Corporation, by any contributing employer (or any member of the controlled group of the contributing employer).
(6) Definitions For purposes of this subsection—
(A) Due date; required installment The terms “due date” and “required installment” have the meanings given such terms by subsection (f), except that in the case of a payment other than a required installment, the due date shall be the date such payment is required to be made under this section.
(B) Controlled group The term “controlled group” means any group treated as a single employer under subsections (b), (c), (m), and (o) of section 414 of title 26.
(h) Current liability For purposes of this section—
(1) In general The term “current liability” means all liabilities to employees and their beneficiaries under the plan.
(2) Treatment of unpredictable contingent event benefits (A) In general For purposes of paragraph (1), any unpredictable contingent event benefit shall not be taken into account until the event on which the benefit is contingent occurs.
(B) Unpredictable contingent event benefit The term “unpredictable contingent event benefit” means any benefit contingent on an event other than—
(i) age, service, compensation, death, or disability, or
(ii) an event which is reasonably and reliably predictable (as determined by the Secretary of the Treasury).
(3) Interest rate and mortality assumptions used (A) Interest rate The rate of interest used to determine current liability under this section shall be the third segment rate determined under section 1083(h)(2)(C) of this title.
(B) Mortality tables (i) Secretarial authority The Secretary of the Treasury may by regulation prescribe mortality tables to be used in determining current liability under this subsection. Such tables shall be based upon the actual experience of pension plans and projected trends in such experience. In prescribing such tables, the Secretary of the Treasury shall take into account results of available independent studies of mortality of individuals covered by pension plans.
(ii) Periodic review The Secretary of the Treasury shall periodically (at least every 5 years) review any tables in effect under this subsection and shall, to the extent the Secretary of the Treasury determines necessary, by regulation update the tables to reflect the actual experience of pension plans and projected trends in such experience.
(C) Separate mortality tables for the disabled Notwithstanding subparagraph (B)—
(i) In general In the case of plan years beginning after December 31, 1995, the Secretary of the Treasury shall establish mortality tables which may be used (in lieu of the tables under subparagraph (B)) to determine current liability under this subsection for individuals who are entitled to benefits under the plan on account of disability. The Secretary of the Treasury shall establish separate tables for individuals whose disabilities occur in plan years beginning before January 1, 1995, and for individuals whose disabilities occur in plan years beginning on or after such date.
(ii) Special rule for disabilities occurring after 1994 In the case of disabilities occurring in plan years beginning after December 31, 1994, the tables under clause (i) shall apply only with respect to individuals described in such subclause who are disabled within the meaning of title II of the Social Security Act [42 U.S.C. 401 et seq.] and the regulations thereunder.
(4) Certain service disregarded (A) In general In the case of a participant to whom this paragraph applies, only the applicable percentage of the years of service before such individual became a participant shall be taken into account in computing the current liability of the plan.
(B) Applicable percentage For purposes of this subparagraph, the applicable percentage shall be determined as follows: If the years of participation are:The applicable percentage is: 1 20 2 40 3 60 4 80 5 or more100.
(C) Participants to whom paragraph applies This subparagraph shall apply to any participant who, at the time of becoming a participant—
(i) has not accrued any other benefit under any defined benefit plan (whether or not terminated) maintained by the employer or a member of the same controlled group of which the employer is a member,
(ii) who first becomes a participant under the plan in a plan year beginning after December 31, 1987, and
(iii) has years of service greater than the minimum years of service necessary for eligibility to participate in the plan.
(D) Election An employer may elect not to have this subparagraph apply. Such an election, once made, may be revoked only with the consent of the Secretary of the Treasury.
(i) Funded current liability percentage For purposes of this section, the term “funded current liability percentage” means, with respect to any plan year, the percentage which—
(1) the value of the plans assets determined under subsection (c)(2), is of
(2) the current liability under the plan.
(j) Funding restoration status Notwithstanding any other provisions of this section—
(1) Normal cost payment (A) In general In the case of a CSEC plan that is in funding restoration status for a plan year, for purposes of section 1082 of this title, the term “accumulated funding deficiency” means, for such plan year, the greater of—
(i) the amount described in subsection (a), or
(ii) the excess of the normal cost of the plan for the plan year over the amount actually contributed to or under the plan for the plan year.
(B) Normal cost In the case of a CSEC plan that uses a spread gain funding method, for purposes of this subsection, the term “normal cost” means normal cost as determined under the entry age normal funding method.
(2) Plan amendments In the case of a CSEC plan that is in funding restoration status for a plan year, no amendment to such plan may take effect during such plan year if such amendment has the effect of increasing liabilities of the plan by means of increases in benefits, establishment of new benefits, changing the rate of benefit accrual, or changing the rate at which benefits become nonforfeitable. This paragraph shall not apply to any plan amendment that is required to comply with any applicable law. This paragraph shall cease to apply with respect to any plan year, effective as of the first day of the plan year (or if later, the effective date of the amendment) upon payment by the plan sponsor of a contribution to the plan (in addition to any contribution required under this section without regard to this paragraph) in an amount equal to the increase in the funding liability of the plan attributable to the plan amendment.
(3) Funding restoration plan The sponsor of a CSEC plan shall establish a written funding restoration plan within 180 days of the receipt by the plan sponsor of a certification from the plan actuary that the plan is in funding restoration status for a plan year. Such funding restoration plan shall consist of actions that are calculated, based on reasonably anticipated experience and reasonable actuarial assumptions, to increase the plans funded percentage to 100 percent over a period that is not longer than the greater of 7 years or the shortest amount of time practicable. Such funding restoration plan shall take into account contributions required under this section (without regard to this paragraph). If a plan remains in funding restoration status for 2 or more years, such funding restoration plan shall be updated each year after the 1st such year within 180 days of receipt by the plan sponsor of a certification from the plan actuary that the plan remains in funding restoration status for the plan year.
(4) Annual certification by plan actuary Not later than the 90th day of each plan year of a CSEC plan, the plan actuary shall certify to the plan sponsor whether or not the plan is in funding restoration status for the plan year, based on the plans funded percentage as of the beginning of the plan year. For this purpose, the actuary may conclusively rely on an estimate of—
(A) the plans funding liability, based on the funding liability of the plan for the preceding plan year and on reasonable actuarial estimates, assumptions, and methods, and
(B) the amount of any contributions reasonably anticipated to be made for the preceding plan year.
Contributions described in subparagraph (B) shall be taken into account in determining the plans funded percentage as of the beginning of the plan year.
(5) Definitions For purposes of this subsection—
(A) Funding restoration status A CSEC plan shall be treated as in funding restoration status for a plan year if the plans funded percentage as of the beginning of such plan year is less than 80 percent.
(B) Funded percentage The term “funded percentage” means the ratio (expressed as a percentage) which—
(i) the value of plan assets (as determined under subsection (c)(2)), bears to
(ii) the plans funding liability.
(C) Funding liability The term “funding liability” for a plan year means the present value of all benefits accrued or earned under the plan as of the beginning of the plan year, based on the assumptions used by the plan pursuant to this section, including the interest rate described in subsection (b)(5)(A) (without regard to subsection (b)(5)(B)).
(D) Spread gain funding method The term “spread gain funding method” has the meaning given such term under rules and forms issued by the Secretary of the Treasury.
(Pub. L. 93406, title I, § 306, as added Pub. L. 11397, title I, § 102(a), Apr. 7, 2014, 128 Stat. 1102.)
## Notes
Editorial Notes
References in TextSection 104 of the Pension Protection Act of 2006, referred to in subsec. (b)(6), is section 104 of Pub. L. 109280, which is set out as a note under section 401 of Title 26, Internal Revenue Code. The Social Security Act, referred to in subsecs. (c)(4)(A) and (h)(3)(C)(ii), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, which is classified generally to chapter 7 (§ 301 et seq.) of Title 42, The Public Health and Welfare. Title II of the Act is classified generally to subchapter II (§ 401 et seq.) of chapter 7 of Title 42. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables. This chapter, referred to in subsec. (d), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
Prior ProvisionsA prior section 1085a, Pub. L. 93406, title I, § 306, as added Pub. L. 99272, title XI, § 11015(a)(1)(A)(ii), Apr. 7, 1986, 100 Stat. 264; amended Pub. L. 100203, title IX, § 9306(e)(2), Dec. 22, 1987, 101 Stat. 1330355; Pub. L. 101239, title VII, § 7891(a)(1), Dec. 19, 1989, 103 Stat. 2445, related to security for waivers of minimum funding standard and extensions of amortization period, prior to repeal by Pub. L. 109280, title I, § 101(a), Aug. 17, 2006, 120 Stat. 784.
Statutory Notes and Related Subsidiaries
Effective DateSection applicable to years beginning after Dec. 31, 2013, see section 3 of Pub. L. 11397, set out as an Effective Date of 2014 Amendment note under section 401 of Title 26, Internal Revenue Code.
@@ -0,0 +1,109 @@
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# 29 U.S.C. § 1101 - Coverage
## Text
(a) Scope of coverage This part shall apply to any employee benefit plan described in section 1003(a) of this title (and not exempted under section 1003(b) of this title), other than—
(1) a plan which is unfunded and is maintained by an employer primarily for the purpose of providing deferred compensation for a select group of management or highly compensated employees; or
(2) any agreement described in section 736 of title 26, which provides payments to a retired partner or deceased partner or a deceased partners successor in interest.
(b) Securities or policies deemed to be included in plan assets For purposes of this part:
(1) In the case of a plan which invests in any security issued by an investment company registered under the Investment Company Act of 1940 [15 U.S.C. 80a1 et seq.], the assets of such plan shall be deemed to include such security but shall not, solely by reason of such investment, be deemed to include any assets of such investment company.
(2) In the case of a plan to which a guaranteed benefit policy is issued by an insurer, the assets of such plan shall be deemed to include such policy, but shall not, solely by reason of the issuance of such policy, be deemed to include any assets of such insurer. For purposes of this paragraph:
(A) The term “insurer” means an insurance company, insurance service, or insurance organization, qualified to do business in a State.
(B) The term “guaranteed benefit policy” means an insurance policy or contract to the extent that such policy or contract provides for benefits the amount of which is guaranteed by the insurer. Such term includes any surplus in a separate account, but excludes any other portion of a separate account.
(c) Clarification of application of ERISA to insurance company general accounts (1) (A) Not later than June 30, 1997, the Secretary shall issue proposed regulations to provide guidance for the purpose of determining, in cases where an insurer issues 1 or more policies to or for the benefit of an employee benefit plan (and such policies are supported by assets of such insurers general account), which assets held by the insurer (other than plan assets held in its separate accounts) constitute assets of the plan for purposes of this part and section 4975 of title 26 and to provide guidance with respect to the application of this subchapter to the general account assets of insurers.
(B) The proposed regulations under subparagraph (A) shall be subject to public notice and comment until September 30, 1997.
(C) The Secretary shall issue final regulations providing the guidance described in subparagraph (A) not later than December 31, 1997.
(D) Such regulations shall only apply with respect to policies which are issued by an insurer on or before December 31, 1998, to or for the benefit of an employee benefit plan which is supported by assets of such insurers general account. With respect to policies issued on or before December 31, 1998, such regulations shall take effect at the end of the 18-month period following the date on which such regulations become final.
(2) The Secretary shall ensure that the regulations issued under paragraph (1)—
(A) are administratively feasible, and
(B) protect the interests and rights of the plan and of its participants and beneficiaries (including meeting the requirements of paragraph (3)).
(3) The regulations prescribed by the Secretary pursuant to paragraph (1) shall require, in connection with any policy issued by an insurer to or for the benefit of an employee benefit plan to the extent that the policy is not a guaranteed benefit policy (as defined in subsection (b)(2)(B))—
(A) that a plan fiduciary totally independent of the insurer authorize the purchase of such policy (unless such purchase is a transaction exempt under section 1108(b)(5) of this title),
(B) that the insurer describe (in such form and manner as shall be prescribed in such regulations), in annual reports and in policies issued to the policyholder after the date on which such regulations are issued in final form pursuant to paragraph (1)(C)—
(i) a description of the method by which any income and expenses of the insurers general account are allocated to the policy during the term of the policy and upon the termination of the policy, and
(ii) for each report, the actual return to the plan under the policy and such other financial information as the Secretary may deem appropriate for the period covered by each such annual report,
(C) that the insurer disclose to the plan fiduciary the extent to which alternative arrangements supported by assets of separate accounts of the insurer (which generally hold plan assets) are available, whether there is a right under the policy to transfer funds to a separate account and the terms governing any such right, and the extent to which support by assets of the insurers general account and support by assets of separate accounts of the insurer might pose differing risks to the plan, and
(D) that the insurer manage those assets of the insurer which are assets of such insurers general account (irrespective of whether any such assets are plan assets) with the care, skill, prudence, and diligence under the circumstances then prevailing that a prudent man acting in a like capacity and familiar with such matters would use in the conduct of an enterprise of a like character and with like aims, taking into account all obligations supported by such enterprise.
(4) Compliance by the insurer with all requirements of the regulations issued by the Secretary pursuant to paragraph (1) shall be deemed compliance by such insurer with sections 1104, 1106, and 1107 of this title with respect to those assets of the insurers general account which support a policy described in paragraph (3).
(5) (A) Subject to subparagraph (B), any regulations issued under paragraph (1) shall not take effect before the date on which such regulations become final.
(B) No person shall be subject to liability under this part or section 4975 of title 26 for conduct which occurred before the date which is 18 months following the date described in subparagraph (A) on the basis of a claim that the assets of an insurer (other than plan assets held in a separate account) constitute assets of the plan, except—
(i) as otherwise provided by the Secretary in regulations intended to prevent avoidance of the regulations issued under paragraph (1), or
(ii) as provided in an action brought by the Secretary pursuant to paragraph (2) or (5) of section 1132(a) of this title for a breach of fiduciary responsibilities which would also constitute a violation of Federal or State criminal law.
The Secretary shall bring a cause of action described in clause (ii) if a participant, beneficiary, or fiduciary demonstrates to the satisfaction of the Secretary that a breach described in clause (ii) has occurred.
(6) Nothing in this subsection shall preclude the application of any Federal criminal law.
(7) For purposes of this subsection, the term “policy” includes a contract.
(Pub. L. 93406, title I, § 401, Sept. 2, 1974, 88 Stat. 874; Pub. L. 101239, title VII, § 7891(a)(1), Dec. 19, 1989, 103 Stat. 2445; Pub. L. 104188, title I, § 1460(a), Aug. 20, 1996, 110 Stat. 1820.)
## Notes
Editorial Notes
References in TextThe Investment Company Act of 1940, referred to in subsec. (b)(1), is title I of act Aug. 22, 1940, ch. 686, 54 Stat. 789, which is classified generally to subchapter I (§ 80a1 et seq.) of chapter 2D of Title 15, Commerce and Trade. For complete classification of this Act to the Code, see section 80a51 of Title 15 and Tables.
Amendments1996—Subsec. (c). Pub. L. 104188 added subsec. (c). 1989—Subsec. (a)(2). Pub. L. 101239 substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text.
Statutory Notes and Related Subsidiaries
Effective Date of 1996 AmendmentPub. L. 104188, title I, § 1460(b), Aug. 20, 1996, 110 Stat. 1822, provided that: “(1) In general.—Except as provided in paragraph (2), the amendment made by this section [amending this section] shall take effect on January 1, 1975. “(2) Civil actions.—The amendment made by this section shall not apply to any civil action commenced before November 7, 1995.”
Effective Date of 1989 AmendmentAmendment by Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title.
Plan Amendments Not Required Until January 1, 1998For provisions directing that if any amendments made by subtitle D [§§ 14011465] of title I of Pub. L. 104188 require an amendment to any plan or annuity contract, such amendment shall not be required to be made before the first day of the first plan year beginning on or after Jan. 1, 1998, see section 1465 of Pub. L. 104188, set out as a note under section 401 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1102 - Establishment of plan
## Text
(a) Named fiduciaries (1) Every employee benefit plan shall be established and maintained pursuant to a written instrument. Such instrument shall provide for one or more named fiduciaries who jointly or severally shall have authority to control and manage the operation and administration of the plan.
(2) For purposes of this subchapter, the term “named fiduciary” means a fiduciary who is named in the plan instrument, or who, pursuant to a procedure specified in the plan, is identified as a fiduciary (A) by a person who is an employer or employee organization with respect to the plan or (B) by such an employer and such an employee organization acting jointly.
(b) Requisite features of plan Every employee benefit plan shall—
(1) provide a procedure for establishing and carrying out a funding policy and method consistent with the objectives of the plan and the requirements of this subchapter,
(2) describe any procedure under the plan for the allocation of responsibilities for the operation and administration of the plan (including any procedure described in section 1105(c)(1) of this title),
(3) provide a procedure for amending such plan, and for identifying the persons who have authority to amend the plan, and
(4) specify the basis on which payments are made to and from the plan.
(c) Optional features of plan Any employee benefit plan may provide—
(1) that any person or group of persons may serve in more than one fiduciary capacity with respect to the plan (including service both as trustee and administrator);
(2) that a named fiduciary, or a fiduciary designated by a named fiduciary pursuant to a plan procedure described in section 1105(c)(1) of this title, may employ one or more persons to render advice with regard to any responsibility such fiduciary has under the plan; or
(3) that a person who is a named fiduciary with respect to control or management of the assets of the plan may appoint an investment manager or managers to manage (including the power to acquire and dispose of) any assets of a plan.
(Pub. L. 93406, title I, § 402, Sept. 2, 1974, 88 Stat. 875.)
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# 29 U.S.C. § 1103 - Establishment of trust
## Text
(a) Benefit plan assets to be held in trust; authority of trustees Except as provided in subsection (b), all assets of an employee benefit plan shall be held in trust by one or more trustees. Such trustee or trustees shall be either named in the trust instrument or in the plan instrument described in section 1102(a) of this title or appointed by a person who is a named fiduciary, and upon acceptance of being named or appointed, the trustee or trustees shall have exclusive authority and discretion to manage and control the assets of the plan, except to the extent that—
(1) the plan expressly provides that the trustee or trustees are subject to the direction of a named fiduciary who is not a trustee, in which case the trustees shall be subject to proper directions of such fiduciary which are made in accordance with the terms of the plan and which are not contrary to this chapter, or
(2) authority to manage, acquire, or dispose of assets of the plan is delegated to one or more investment managers pursuant to section 1102(c)(3) of this title.
(b) Exceptions The requirements of subsection (a) of this section shall not apply—
(1) to any assets of a plan which consist of insurance contracts or policies issued by an insurance company qualified to do business in a State;
(2) to any assets of such an insurance company or any assets of a plan which are held by such an insurance company;
(3) to a plan—
(A) some or all of the participants of which are employees described in section 401(c)(1) of title 26; or
(B) which consists of one or more individual retirement accounts described in section 408 of title 26;
to the extent that such plans assets are held in one or more custodial accounts which qualify under section 401(f) or 408(h) of title 26, whichever is applicable.
(4) to a plan which the Secretary exempts from the requirement of subsection (a) and which is not subject to any of the following provisions of this chapter—
(A) part 2 of this subtitle,
(B) part 3 of this subtitle, or
(C) subchapter III of this chapter; or
(5) to a contract established and maintained under section 403(b) of title 26 to the extent that the assets of the contract are held in one or more custodial accounts pursuant to section 403(b)(7) of title 26.
(6) Any plan, fund or program under which an employer, all of whose stock is directly or indirectly owned by employees, former employees or their beneficiaries, proposes through an unfunded arrangement to compensate retired employees for benefits which were forfeited by such employees under a pension plan maintained by a former employer prior to the date such pension plan became subject to this chapter.
(c) Assets of plan not to inure to benefit of employer; allowable purposes of holding plan assets (1) Except as provided in paragraph (2), (3), or (4) 11 See References in Text note below. or subsection (d), or under sections 1342 and 1344 of this title (relating to termination of insured plans), or under section 420 of title 26 (as in effect on December 29, 2022), the assets of a plan shall never inure to the benefit of any employer and shall be held for the exclusive purposes of providing benefits to participants in the plan and their beneficiaries and defraying reasonable expenses of administering the plan.
(2) (A) In the case of a contribution, or a payment of withdrawal liability under part 1 of subtitle E of subchapter III—
(i) if such contribution or payment is made by an employer to a plan (other than a multiemployer plan) by a mistake of fact, paragraph (1) shall not prohibit the return of such contribution to the employer within one year after the payment of the contribution, and
(ii) if such contribution or payment is made by an employer to a multiemployer plan by a mistake of fact or law (other than a mistake relating to whether the plan is described in section 401(a) of title 26 or the trust which is part of such plan is exempt from taxation under section 501(a) of title 26), paragraph (1) shall not prohibit the return of such contribution or payment to the employer within 6 months after the plan administrator determines that the contribution was made by such a mistake.
(B) If a contribution is conditioned on initial qualification of the plan under section 401 or 403(a) of title 26, and if the plan receives an adverse determination with respect to its initial qualification, then paragraph (1) shall not prohibit the return of such contribution to the employer within one year after such determination, but only if the application for the determination is made by the time prescribed by law for filing the employers return for the taxable year in which such plan was adopted, or such later date as the Secretary of the Treasury may prescribe.
(C) If a contribution is conditioned upon the deductibility of the contribution under section 404 of title 26, then, to the extent the deduction is disallowed, paragraph (1) shall not prohibit the return to the employer of such contribution (to the extent disallowed) within one year after the disallowance of the deduction.
(3) In the case of a withdrawal liability payment which has been determined to be an overpayment, paragraph (1) shall not prohibit the return of such payment to the employer within 6 months after the date of such determination.
(d) Termination of plan (1) Upon termination of a pension plan to which section 1321 of this title does not apply at the time of termination and to which this part applies (other than a plan to which no employer contributions have been made) the assets of the plan shall be allocated in accordance with the provisions of section 1344 of this title, except as otherwise provided in regulations of the Secretary.
(2) The assets of a welfare plan which terminates shall be distributed in accordance with the terms of the plan, except as otherwise provided in regulations of the Secretary.
(Pub. L. 93406, title I, § 403, Sept. 2, 1974, 88 Stat. 876; Pub. L. 96364, title III, § 310, title IV, §§ 402(b)(2), 410(a), 411(c), Sept. 26, 1980, 94 Stat. 1296, 1299, 1308; Pub. L. 100203, title IX, § 9343(c), Dec. 22, 1987, 101 Stat. 1330372; Pub. L. 101239, title VII, §§ 7881(k), 7891(a)(1), 7894(e)(1)(A), (3), Dec. 19, 1989, 103 Stat. 2443, 2445, 2450; Pub. L. 101508, title XII, § 12012(a), Nov. 5, 1990, 104 Stat. 1388571; Pub. L. 103465, title VII, § 731(c)(4)(B), Dec. 8, 1994, 108 Stat. 5004; Pub. L. 106170, title V, § 535(a)(2)(B), Dec. 17, 1999, 113 Stat. 1934; Pub. L. 108218, title II, § 204(b)(2), Apr. 10, 2004, 118 Stat. 609; Pub. L. 108357, title VII, § 709(a)(2), Oct. 22, 2004, 118 Stat. 1551; Pub. L. 109280, title I, § 108(a)(11), formerly § 107(a)(11), Aug. 17, 2006, 120 Stat. 819, renumbered Pub. L. 111192, title II, § 202(a), June 25, 2010, 124 Stat. 1297; Pub. L. 112141, div. D, title II, § 40241(b)(1), July 6, 2012, 126 Stat. 859; Pub. L. 11441, title II, § 2007(b)(1), July 31, 2015, 129 Stat. 459; Pub. L. 117328, div. T, title VI, § 606(b)(2), Dec. 29, 2022, 136 Stat. 5397.)
## Notes
Editorial Notes
References in TextThis chapter, referred to in subsecs. (a)(1) and (b)(4), (6), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables. Paragraph (2), (3), or (4), referred to in subsec. (c)(1), probably should be a reference only to par. (2) or (3) of subsec. (c), as par. (3) was struck out, and par. (4) was redesignated as (3), by Pub. L. 101239, title VII, § 7881(k), Dec. 19, 1989, 103 Stat. 2443.
Amendments2022—Subsec. (c)(1). Pub. L. 117328 substituted “(as in effect on December 29, 2022)” for “(as in effect on July 31, 2015)”. 2015—Subsec. (c)(1). Pub. L. 11441 substituted “July 31, 2015” for “July 6, 2012”. Amendment was executed to reflect the probable intent of Congress notwithstanding an extra closing quotation mark in the directory language. 2012—Subsec. (c)(1). Pub. L. 112141 substituted “July 6, 2012” for “August 17, 2006”. 2006—Subsec. (c)(1). Pub. L. 109280 substituted “August 17, 2006” for “October 22, 2004”. 2004—Subsec. (c)(1). Pub. L. 108357 substituted “October 22, 2004” for “April 10, 2004”. Pub. L. 108218 substituted “April 10, 2004” for “December 17, 1999”. 1999—Subsec. (c)(1). Pub. L. 106170 substituted “December 17, 1999” for “January 1, 1995”. 1994—Subsec. (c)(1). Pub. L. 103465 substituted “1995” for “1991”. 1990—Subsec. (c)(1). Pub. L. 101508 inserted “, or under section 420 of title 26 (as in effect on January 1, 1991)” after “insured plans”. 1989—Subsecs. (b)(3), (5), (c)(2)(A)(ii), (C). Pub. L. 101239, § 7891(a)(1), substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text. Subsec. (b)(3). Pub. L. 101239, § 7894(e)(3), redesignated cls. (i) and (ii) as subpars. (A) and (B), respectively, struck out “, to the extent that such plans assets are held in one or more custodial accounts which qualify under section 401(f) or 408(h) of title 26, whichever is applicable” before the semicolon in subpar. (B), and inserted concluding provision “to the extent that such plans assets are held in one or more custodial accounts which qualify under section 401(f) or 408(h) of title 26, whichever is applicable.” Subsec. (c)(2)(A). Pub. L. 101239, § 7894(e)(1)(A), in introductory provisions, made technical amendment to reference to part 1 of subtitle E of subchapter III of this chapter to correct reference to corresponding part of original Act, requiring no change in text, and in cls. (i) and (ii), inserted “if such contribution or payment is” before “made by an employer”. Subsec. (c)(3), (4). Pub. L. 101239, § 7881(k), redesignated par. (4) as (3) and struck out former par. (3) which read as follows: “In the case of a contribution which would otherwise be an excess contribution (as defined in section 4979(c) of title 26) paragraph (1) shall not prohibit a correcting distribution with respect to such contribution from the plan to the employer to the extent permitted in such section to avoid payment of an excise tax on excess contributions under such section.” 1987—Subsec. (c)(2)(B). Pub. L. 100203, § 9343(c)(1), amended subpar. (B) generally. Prior to amendment, subpar. (B) read as follows: “If a contribution is conditioned on qualification of the plan under section 401, 403(a), or 405(a) of title 26, and if the plan does not qualify, then paragraph (1) shall not prohibit the return of such contributions to the employer within one year after the date of denial of qualification of the plan.” Subsec. (c)(3). Pub. L. 100203, § 9343(c)(2), substituted “section 4979(c) of title 26” for “section 4972(b) of title 26”. 1980—Subsec. (a)(1). Pub. L. 96364, § 402(b)(2), substituted “chapter” for “subchapter”. Subsec. (b)(6). Pub. L. 96364, § 411(c), added par. (6). Subsec. (c)(1). Pub. L. 96364, § 310(1), inserted reference to par. (4). Subsec. (c)(2)(A). Pub. L. 96364, § 410(a), substituted provisions relating to contributions or payments of withdrawal liability under part 1 of subtitle E of subchapter III of this chapter made by an employer to a plan by a mistake of fact, and by an employer to a multiemployer plan by a mistake of fact or law, for provisions relating to contributions made by an employer by a mistake of fact. Subsec. (c)(4). Pub. L. 96364, § 310(2), added par. (4).
Statutory Notes and Related Subsidiaries
Effective Date of 2022 AmendmentAmendment by Pub. L. 117328 applicable to transfers made after Dec. 29, 2022, see section 606(c) of Pub. L. 117328, set out as a note under section 420 of Title 26, Internal Revenue Code.
Effective Date of 2006 AmendmentAmendment by Pub. L. 109280 applicable to plan years beginning after 2007, see section 108(e) of Pub. L. 109280, set out as a note under section 1021 of this title.
Effective Date of 1999 AmendmentAmendment by Pub. L. 106170 applicable to qualified transfers occurring after Dec. 17, 1999, see section 535(c)(1) of Pub. L. 106170, set out as a note under section 420 of Title 26, Internal Revenue Code.
Effective Date of 1990 AmendmentAmendment by Pub. L. 101508 applicable to qualified transfers under section 420 of title 26 made after Nov. 5, 1990, see section 12012(e) of Pub. L. 101508, set out as a note under section 1021 of this title.
Effective Date of 1989 AmendmentAmendment by section 7881(k) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Pension Protection Act, Pub. L. 100203, §§ 93029346, to which such amendment relates, see section 7882 of Pub. L. 101239, set out as a note under section 401 of Title 26, Internal Revenue Code. Amendment by section 7891(a)(1) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title. Section 7894(e)(1)(B) of Pub. L. 101239 provided that: “The amendments made by subparagraph (A) [amending this section] shall take effect as if included in section 410 of the Multiemployer Pension Plan Amendments Act of 1980 [Pub. L. 96364].” Amendment by section 7894(e)(3) of Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
Effective Date of 1980 AmendmentAmendment by Pub. L. 96364 effective Sept. 26, 1980, except as specifically provided, see section 1461(e) of this title. Amendment by section 410(a) of Pub. L. 96364 effective Jan. 1, 1975, except with respect to contributions received by a collectively bargained plan maintained by more than one employer before Sept. 26, 1980, see section 410(c) of Pub. L. 96364, set out as a note under section 401 of Title 26, Internal Revenue Code.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this part call for the promulgation of regulations, see sections 1031 and 1114 of this title.
Applicability of Amendments by Subtitles A and B of Title I of Pub. L. 109280For special rules on applicability of amendments by subtitles A (§§ 101108) and B (§§ 111116) of title I of Pub. L. 109280 to certain eligible cooperative plans, PBGC settlement plans, and eligible government contractor plans, see sections 104, 105, and 106 of Pub. L. 109280, set out as notes under section 401 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1104 - Fiduciary duties
## Text
(a) Prudent man standard of care (1) Subject to sections 1103(c) and (d), 1342, and 1344 of this title, a fiduciary shall discharge his duties with respect to a plan solely in the interest of the participants and beneficiaries and—
(A) for the exclusive purpose of:
(i) providing benefits to participants and their beneficiaries; and
(ii) defraying reasonable expenses of administering the plan;
(B) with the care, skill, prudence, and diligence under the circumstances then prevailing that a prudent man acting in a like capacity and familiar with such matters would use in the conduct of an enterprise of a like character and with like aims;
(C) by diversifying the investments of the plan so as to minimize the risk of large losses, unless under the circumstances it is clearly prudent not to do so; and
(D) in accordance with the documents and instruments governing the plan insofar as such documents and instruments are consistent with the provisions of this subchapter and subchapter III.
(2) In the case of an eligible individual account plan (as defined in section 1107(d)(3) of this title), the diversification requirement of paragraph (1)(C) and the prudence requirement (only to the extent that it requires diversification) of paragraph (1)(B) is not violated by acquisition or holding of qualifying employer real property or qualifying employer securities (as defined in section 1107(d)(4) and (5) of this title).
(b) Indicia of ownership of assets outside jurisdiction of district courts Except as authorized by the Secretary by regulations, no fiduciary may maintain the indicia of ownership of any assets of a plan outside the jurisdiction of the district courts of the United States.
(c) Control over assets by participant or beneficiary (1) (A) In the case of a pension plan which provides for individual accounts and permits a participant or beneficiary to exercise control over the assets in his account, if a participant or beneficiary exercises control over the assets in his account (as determined under regulations of the Secretary)—
(i) such participant or beneficiary shall not be deemed to be a fiduciary by reason of such exercise, and
(ii) no person who is otherwise a fiduciary shall be liable under this part for any loss, or by reason of any breach, which results from such participants or beneficiarys exercise of control, except that this clause shall not apply in connection with such participant or beneficiary for any blackout period during which the ability of such participant or beneficiary to direct the investment of the assets in his or her account is suspended by a plan sponsor or fiduciary.
(B) If a person referred to in subparagraph (A)(ii) meets the requirements of this subchapter in connection with authorizing and implementing the blackout period, any person who is otherwise a fiduciary shall not be liable under this subchapter for any loss occurring during such period.
(C) For purposes of this paragraph, the term “blackout period” has the meaning given such term by section 1021(i)(7) of this title.
(2) In the case of a simple retirement account established pursuant to a qualified salary reduction arrangement under section 408(p) of title 26, a participant or beneficiary shall, for purposes of paragraph (1), be treated as exercising control over the assets in the account upon the earliest of—
(A) an affirmative election among investment options with respect to the initial investment of any contribution,
(B) a rollover to any other simple retirement account or individual retirement plan, or
(C) one year after the simple retirement account is established.
No reports, other than those required under section 1021(g) of this title, shall be required with respect to a simple retirement account established pursuant to such a qualified salary reduction arrangement.
(3) In the case of a pension plan which makes a transfer to an individual retirement account or annuity of a designated trustee or issuer under section 401(a)(31)(B) of title 26, the participant or beneficiary shall, for purposes of paragraph (1), be treated as exercising control over the assets in the account or annuity upon—
(A) the earlier of—
(i) a rollover of all or a portion of the amount to another individual retirement account or annuity; or
(ii) one year after the transfer is made; or
(B) a transfer that is made in a manner consistent with guidance provided by the Secretary.
(4) (A) In any case in which a qualified change in investment options occurs in connection with an individual account plan, a participant or beneficiary shall not be treated for purposes of paragraph (1) as not exercising control over the assets in his account in connection with such change if the requirements of subparagraph (C) are met in connection with such change.
(B) For purposes of subparagraph (A), the term “qualified change in investment options” means, in connection with an individual account plan, a change in the investment options offered to the participant or beneficiary under the terms of the plan, under which—
(i) the account of the participant or beneficiary is reallocated among one or more remaining or new investment options which are offered in lieu of one or more investment options offered immediately prior to the effective date of the change, and
(ii) the stated characteristics of the remaining or new investment options provided under clause (i), including characteristics relating to risk and rate of return, are, as of immediately after the change, reasonably similar to those of the existing investment options as of immediately before the change.
(C) The requirements of this subparagraph are met in connection with a qualified change in investment options if—
(i) at least 30 days and no more than 60 days prior to the effective date of the change, the plan administrator furnishes written notice of the change to the participants and beneficiaries, including information comparing the existing and new investment options and an explanation that, in the absence of affirmative investment instructions from the participant or beneficiary to the contrary, the account of the participant or beneficiary will be invested in the manner described in subparagraph (B),
(ii) the participant or beneficiary has not provided to the plan administrator, in advance of the effective date of the change, affirmative investment instructions contrary to the change, and
(iii) the investments under the plan of the participant or beneficiary as in effect immediately prior to the effective date of the change were the product of the exercise by such participant or beneficiary of control over the assets of the account within the meaning of paragraph (1).
(5) Default investment arrangements.— (A) In general.— For purposes of paragraph (1), a participant or beneficiary in an individual account plan meeting the notice requirements of subparagraph (B) shall be treated as exercising control over the assets in the account with respect to the amount of contributions and earnings which, in the absence of an investment election by the participant or beneficiary, are invested by the plan in accordance with regulations prescribed by the Secretary. The regulations under this subparagraph shall provide guidance on the appropriateness of designating default investments that include a mix of asset classes consistent with capital preservation or long-term capital appreciation, or a blend of both.
(B) Notice requirements.— (i) In general.— The requirements of this subparagraph are met if each participant or beneficiary—
(I) receives, within a reasonable period of time before each plan year, a notice explaining the employees right under the plan to designate how contributions and earnings will be invested and explaining how, in the absence of any investment election by the participant or beneficiary, such contributions and earnings will be invested, and
(II) has a reasonable period of time after receipt of such notice and before the beginning of the plan year to make such designation.
(ii) Form of notice.— The requirements of clauses (i) and (ii) of section 401(k)(12)(D) of title 26 shall apply with respect to the notices described in this subparagraph.
(6) Default investment arrangements for a pension-linked emergency savings account.— For purposes of paragraph (1), a participant in a pension-linked emergency savings account shall be treated as exercising control over the assets in the account with respect to the amount of contributions and earnings which are invested in accordance with section 1193(c)(1)(A)(iii) of this title.
(d) Plan terminations (1) If, in connection with the termination of a pension plan which is a single-employer plan, there is an election to establish or maintain a qualified replacement plan, or to increase benefits, as provided under section 4980(d) of title 26, a fiduciary shall discharge the fiduciarys duties under this subchapter and subchapter III in accordance with the following requirements:
(A) In the case of a fiduciary of the terminated plan, any requirement—
(i) under section 4980(d)(2)(B) of title 26 with respect to the transfer of assets from the terminated plan to a qualified replacement plan, and
(ii) under section 4980(d)(2)(B)(ii) or 4980(d)(3) of title 26 with respect to any increase in benefits under the terminated plan.
(B) In the case of a fiduciary of a qualified replacement plan, any requirement—
(i) under section 4980(d)(2)(A) of title 26 with respect to participation in the qualified replacement plan of active participants in the terminated plan,
(ii) under section 4980(d)(2)(B) of title 26 with respect to the receipt of assets from the terminated plan, and
(iii) under section 4980(d)(2)(C) of title 26 with respect to the allocation of assets to participants of the qualified replacement plan.
(2) For purposes of this subsection—
(A) any term used in this subsection which is also used in section 4980(d) of title 26 shall have the same meaning as when used in such section, and
(B) any reference in this subsection to title 26 shall be a reference to title 26 as in effect immediately after the enactment of the Omnibus Budget Reconciliation Act of 1990.
(e) Safe harbor for annuity selection (1) In general With respect to the selection of an insurer for a guaranteed retirement income contract, the requirements of subsection (a)(1)(B) will be deemed to be satisfied if a fiduciary—
(A) engages in an objective, thorough, and analytical search for the purpose of identifying insurers from which to purchase such contracts;
(B) with respect to each insurer identified under subparagraph (A)—
(i) considers the financial capability of such insurer to satisfy its obligations under the guaranteed retirement income contract; and
(ii) considers the cost (including fees and commissions) of the guaranteed retirement income contract offered by the insurer in relation to the benefits and product features of the contract and administrative services to be provided under such contract; and
(C) on the basis of such consideration, concludes that—
(i) at the time of the selection, the insurer is financially capable of satisfying its obligations under the guaranteed retirement income contract; and
(ii) the relative cost of the selected guaranteed retirement income contract as described in subparagraph (B)(ii) is reasonable.
(2) Financial capability of the insurer A fiduciary will be deemed to satisfy the requirements of paragraphs (1)(B)(i) and (1)(C)(i) if—
(A) the fiduciary obtains written representations from the insurer that—
(i) the insurer is licensed to offer guaranteed retirement income contracts;
(ii) the insurer, at the time of selection and for each of the immediately preceding 7 plan years—
(I) operates under a certificate of authority from the insurance commissioner of its domiciliary State which has not been revoked or suspended;
(II) has filed audited financial statements in accordance with the laws of its domiciliary State under applicable statutory accounting principles;
(III) maintains (and has maintained) reserves which satisfies all the statutory requirements of all States where the insurer does business; and
(IV) is not operating under an order of supervision, rehabilitation, or liquidation;
(iii) the insurer undergoes, at least every 5 years, a financial examination (within the meaning of the law of its domiciliary State) by the insurance commissioner of the domiciliary State (or representative, designee, or other party approved by such commissioner); and
(iv) the insurer will notify the fiduciary of any change in circumstances occurring after the provision of the representations in clauses (i), (ii), and (iii) which would preclude the insurer from making such representations at the time of issuance of the guaranteed retirement income contract; and
(B) after receiving such representations and as of the time of selection, the fiduciary has not received any notice described in subparagraph (A)(iv) and is in possession of no other information which would cause the fiduciary to question the representations provided.
(3) No requirement to select lowest cost Nothing in this subsection shall be construed to require a fiduciary to select the lowest cost contract. A fiduciary may consider the value of a contract, including features and benefits of the contract and attributes of the insurer (including, without limitation, the insurers financial strength) in conjunction with the cost of the contract.
(4) Time of selection (A) In general For purposes of this subsection, the time of selection is—
(i) the time that the insurer and the contract are selected for distribution of benefits to a specific participant or beneficiary; or
(ii) if the fiduciary periodically reviews the continuing appropriateness of the conclusion described in paragraph (1)(C) with respect to a selected insurer, taking into account the considerations described in such paragraph, the time that the insurer and the contract are selected to provide benefits at future dates to participants or beneficiaries under the plan.
Nothing in the preceding sentence shall be construed to require the fiduciary to review the appropriateness of a selection after the purchase of a contract for a participant or beneficiary.
(B) Periodic review A fiduciary will be deemed to have conducted the periodic review described in subparagraph (A)(ii) if the fiduciary obtains the written representations described in clauses (i), (ii), and (iii) of paragraph (2)(A) from the insurer on an annual basis, unless the fiduciary receives any notice described in paragraph (2)(A)(iv) or otherwise becomes aware of facts that would cause the fiduciary to question such representations.
(5) Limited liability A fiduciary which satisfies the requirements of this subsection shall not be liable following the distribution of any benefit, or the investment by or on behalf of a participant or beneficiary pursuant to the selected guaranteed retirement income contract, for any losses that may result to the participant or beneficiary due to an insurers inability to satisfy its financial obligations under the terms of such contract.
(6) Definitions For purposes of this subsection—
(A) Insurer The term “insurer” means an insurance company, insurance service, or insurance organization, including affiliates of such companies.
(B) Guaranteed retirement income contract The term “guaranteed retirement income contract” means an annuity contract for a fixed term or a contract (or provision or feature thereof) which provides guaranteed benefits annually (or more frequently) for at least the remainder of the life of the participant or the joint lives of the participant and the participants designated beneficiary as part of an individual account plan.
(Pub. L. 93406, title I, § 404, Sept. 2, 1974, 88 Stat. 877; Pub. L. 96364, title III, § 309, Sept. 26, 1980, 94 Stat. 1296; Pub. L. 101508, title XII, § 12002(b)(1), (2)(A), Nov. 5, 1990, 104 Stat. 1388565, 1388566; Pub. L. 104188, title I, § 1421(d)(2), Aug. 20, 1996, 110 Stat. 1799; Pub. L. 10716, title VI, § 657(c)(1), June 7, 2001, 115 Stat. 136; Pub. L. 107147, title IV, § 411(t), Mar. 9, 2002, 116 Stat. 51; Pub. L. 109280, title VI, §§ 621(a), 624(a), Aug. 17, 2006, 120 Stat. 978, 980; Pub. L. 110458, title I, § 106(d), Dec. 23, 2008, 122 Stat. 5107; Pub. L. 11694, div. O, title II, § 204, Dec. 20, 2019, 133 Stat. 3165; Pub. L. 117328, div. T, title I, § 127(d), Dec. 29, 2022, 136 Stat. 5324.)
## Notes
Editorial Notes
References in TextThe enactment of the Omnibus Budget Reconciliation Act of 1990, referred to in subsec. (d)(2)(B), is the enactment of Pub. L. 101508, which was approved Nov. 5, 1990.
Amendments2022—Subsec. (c)(6). Pub. L. 117328 added par. (6). 2019—Subsec. (e). Pub. L. 11694 added subsec. (e). 2008—Subsec. (c)(5). Pub. L. 110458 substituted “participant or beneficiary” for “participant” wherever appearing. 2006—Subsec. (c)(1). Pub. L. 109280, § 621(a)(1), designated existing provisions as subpar. (A), redesignated former subpars. (A) and (B) as cls. (i) and (ii), respectively, of subpar. (A), in cl. (ii), inserted “, except that this clause shall not apply in connection with such participant or beneficiary for any blackout period during which the ability of such participant or beneficiary to direct the investment of the assets in his or her account is suspended by a plan sponsor or fiduciary” before period at end, and added subpars. (B) and (C). Subsec. (c)(4). Pub. L. 109280, § 621(a)(2), added par. (4). Subsec. (c)(5). Pub. L. 109280, § 624(a), added par. (5). 2002—Subsec. (c)(3)(A). Pub. L. 107147, § 411(t)(1), struck out “the earlier of” after “the earlier of” in introductory provisions. Subsec. (c)(3)(B). Pub. L. 107147, § 411(t)(2), substituted “a transfer that” for “if the transfer”. 2001—Subsec. (c)(3). Pub. L. 10716 added par. (3). 1996—Subsec. (c). Pub. L. 104188 designated existing provisions as par. (1), redesignated former pars. (1) and (2) as subpars. (A) and (B), respectively, and added par. (2). 1990—Subsec. (a)(1)(D). Pub. L. 101508, § 12002(b)(2)(A), substituted “and subchapter III” for “or subchapter III”. Subsec. (d). Pub. L. 101508, § 12002(b)(1), added subsec. (d). 1980—Subsec. (a)(1)(D). Pub. L. 96364 inserted reference to subchapter III of this chapter.
Statutory Notes and Related Subsidiaries
Effective Date of 2022 AmendmentAmendment by Pub. L. 117328 applicable to plan years beginning after Dec. 31, 2023, see section 127(g) of Pub. L. 117328, set out as a note under section 72 of Title 26, Internal Revenue Code.
Effective Date of 2008 AmendmentAmendment by Pub. L. 110458 effective as if included in the provisions of Pub. L. 109280 to which the amendment relates, except as otherwise provided, see section 112 of Pub. L. 110458, set out as a note under section 72 of Title 26, Internal Revenue Code.
Effective Date of 2006 AmendmentPub. L. 109280, title VI, § 621(b), Aug. 17, 2006, 120 Stat. 979, provided that: “(1) In general.—The amendments made by this section [amending this section] shall apply to plan years beginning after December 31, 2007. “(2) Special rule for collectively bargained agreements.—In the case of a plan maintained pursuant to 1 or more collective bargaining agreements between employee representatives and 1 or more employers ratified on or before the date of the enactment of this Act [Aug. 17, 2006], paragraph (1) shall be applied to benefits pursuant to, and individuals covered by, any such agreement by substituting for December 31, 2007 the earlier of—“(A) the later of—“(i) December 31, 2008, or “(ii) the date on which the last of such collective bargaining agreements terminates (determined without regard to any extension thereof after such date of enactment), or “(B) December 31, 2009.” Pub. L. 109280, title VI, § 624(b), Aug. 17, 2006, 120 Stat. 980, provided that: “(1) In general.—The amendments made by this section [amending this section] shall apply to plan years beginning after December 31, 2006. “(2) Regulations.—Final regulations under section 404(c)(5)(A) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1104(c)(5)(A)] (as added by this section) shall be issued no later than 6 months after the date of the enactment of this Act [Aug. 17, 2006].”
Effective Date of 2002 AmendmentAmendment by Pub. L. 107147 effective as if included in the provisions of the Economic Growth and Tax Relief Reconciliation Act of 2001, Pub. L. 10716, to which such amendment relates, see section 411(x) of Pub. L. 107147, set out as a note under section 25B of Title 26, Internal Revenue Code.
Effective Date of 2001 AmendmentAmendment by Pub. L. 10716 applicable to distributions made after Mar. 28, 2005, see section 657(d) of Pub. L. 10716, set out as a note under section 401 of Title 26, Internal Revenue Code.
Effective Date of 1996 AmendmentAmendment by Pub. L. 104188 applicable to taxable years beginning after Dec. 31, 1996, see section 1421(e) of Pub. L. 104188, set out as a note under section 72 of Title 26, Internal Revenue Code.
Effective Date of 1990 AmendmentAmendment by Pub. L. 101508 applicable to reversions occurring after Sept. 30, 1990, but not applicable to any reversion after Sept. 30, 1990, if (1) in the case of plans subject to subchapter III of this chapter, notice of intent to terminate under such subchapter was provided to participants (or if no participants, to Pension Benefit Guaranty Corporation) before Oct. 1, 1990, (2) in the case of plans subject to subchapter I of this chapter (and not subchapter III), notice of intent to reduce future accruals under section 1054(h) of this title was provided to participants in connection with termination before Oct. 1, 1990, (3) in the case of plans not subject to subchapter I or III of this chapter, a request for a determination letter with respect to termination was filed with Secretary of the Treasury or Secretarys delegate before Oct. 1, 1990, or (4) in the case of plans not subject to subchapter I or III of this chapter and having only one participant, a resolution terminating the plan was adopted by employer before Oct. 1, 1990, see section 12003 of Pub. L. 101508, set out as a note under section 4980 of Title 26, Internal Revenue Code.
Effective Date of 1980 AmendmentAmendment by Pub. L. 96364 effective Sept. 26, 1980, except as specifically provided, see section 1461(e) of this title.
RegulationsPub. L. 109280, title VI, § 625, Aug. 17, 2006, 120 Stat. 980, provided that: “(a) In General.—Not later than 1 year after the date of the enactment of this Act [Aug. 17, 2006], the Secretary of Labor shall issue final regulations clarifying that the selection of an annuity contract as an optional form of distribution from an individual account plan to a participant or beneficiary—“(1) is not subject to the safest available annuity standard under Interpretive Bulletin 951 (29 CFR 2509.951), and “(2) is subject to all otherwise applicable fiduciary standards. “(b) Effective Date.—This section shall take effect on the date of enactment of this Act [Aug. 17, 2006].” Secretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this part call for the promulgation of regulations, see sections 1031 and 1114 of this title.
Performance Benchmarks for Asset Allocation FundsPub. L. 117328, div. T, title III, § 318(a), Dec. 29, 2022, 136 Stat. 5353, provided that: Not later than 2 years after the date of enactment of this Act [Dec. 29, 2022], the Secretary of Labor shall promulgate regulations under section 404 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1104) providing that, in the case of a designated investment alternative that contains a mix of asset classes, the administrator of a plan may, but is not required to, use a benchmark that is a blend of different broad-based securities market indices if— “(1) the blend is reasonably representative of the asset class holdings of the designated investment alternative; “(2) for purposes of determining the blends returns for 1-, 5-, and 10-calendar-year periods (or for the life of the alternative, if shorter), the blend is modified at least once per year if needed to reflect changes in the asset class holdings of the designated investment alternative; “(3) the blend is furnished to participants and beneficiaries in a manner that is reasonably calculated to be understood by the average plan participant; and “(4) each securities market index that is used for an associated asset class would separately satisfy the requirements of such regulation for such asset class.”
Plan Amendments Not Required Until January 1, 1998For provisions directing that if any amendments made by subtitle D [§§ 14011465] of title I of Pub. L. 104188 require an amendment to any plan or annuity contract, such amendment shall not be required to be made before the first day of the first plan year beginning on or after Jan. 1, 1998, see section 1465 of Pub. L. 104188, set out as a note under section 401 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1105 - Liability for breach of co-fiduciary
## Text
(a) Circumstances giving rise to liability In addition to any liability which he may have under any other provisions of this part, a fiduciary with respect to a plan shall be liable for a breach of fiduciary responsibility of another fiduciary with respect to the same plan in the following circumstances:
(1) if he participates knowingly in, or knowingly undertakes to conceal, an act or omission of such other fiduciary, knowing such act or omission is a breach;
(2) if, by his failure to comply with section 1104(a)(1) of this title in the administration of his specific responsibilities which give rise to his status as a fiduciary, he has enabled such other fiduciary to commit a breach; or
(3) if he has knowledge of a breach by such other fiduciary, unless he makes reasonable efforts under the circumstances to remedy the breach.
(b) Assets held by two or more trustees (1) Except as otherwise provided in subsection (d) and in section 1103(a)(1) and (2) of this title, if the assets of a plan are held by two or more trustees—
(A) each shall use reasonable care to prevent a co-trustee from committing a breach; and
(B) they shall jointly manage and control the assets of the plan, except that nothing in this subparagraph (B) shall preclude any agreement, authorized by the trust instrument, allocating specific responsibilities, obligations, or duties among trustees, in which event a trustee to whom certain responsibilities, obligations, or duties have not been allocated shall not be liable by reason of this subparagraph (B) either individually or as a trustee for any loss resulting to the plan arising from the acts or omissions on the part of another trustee to whom such responsibilities, obligations, or duties have been allocated.
(2) Nothing in this subsection shall limit any liability that a fiduciary may have under subsection (a) or any other provision of this part.
(3) (A) In the case of a plan the assets of which are held in more than one trust, a trustee shall not be liable under paragraph (1) except with respect to an act or omission of a trustee of a trust of which he is a trustee.
(B) No trustee shall be liable under this subsection for following instructions referred to in section 1103(a)(1) of this title.
(c) Allocation of fiduciary responsibility; designated persons to carry out fiduciary responsibilities (1) The instrument under which a plan is maintained may expressly provide for procedures (A) for allocating fiduciary responsibilities (other than trustee responsibilities) among named fiduciaries, and (B) for named fiduciaries to designate persons other than named fiduciaries to carry out fiduciary responsibilities (other than trustee responsibilities) under the plan.
(2) If a plan expressly provides for a procedure described in paragraph (1), and pursuant to such procedure any fiduciary responsibility of a named fiduciary is allocated to any person, or a person is designated to carry out any such responsibility, then such named fiduciary shall not be liable for an act or omission of such person in carrying out such responsibility except to the extent that—
(A) the named fiduciary violated section 1104(a)(1) of this title—
(i) with respect to such allocation or designation,
(ii) with respect to the establishment or implementation of the procedure under paragraph (1), or
(iii) in continuing the allocation or designation; or
(B) the named fiduciary would otherwise be liable in accordance with subsection (a).
(3) For purposes of this subsection, the term “trustee responsibility” means any responsibility provided in the plans trust instrument (if any) to manage or control the assets of the plan, other than a power under the trust instrument of a named fiduciary to appoint an investment manager in accordance with section 1102(c)(3) of this title.
(d) Investment managers (1) If an investment manager or managers have been appointed under section 1102(c)(3) of this title, then, notwithstanding subsections (a)(2) and (3) and subsection (b), no trustee shall be liable for the acts or omissions of such investment manager or managers, or be under an obligation to invest or otherwise manage any asset of the plan which is subject to the management of such investment manager.
(2) Nothing in this subsection shall relieve any trustee of any liability under this part for any act of such trustee.
(Pub. L. 93406, title I, § 405, Sept. 2, 1974, 88 Stat. 878.)
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# 29 U.S.C. § 1106 - Prohibited transactions
## Text
(a) Transactions between plan and party in interest Except as provided in section 1108 of this title:
(1) A fiduciary with respect to a plan shall not cause the plan to engage in a transaction, if he knows or should know that such transaction constitutes a direct or indirect—
(A) sale or exchange, or leasing, of any property between the plan and a party in interest;
(B) lending of money or other extension of credit between the plan and a party in interest;
(C) furnishing of goods, services, or facilities between the plan and a party in interest;
(D) transfer to, or use by or for the benefit of a party in interest, of any assets of the plan; or
(E) acquisition, on behalf of the plan, of any employer security or employer real property in violation of section 1107(a) of this title.
(2) No fiduciary who has authority or discretion to control or manage the assets of a plan shall permit the plan to hold any employer security or employer real property if he knows or should know that holding such security or real property violates section 1107(a) of this title.
(b) Transactions between plan and fiduciary A fiduciary with respect to a plan shall not—
(1) deal with the assets of the plan in his own interest or for his own account,
(2) in his individual or in any other capacity act in any transaction involving the plan on behalf of a party (or represent a party) whose interests are adverse to the interests of the plan or the interests of its participants or beneficiaries, or
(3) receive any consideration for his own personal account from any party dealing with such plan in connection with a transaction involving the assets of the plan.
(c) Transfer of real or personal property to plan by party in interest A transfer of real or personal property by a party in interest to a plan shall be treated as a sale or exchange if the property is subject to a mortgage or similar lien which the plan assumes or if it is subject to a mortgage or similar lien which a party-in-interest placed on the property within the 10-year period ending on the date of the transfer.
(Pub. L. 93406, title I, § 406, Sept. 2, 1974, 88 Stat. 879.)
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# 29 U.S.C. § 1107 - Limitation with respect to acquisition and holding of employer securities and employer real property by certain plans
## Text
(a) Percentage limitation Except as otherwise provided in this section and section 1114 of this title:
(1) A plan may not acquire or hold—
(A) any employer security which is not a qualifying employer security, or
(B) any employer real property which is not qualifying employer real property.
(2) A plan may not acquire any qualifying employer security or qualifying employer real property, if immediately after such acquisition the aggregate fair market value of employer securities and employer real property held by the plan exceeds 10 percent of the fair market value of the assets of the plan.
(3) (A) After December 31, 1984, a plan may not hold any qualifying employer securities or qualifying employer real property (or both) to the extent that the aggregate fair market value of such securities and property determined on December 31, 1984, exceeds 10 percent of the greater of—
(i) the fair market value of the assets of the plan, determined on December 31, 1984, or
(ii) the fair market value of the assets of the plan determined on January 1, 1975.
(B) Subparagraph (A) of this paragraph shall not apply to any plan which on any date after December 31, 1974; and before January 1, 1985, did not hold employer securities or employer real property (or both) the aggregate fair market value of which determined on such date exceeded 10 percent of the greater of 11 So in original. Probably should be followed by a dash.
(i) the fair market value of the assets of the plan, determined on such date, or
(ii) the fair market value of the assets of the plan determined on January 1, 1975.
(4) (A) After December 31, 1979, a plan may not hold any employer securities or employer real property in excess of the amount specified in regulations under subparagraph (B). This subparagraph shall not apply to a plan after the earliest date after December 31, 1974, on which it complies with such regulations.
(B) Not later than December 31, 1976, the Secretary shall prescribe regulations which shall have the effect of requiring that a plan divest itself of 50 percent of the holdings of employer securities and employer real property which the plan would be required to divest before January 1, 1985, under paragraph (2) or subsection (c) (whichever is applicable).
(b) Exception (1) Subsection (a) of this section shall not apply to any acquisition or holding of qualifying employer securities or qualifying employer real property by an eligible individual account plan.
(2) (A) If this paragraph applies to an eligible individual account plan, the portion of such plan which consists of applicable elective deferrals (and earnings allocable thereto) shall be treated as a separate plan—
(i) which is not an eligible individual account plan, and
(ii) to which the requirements of this section apply.
(B) (i) This paragraph shall apply to any eligible individual account plan if any portion of the plans applicable elective deferrals (or earnings allocable thereto) are required to be invested in qualifying employer securities or qualifying employer real property or both—
(I) pursuant to the terms of the plan, or
(II) at the direction of a person other than the participant on whose behalf such elective deferrals are made to the plan (or a beneficiary).
(ii) This paragraph shall not apply to an individual account plan for a plan year if, on the last day of the preceding plan year, the fair market value of the assets of all individual account plans maintained by the employer equals not more than 10 percent of the fair market value of the assets of all pension plans (other than multiemployer plans) maintained by the employer.
(iii) This paragraph shall not apply to an individual account plan that is an employee stock ownership plan as defined in section 4975(e)(7) of title 26.
(iv) This paragraph shall not apply to an individual account plan if, pursuant to the terms of the plan, the portion of any employees applicable elective deferrals which is required to be invested in qualifying employer securities and qualifying employer real property for any year may not exceed 1 percent of the employees compensation which is taken into account under the plan in determining the maximum amount of the employees applicable elective deferrals for such year.
(C) For purposes of this paragraph, the term “applicable elective deferral” means any elective deferral (as defined in section 402(g)(3)(A) of title 26) which is made pursuant to a qualified cash or deferred arrangement as defined in section 401(k) of title 26.
(3) Cross References.— (A) For exemption from diversification requirements for holding of qualifying employer securities and qualifying employer real property by eligible individual account plans, see section 1104(a)(2) of this title.
(B) For exemption from prohibited transactions for certain acquisitions of qualifying employer securities and qualifying employer real property which are not in violation of 10 percent limitation, see section 1108(e) of this title.
(C) For transitional rules respecting securities or real property subject to binding contracts in effect on June 30, 1974, see section 1114(c) of this title.
(D) For diversification requirements for qualifying employer securities held in certain individual account plans, see section 1054(j) of this title.
(c) Election (1) A plan which makes the election, under paragraph (3) shall be treated as satisfying the requirement of subsection (a)(3) if and only if employer securities held on any date after December 31, 1974 and before January 1, 1985 have a fair market value, determined as of December 31, 1974, not in excess of 10 percent of the lesser of—
(A) the fair market value of the assets of the plan determined on such date (disregarding any portion of the fair market value of employer securities which is attributable to appreciation of such securities after December 31, 1974) but not less than the fair market value of plan assets on January 1, 1975, or
(B) an amount equal to the sum of (i) the total amount of the contributions to the plan received after December 31, 1974, and prior to such date, plus (ii) the fair market value of the assets of the plan, determined on January 1, 1975.
(2) For purposes of this subsection, in the case of an employer security held by a plan after January 1, 1975, the ownership of which is derived from ownership of employer securities held by the plan on January 1, 1975, or from the exercise of rights derived from such ownership, the value of such security held after January 1, 1975, shall be based on the value as of January 1, 1975, of the security from which ownership was derived. The Secretary shall prescribe regulations to carry out this paragraph.
(3) An election under this paragraph may not be made after December 31, 1975. Such an election shall be made in accordance with regulations prescribed by the Secretary, and shall be irrevocable. A plan may make an election under this paragraph only if on January 1, 1975, the plan holds no employer real property. After such election and before January 1, 1985 the plan may not acquire any employer real property.
(d) Definitions For purposes of this section—
(1) The term “employer security” means a security issued by an employer of employees covered by the plan, or by an affiliate of such employer. A contract to which section 1108(b)(5) of this title applies shall not be treated as a security for purposes of this section.
(2) The term “employer real property” means real property (and related personal property) which is leased to an employer of employees covered by the plan, or to an affiliate of such employer. For purposes of determining the time at which a plan acquires employer real property for purposes of this section, such property shall be deemed to be acquired by the plan on the date on which the plan acquires the property or on the date on which the lease to the employer (or affiliate) is entered into, whichever is later.
(3) (A) The term “eligible individual account plan” means an individual account plan which is (i) a profit-sharing, stock bonus, thrift, or savings plan; (ii) an employee stock ownership plan; or (iii) a money purchase plan which was in existence on September 2, 1974, and which on such date invested primarily in qualifying employer securities. Such term excludes an individual retirement account or annuity described in section 408 of title 26.
(B) Notwithstanding subparagraph (A), a plan shall be treated as an eligible individual account plan with respect to the acquisition or holding of qualifying employer real property or qualifying employer securities only if such plan explicitly provides for acquisition and holding of qualifying employer securities or qualifying employer real property (as the case may be). In the case of a plan in existence on September 2, 1974, this subparagraph shall not take effect until January 1, 1976.
(C) The term “eligible individual account plan” does not include any individual account plan the benefits of which are taken into account in determining the benefits payable to a participant under any defined benefit plan.
(4) The term “qualifying employer real property” means parcels of employer real property—
(A) if a substantial number of the parcels are dispersed geographically;
(B) if each parcel of real property and the improvements thereon are suitable (or adaptable without excessive cost) for more than one use;
(C) even if all of such real property is leased to one lessee (which may be an employer, or an affiliate of an employer); and
(D) if the acquisition and retention of such property comply with the provisions of this part (other than section 1104(a)(1)(B) of this title to the extent it requires diversification, and sections 1104(a)(1)(C), 1106 of this title, and subsection (a) of this section).
(5) The term “qualifying employer security” means an employer security which is—
(A) stock,
(B) a marketable obligation (as defined in subsection (e)), or
(C) an interest in a publicly traded partnership (as defined in section 7704(b) of title 26), but only if such partnership is an existing partnership as defined in section 10211(c)(2)(A) of the Revenue Act of 1987 (Public Law 100203).
After December 17, 1987, in the case of a plan other than an eligible individual account plan, an employer security described in subparagraph (A) or (C) shall be considered a qualifying employer security only if such employer security satisfies the requirements of subsection (f)(1).
(6) The term “employee stock ownership plan” means an individual account plan—
(A) which is a stock bonus plan which is qualified, or a stock bonus plan and money purchase plan both of which are qualified, under section 401 of title 26, and which is designed to invest primarily in qualifying employer securities, and
(B) which meets such other requirements as the Secretary of the Treasury may prescribe by regulation.
(7) A corporation is an affiliate of an employer if it is a member of any controlled group of corporations (as defined in section 1563(a) of title 26, except that “applicable percentage” shall be substituted for “80 percent” wherever the latter percentage appears in such section) of which the employer who maintains the plan is a member. For purposes of the preceding sentence, the term “applicable percentage” means 50 percent, or such lower percentage as the Secretary may prescribe by regulation. A person other than a corporation shall be treated as an affiliate of an employer to the extent provided in regulations of the Secretary. An employer which is a person other than a corporation shall be treated as affiliated with another person to the extent provided by regulations of the Secretary. Regulations under this paragraph shall be prescribed only after consultation and coordination with the Secretary of the Treasury.
(8) The Secretary may prescribe regulations specifying the extent to which conversions, splits, the exercise of rights, and similar transactions are not treated as acquisitions.
(9) For purposes of this section, an arrangement which consists of a defined benefit plan and an individual account plan shall be treated as 1 plan if the benefits of such individual account plan are taken into account in determining the benefits payable under such defined benefit plan.
(e) Marketable obligations For purposes of subsection (d)(5), the term “marketable obligation” means a bond, debenture, note, or certificate, or other evidence of indebtedness (hereinafter in this subsection referred to as “obligation”) if—
(1) such obligation is acquired—
(A) on the market, either (i) at the price of the obligation prevailing on a national securities exchange which is registered with the Securities and Exchange Commission, or (ii) if the obligation is not traded on such a national securities exchange, at a price not less favorable to the plan than the offering price for the obligation as established by current bid and asked prices quoted by persons independent of the issuer;
(B) from an underwriter, at a price (i) not in excess of the public offering price for the obligation as set forth in a prospectus or offering circular filed with the Securities and Exchange Commission, and (ii) at which a substantial portion of the same issue is acquired by persons independent of the issuer; or
(C) directly from the issuer, at a price not less favorable to the plan than the price paid currently for a substantial portion of the same issue by persons independent of the issuer;
(2) immediately following acquisition of such obligation—
(A) not more than 25 percent of the aggregate amount of obligations issued in such issue and outstanding at the time of acquisition is held by the plan, and
(B) at least 50 percent of the aggregate amount referred to in subparagraph (A) is held by persons independent of the issuer; and
(3) immediately following acquisition of the obligation, not more than 25 percent of the assets of the plan is invested in obligations of the employer or an affiliate of the employer.
(f) Maximum percentage of stock held by plan; time of holding or acquisition; necessity of legally binding contract (1) Stock satisfies the requirements of this paragraph if, immediately following the acquisition of such stock—
(A) no more than 25 percent of the aggregate amount of stock of the same class issued and outstanding at the time of acquisition is held by the plan, and
(B) at least 50 percent of the aggregate amount referred to in subparagraph (A) is held by persons independent of the issuer.
(2) Until January 1, 1993, a plan shall not be treated as violating subsection (a) solely by holding stock which fails to satisfy the requirements of paragraph (1) if such stock—
(A) has been so held since December 17, 1987, or
(B) was acquired after December 17, 1987, pursuant to a legally binding contract in effect on December 17, 1987, and has been so held at all times after the acquisition.
(Pub. L. 93406, title I, § 407, Sept. 2, 1974, 88 Stat. 880; Pub. L. 100203, title IX, § 9345(a)(1), (2), (b), Dec. 22, 1987, 101 Stat. 1330373; Pub. L. 101239, title VII, §§ 7881(l)(1)(4), 7891(a)(1), 7894(e)(2), Dec. 19, 1989, 103 Stat. 2443, 2445, 2450; Pub. L. 101540, § 1, Nov. 8, 1990, 104 Stat. 2379; Pub. L. 10534, title XV, § 1524(a), Aug. 5, 1997, 111 Stat. 1071; Pub. L. 109280, title IX, § 901(b)(2), Aug. 17, 2006, 120 Stat. 1032.)
## Notes
Editorial Notes
References in TextSection 10211(c)(2)(A) of the Revenue Act of 1987 (Public Law 100203), referred to in subsec. (d)(5)(C), is set out as a note under section 7704 of Title 26, Internal Revenue Code.
Amendments2006—Subsec. (b)(3)(D). Pub. L. 109280 added subpar. (D). 1997—Subsec. (b)(2), (3). Pub. L. 10534 added par. (2) and redesignated former par. (2) as (3). 1990—Subsec. (d)(5). Pub. L. 101540 amended par. (5) generally. Prior to amendment, par. (5) read as follows: “The term qualifying employer security means an employer security which is stock or a marketable obligation (as defined in subsection (e)). After December 17, 1987, in the case of a plan other than an eligible individual account plan, stock shall be considered a qualifying employer security only if such stock satisfies the requirements of subsection (f)(1).” 1989—Subsec. (d)(3)(A), (6)(A), (7). Pub. L. 101239, § 7891(a)(1), substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text. Subsec. (d)(3)(C). Pub. L. 101239, § 7881(l)(1), realigned margin. Subsec. (d)(6)(A). Pub. L. 101239, § 7894(e)(2), substituted “money purchase plan” for “money purchase” and “employer securities” for “employee securities”. Subsec. (d)(9). Pub. L. 101239, § 7881(l)(2), substituted “such individual account plan” for “such arrangement” and realigned margin. Subsec. (f)(1). Pub. L. 101239, § 7881(l)(3)(A), (4), substituted “paragraph” for “subsection” and “if, immediately following the acquisition of such stock” for “if”. Subsec. (f)(3). Pub. L. 101239, § 7881(l)(3)(B), struck out par. (3) which read as follows: “After December 17, 1987, no plan may acquire stock which does not satisfy the requirements of paragraph (1) unless the acquisition is made pursuant to a legally binding contract in effect on such date.” 1987—Subsec. (d)(3)(C). Pub. L. 100203, § 9345(a)(1), added subpar. (C). Subsec. (d)(5). Pub. L. 100203, § 9345(b)(1), inserted at end “After December 17, 1987, in the case of a plan other than an eligible individual account plan, stock shall be considered a qualifying employer security only if such stock satisfies the requirements of subsection (f)(1).” Subsec. (d)(9). Pub. L. 100203, § 9345(a)(2), added par. (9). Subsec. (f). Pub. L. 100203, § 9345(b)(2), added subsec. (f).
Statutory Notes and Related Subsidiaries
Effective Date of 2006 AmendmentAmendment by Pub. L. 109280 applicable to plan years beginning after Dec. 31, 2006, with special rules for collectively bargained agreements and certain employer securities held in an ESOP, see section 901(c) of Pub. L. 109280, set out as a note under section 401 of Title 26, Internal Revenue Code.
Effective Date of 1997 AmendmentPub. L. 10534, title XV, § 1524(b), Aug. 5, 1997, 111 Stat. 1072, as amended by Pub. L. 10716, title VI, § 655(a), June 7, 2001, 115 Stat. 131, provided that: “(1) In general.—Except as provided in paragraph (2), the amendments made by this section [amending this section] shall apply to elective deferrals for plan years beginning after December 31, 1998. “(2) Nonapplication to previously acquired property.—The amendments made by this section shall not apply to any elective deferral which is invested in assets consisting of qualifying employer securities, qualifying employer real property, or both, if such assets were acquired before January 1, 1999.” [Pub. L. 10716, title VI, § 655(b), June 7, 2001, 115 Stat. 131, provided that: “The amendment made by this section [amending section 1524(b) of Pub. L. 10534, set out above] shall apply as if included in the provision of the Taxpayer Relief Act of 1997 [Pub. L. 10534] to which it relates.” ]
Effective Date of 1990 AmendmentPub. L. 101540, § 2, Nov. 8, 1990, 104 Stat. 2379, provided that: “The amendment made by section 1 [amending this section] shall apply to interests in publicly traded partnerships acquired before, on, or after January 1, 1987.”
Effective Date of 1989 AmendmentAmendment by section 7881(l)(1)(4) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Pension Protection Act, Pub. L. 100203, §§ 93029346, to which such amendment relates, see section 7882 of Pub. L. 101239, set out as a note under section 401 of Title 26, Internal Revenue Code. Amendment by section 7891(a)(1) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title. Amendment by section 7894(e)(2) of Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
Effective Date of 1987 AmendmentPub. L. 100203, title IX, § 9345(a)(3), Dec. 22, 1987, 101 Stat. 1330373, provided that: “The amendments made by this subsection [amending this section] shall apply with respect to arrangements established after December 17, 1987.”
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this part call for the promulgation of regulations, see sections 1031 and 1114 of this title.
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# 29 U.S.C. § 1109 - Liability for breach of fiduciary duty
## Text
(a) Any person who is a fiduciary with respect to a plan who breaches any of the responsibilities, obligations, or duties imposed upon fiduciaries by this subchapter shall be personally liable to make good to such plan any losses to the plan resulting from each such breach, and to restore to such plan any profits of such fiduciary which have been made through use of assets of the plan by the fiduciary, and shall be subject to such other equitable or remedial relief as the court may deem appropriate, including removal of such fiduciary. A fiduciary may also be removed for a violation of section 1111 of this title.
(b) No fiduciary shall be liable with respect to a breach of fiduciary duty under this subchapter if such breach was committed before he became a fiduciary or after he ceased to be a fiduciary.
(Pub. L. 93406, title I, § 409, Sept. 2, 1974, 88 Stat. 886.)
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# 29 U.S.C. § 1110 - Exculpatory provisions; insurance
## Text
(a) Except as provided in sections 1105(b)(1) and 1105(d) of this title, any provision in an agreement or instrument which purports to relieve a fiduciary from responsibility or liability for any responsibility, obligation, or duty under this part shall be void as against public policy.
(b) Nothing in this subpart 11 So in original. This part does not contain subparts. shall preclude—
(1) a plan from purchasing insurance for its fiduciaries or for itself to cover liability or losses occurring by reason of the act or omission of a fiduciary, if such insurance permits recourse by the insurer against the fiduciary in the case of a breach of a fiduciary obligation by such fiduciary;
(2) a fiduciary from purchasing insurance to cover liability under this part from and for his own account; or
(3) an employer or an employee organization from purchasing insurance to cover potential liability of one or more persons who serve in a fiduciary capacity with regard to an employee benefit plan.
(Pub. L. 93406, title I, § 410, Sept. 2, 1974, 88 Stat. 886.)
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# 29 U.S.C. § 1111 - Persons prohibited from holding certain positions
## Text
(a) Conviction or imprisonment No person who has been convicted of, or has been imprisoned as a result of his conviction of, robbery, bribery, extortion, embezzlement, fraud, grand larceny, burglary, arson, a felony violation of Federal or State law involving substances defined in section 802(6) of title 21, murder, rape, kidnaping, perjury, assault with intent to kill, any crime described in section 80a9(a)(1) of title 15, a violation of any provision of this chapter, a violation of section 186 of this title, a violation of chapter 63 of title 18, a violation of section 874, 1027, 1503, 1505, 1506, 1510, 1951, or 1954 of title 18, a violation of the Labor-Management Reporting and Disclosure Act of 1959 (29 U.S.C. 401), any felony involving abuse or misuse of such persons position or employment in a labor organization or employee benefit plan to seek or obtain an illegal gain at the expense of the members of the labor organization or the beneficiaries of the employee benefit plan, or conspiracy to commit any such crimes or attempt to commit any such crimes, or a crime in which any of the foregoing crimes is an element, shall serve or be permitted to serve—
(1) as an administrator, fiduciary, officer, trustee, custodian, counsel, agent, employee, or representative in any capacity of any employee benefit plan,
(2) as a consultant or adviser to an employee benefit plan, including but not limited to any entity whose activities are in whole or substantial part devoted to providing goods or services to any employee benefit plan, or
(3) in any capacity that involves decisionmaking authority or custody or control of the moneys, funds, assets, or property of any employee benefit plan,
during or for the period of thirteen years after such conviction or after the end of such imprisonment, whichever is later, unless the sentencing court on the motion of the person convicted sets a lesser period of at least three years after such conviction or after the end of such imprisonment, whichever is later, or unless prior to the end of such period, in the case of a person so convicted or imprisoned (A) his citizenship rights, having been revoked as a result of such conviction, have been fully restored, or (B) if the offense is a Federal offense, the sentencing judge or, if the offense is a State or local offense, the United States district court for the district in which the offense was committed, pursuant to sentencing guidelines and policy statements under section 994(a) of title 28, determines that such persons service in any capacity referred to in paragraphs (1) through (3) would not be contrary to the purposes of this subchapter. Prior to making any such determination the court shall hold a hearing and shall give notice to 11 So in original. Probably should be “of”. such proceeding by certified mail to the Secretary of Labor and to State, county, and Federal prosecuting officials in the jurisdiction or jurisdictions in which such person was convicted. The courts determination in any such proceeding shall be final. No person shall knowingly hire, retain, employ, or otherwise place any other person to serve in any capacity in violation of this subsection. Notwithstanding the preceding provisions of this subsection, no corporation or partnership will be precluded from acting as an administrator, fiduciary, officer, trustee, custodian, counsel, agent, or employee of any employee benefit plan or as a consultant to any employee benefit plan without a notice, hearing, and determination by such court that such service would be inconsistent with the intention of this section.
(b) Penalty Any person who intentionally violates this section shall be fined not more than $10,000 or imprisoned for not more than five years, or both.
(c) Definitions For the purpose of this section—
(1) A person shall be deemed to have been “convicted” and under the disability of “conviction” from the date of the judgment of the trial court, regardless of whether that judgment remains under appeal.
(2) The term “consultant” means any person who, for compensation, advises, or represents an employee benefit plan or who provides other assistance to such plan, concerning the establishment or operation of such plan.
(3) A period of parole or supervised release shall not be considered as part of a period of imprisonment.
(d) Salary of person barred from employee benefit plan office during appeal of conviction Whenever any person—
(1) by operation of this section, has been barred from office or other position in an employee benefit plan as a result of a conviction, and
(2) has filed an appeal of that conviction,
any salary which would be otherwise due such person by virtue of such office or position, shall be placed in escrow by the individual or organization responsible for payment of such salary. Payment of such salary into escrow shall continue for the duration of the appeal or for the period of time during which such salary would be otherwise due, whichever period is shorter. Upon the final reversal of such persons conviction on appeal, the amounts in escrow shall be paid to such person. Upon the final sustaining of that persons conviction on appeal, the amounts in escrow shall be returned to the individual or organization responsible for payments of those amounts. Upon final reversal of such persons conviction, such person shall no longer be barred by this statute 22 So in original. Probably should be “section”. from assuming any position from which such person was previously barred.
(Pub. L. 93406, title I, § 411, Sept. 2, 1974, 88 Stat. 887; Pub. L. 98473, title II, §§ 229, 230, 802, Oct. 12, 1984, 98 Stat. 2031, 2131; Pub. L. 100182, § 15(b), Dec. 7, 1987, 101 Stat. 1269.)
## Notes
Editorial Notes
References in TextThis chapter, referred to in subsec. (a), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables. The Labor-Management Reporting and Disclosure Act of 1959, referred to in subsec. (a), is Pub. L. 86257, Sept. 14, 1959, 73 Stat. 519, which is classified principally to chapter 11 (§ 401 et seq.) of this title. For complete classification of this Act to the Code, see Short Title note set out under section 401 of this title, and Tables.
Amendments1987—Subsec. (a). Pub. L. 100182, in concluding provisions, substituted “if the offense is a Federal offense, the sentencing judge or, if the offense is a State or local offense, the United States district court for the district in which the offense was committed, pursuant to sentencing guidelines and policy statements under section 994(a) of title 28,” for “the United States Parole Commission”, “court shall” for “Commission shall”, “courts” for “Commissions”, “such court” for “such Parole Commission”, and “a hearing” for “an administrative hearing”. 1984—Subsec. (a). Pub. L. 98473, § 229, which directed substitution of “if the offense is a Federal offense, the sentencing judge or, if the offense is a State or local offense, on motion of the United States Department of Justice, the district court of the United States for the district in which the offense was committed, pursuant to sentencing guidelines and policy statements issued pursuant to section 994(a) of title 28,” for “the Board of Parole of the United States Justice Department”, “court” and “courts” for “Board” and “Boards”, respectively, and “a” for “an administrative”, was (except for the last substitution) incapable of execution in view of the previous amendment by section 802 of Pub. L. 98473 which became effective prior to the effective date of the amendment by section 229. See note below. Pub. L. 98473, § 802(a), in amending provisions after “the Labor-Management Reporting and Disclosure Act of 1959 (29 U.S.C. 401),” generally, inserted provisions relating to abuse or misuse of employment in a labor organization or employee benefit plan, in cl. (1) substituted “employee, or representative in any capacity” for “or employee”, in cl. (2) substituted “consultant or adviser to an” for “consultant to any”, added cl. (3), substituted “the period of thirteen years” for “five years”, “unless the sentencing court on the motion of the person convicted sets a lesser period of at least three years after such conviction or after the end of such imprisonment, whichever is later, or unless prior to the end of such period,” for “unless prior to the end of such five-year period,”, in cl. (B) substituted “the United States Parole Commission” for “the Board of Parole of the United States Department of Justice” and “paragraphs (1) through (3)” for “paragraph (1) or (2)”, and in provisions following cl. (B) substituted “Commission” and “Commissions” for “Board” and “Boards”, respectively, inserted provision of notice to the Secretary of Labor, and substituted “hire, retain, employ, or otherwise place any other person to serve in any capacity” for “permit any other person to serve in any capacity referred to in paragraph (1) or (2)” and “Parole Commission” for “Board of Parole”. Subsec. (b). Pub. L. 98473, § 802(b), substituted “five years” for “one year”. Subsec. (c)(1). Pub. L. 98473, § 802(c), substituted “, regardless of whether that judgment remains under appeal” for “or the date of the final sustaining of such judgment on appeal, whichever is the later event”. Subsec. (c)(3). Pub. L. 98473, § 230, inserted “or supervised release” after “parole”. Subsec. (d). Pub. L. 98473, § 802(d), added subsec. (d).
Statutory Notes and Related Subsidiaries
Effective Date of 1987 AmendmentAmendment by Pub. L. 100182 applicable with respect to offenses committed after Dec. 7, 1987, see section 26 of Pub. L. 100182, set out as a note under section 3006A of Title 18, Crimes and Criminal Procedure.
Effective Date of 1984 AmendmentAmendments by sections 229 and 230 of Pub. L. 98473 effective Nov. 1, 1987, and applicable only to offenses committed after the taking effect of such amendments, see section 235(a)(1) of Pub. L. 98473, set out as an Effective Date note under section 3551 of Title 18, Crimes and Criminal Procedure. Amendment by section 802 of Pub. L. 98473 effective with respect to any judgment of conviction entered by the trial court after Oct. 12, 1984, except as otherwise provided, see section 804 of Pub. L. 98473, set out as a note under section 504 of this title.
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# 29 U.S.C. § 1112 - Bonding
## Text
(a) Requisite bonding of plan officials Every fiduciary of an employee benefit plan and every person who handles funds or other property of such a plan (hereafter in this section referred to as “plan official”) shall be bonded as provided in this section; except that—
(1) where such plan is one under which the only assets from which benefits are paid are the general assets of a union or of an employer, the administrator, officers, and employees of such plan shall be exempt from the bonding requirements of this section,
(2) no bond shall be required of any entity which is registered as a broker or a dealer under section 78o(b) of title 15 if the broker or dealer is subject to the fidelity bond requirements of a self-regulatory organization (within the meaning of section 78c(a)(26) of title 15).11 So in original. The period probably should be “, and”.
(3) no bond shall be required of a fiduciary (or of any director, officer, or employee of such fiduciary) if such fiduciary—
(A) is a corporation organized and doing business under the laws of the United States or of any State;
(B) is authorized under such laws to exercise trust powers or to conduct an insurance business;
(C) is subject to supervision or examination by Federal or State authority; and
(D) has at all times a combined capital and surplus in excess of such a minimum amount as may be established by regulations issued by the Secretary, which amount shall be at least $1,000,000. Paragraph (2) shall apply to a bank or other financial institution which is authorized to exercise trust powers and the deposits of which are not insured by the Federal Deposit Insurance Corporation, only if such bank or institution meets bonding or similar requirements under State law which the Secretary determines are at least equivalent to those imposed on banks by Federal law.
The amount of such bond shall be fixed at the beginning of each fiscal year of the plan. Such amount shall be not less than 10 per centum of the amount of funds handled. In no case shall such bond be less than $1,000 nor more than $500,000, except that the Secretary, after due notice and opportunity for hearing to all interested parties, and after consideration of the record, may prescribe an amount in excess of $500,000, subject to the 10 per centum limitation of the preceding sentence. For purposes of fixing the amount of such bond, the amount of funds handled shall be determined by the funds handled by the person, group, or class to be covered by such bond and by their predecessor or predecessors, if any, during the preceding reporting year, or if the plan has no preceding reporting year, the amount of funds to be handled during the current reporting year by such person, group, or class, estimated as provided in regulations of the Secretary. Such bond shall provide protection to the plan against loss by reason of acts of fraud or dishonesty on the part of the plan official, directly or through connivance with others. Any bond shall have as surety thereon a corporate surety company which is an acceptable surety on Federal bonds under authority granted by the Secretary of the Treasury pursuant to sections 93049308 of title 31. Any bond shall be in a form or of a type approved by the Secretary, including individual bonds or schedule or blanket forms of bonds which cover a group or class. In the case of a plan that holds employer securities (within the meaning of section 1107(d)(1) of this title) or in the case of a pooled employer plan (as defined in section 1002(43) of this title), this subsection shall be applied by substituting “$1,000,000” for “$500,000” each place it appears.
(b) Unlawful acts It shall be unlawful for any plan official to whom subsection (a) applies, to receive, handle, disburse, or otherwise exercise custody or control of any of the funds or other property of any employee benefit plan, without being bonded as required by subsection (a) and it shall be unlawful for any plan official of such plan, or any other person having authority to direct the performance of such functions, to permit such functions, or any of them, to be performed by any plan official, with respect to whom the requirements of subsection (a) have not been met.
(c) Conflict of interest prohibited in procuring bonds It shall be unlawful for any person to procure any bond required by subsection (a) from any surety or other company or through any agent or broker in whose business operations such plan or any party in interest in such plan has any control or significant financial interest, direct or indirect.
(d) Exclusiveness of statutory basis for bonding requirement for persons handling funds or other property of employee benefit plans Nothing in any other provision of law shall require any person, required to be bonded as provided in subsection (a) because he handles funds or other property of an employee benefit plan, to be bonded insofar as the handling by such person of the funds or other property of such plan is concerned.
(e) Regulations The Secretary shall prescribe such regulations as may be necessary to carry out the provisions of this section including exempting a plan from the requirements of this section where he finds that (1) other bonding arrangements or (2) the overall financial condition of the plan would be adequate to protect the interests of the beneficiaries and participants. When, in the opinion of the Secretary, the administrator of a plan offers adequate evidence of the financial responsibility of the plan, or that other bonding arrangements would provide adequate protection of the beneficiaries and participants, he may exempt such plan from the requirements of this section.
(Pub. L. 93406, title I, § 412, Sept. 2, 1974, 88 Stat. 888; Pub. L. 109280, title VI, §§ 611(b), 622(a), Aug. 17, 2006, 120 Stat. 968, 979; Pub. L. 11694, div. O, title I, § 101(c)(2), Dec. 20, 2019, 133 Stat. 3144.)
## Notes
Editorial Notes
Codification In subsec. (a), “sections 93049308 of title 31” substituted for “sections 6 through 13 of title 6, United States Code” on authority of Pub. L. 97258, § 4(b), Sept. 13, 1982, 96 Stat. 1067, the first section of which enacted Title 31, Money and Finance.
Amendments2019—Subsec. (a). Pub. L. 11694, in concluding provisions, inserted “or in the case of a pooled employer plan (as defined in section 1002(43) of this title)” after “section 1107(d)(1) of this title”. 2006—Subsec. (a). Pub. L. 109280, § 622(a), inserted at end of concluding provisions “In the case of a plan that holds employer securities (within the meaning of section 1107(d)(1) of this title), this subsection shall be applied by substituting $1,000,000 for $500,000 each place it appears.” Subsec. (a)(2), (3). Pub. L. 109280, § 611(b), added par. (2) and redesignated former par. (2) as (3).
Statutory Notes and Related Subsidiaries
Effective Date of 2019 AmendmentAmendment by Pub. L. 11694 applicable to plan years beginning after Dec. 31, 2020, see section 101(e) of Pub. L. 11694, set out as a note under section 408 of Title 26, Internal Revenue Code.
Effective Date of 2006 AmendmentAmendment by section 611(b) of Pub. L. 109280 applicable to plan years beginning after Aug. 17, 2006, see section 611(h)(2) of Pub. L. 109280, set out as a note under section 4975 of Title 26, Internal Revenue Code. Pub. L. 109280, title VI, § 622(b), Aug. 17, 2006, 120 Stat. 979, provided that: “The amendment made by this section [amending this section] shall apply to plan years beginning after December 31, 2007.”
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this part call for the promulgation of regulations, see sections 1031 and 1114 of this title.
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# 29 U.S.C. § 1113 - Limitation of actions
## Text
No action may be commenced under this subchapter with respect to a fiduciarys breach of any responsibility, duty, or obligation under this part, or with respect to a violation of this part, after the earlier of—
(1) six years after (A) the date of the last action which constituted a part of the breach or violation, or (B) in the case of an omission the latest date on which the fiduciary could have cured the breach or violation, or
(2) three years after the earliest date on which the plaintiff had actual knowledge of the breach or violation;
except that in the case of fraud or concealment, such action may be commenced not later than six years after the date of discovery of such breach or violation.
(Pub. L. 93406, title I, § 413, Sept. 2, 1974, 88 Stat. 889; Pub. L. 100203, title IX, § 9342(b), Dec. 22, 1987, 101 Stat. 1330371; Pub. L. 101239, title VII, §§ 7881(j)(4), 7894(e)(5), Dec. 19, 1989, 103 Stat. 2443, 2450.)
## Notes
Editorial Notes
Amendments1989—Pub. L. 101239, § 7894(e)(5), struck out “(a)” before “No action”. Par. (2). Pub. L. 101239, § 7881(j)(4), struck out comma after “violation”. 1987—Subsec. (a)(2). Pub. L. 100203 struck out “(A)” after “date” and struck out “or (B) on which a report from which he could reasonably be expected to have obtained knowledge of such breach or violation was filed with the Secretary under this subchapter”.
Statutory Notes and Related Subsidiaries
Effective Date of 1989 AmendmentAmendment by section 7881(j)(4) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Pension Protection Act, Pub. L. 100203, §§ 93029346, to which such amendment relates, see section 7882 of Pub. L. 101239, set out as a note under section 401 of Title 26, Internal Revenue Code. Amendment by section 7894(e)(5) of Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
Effective Date of 1987 AmendmentAmendment by Pub. L. 100203 applicable with respect to reports required to be filed after Dec. 31, 1987, see section 9342(d)(1) of Pub. L. 100203, set out as a note under section 1132 of this title.
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# 29 U.S.C. § 1114 - Effective date
## Text
(a) Except as provided in subsections (b), (c), and (d), this part shall take effect on January 1, 1975.
(b) (1) The provisions of this part authorizing the Secretary to promulgate regulations shall take effect on September 2, 1974.
(2) Upon application of a plan, the Secretary may postpone until not later than January 1, 1976, the applicability of any provision of sections 1102, 1103 (other than 1103(c)), 1105 (other than 1105(a) and (d)), and 1110(a) of this title, as it applies to any plan in existence on September 2, 1974, if he determines such postponement is (A) necessary to amend the instrument establishing the plan under which the plan is maintained and (B) not adverse to the interest of participants and beneficiaries.
(3) This part shall take effect on September 2, 1974, with respect to a plan which terminates after June 30, 1974, and before January 1, 1975, and to which at the time of termination section 1321 of this title applies.
(c) Sections 1106 and 1107(a) of this title (relating to prohibited transactions) shall not apply—
(1) until June 30, 1984, to a loan of money or other extension of credit between a plan and a party in interest under a binding contract in effect on July 1, 1974 (or pursuant to renewals of such a contract), if such loan or other extension of credit remains at least as favorable to the plan as an arms-length transaction with an unrelated party would be, and if the execution of the contract, the making of the loan, or the extension of credit was not, at the time of such execution, making, or extension, a prohibited transaction (within the meaning of section 503(b) of title 26 or the corresponding provisions of prior law);
(2) until June 30, 1984, to a lease or joint use of property involving the plan and a party in interest pursuant to a binding contract in effect on July 1, 1974 (or pursuant to renewals of such a contract), if such lease or joint use remains at least as favorable to the plan as an arms-length transaction with an unrelated party would be and if the execution of the contract was not, at the time of such execution, a prohibited transaction (within the meaning of section 503(b) of title 26 or the corresponding provisions of prior law);
(3) until June 30, 1984, to the sale, exchange or other disposition of property described in paragraph (2) between a plan and a party in interest if—
(A) in the case of a sale, exchange, or other disposition of the property by the plan to the party in interest, the plan receives an amount which is not less than the fair market value of the property at the time of such disposition; and
(B) in the case of the acquisition of the property by the plan, the plan pays an amount which is not in excess of the fair market value of the property at the time of such acquisition;
(4) until June 30, 1977, to the provision of services, to which paragraphs (1), (2), and (3) do not apply between a plan and a party in interest—
(A) under a binding contract in effect on July 1, 1974 (or pursuant to renewals of such contract), or
(B) if the party in interest ordinarily and customarily furnished such services on June 30, 1974, if such provision of services remains at least as favorable to the plan as an arms-length transaction with an unrelated party would be and if such provision of services was not, at the time of such provision, a prohibited transaction (within the meaning of section 503(b) of title 26) or the corresponding provisions of prior law; or
(5) the sale, exchange, or other disposition of property which is owned by a plan on June 30, 1974, and all times thereafter, to a party in interest, if such plan is required to dispose of such property in order to comply with the provisions of section 1107(a) of this title (relating to the prohibition against holding excess employer securities and employer real property), and if the plan receives not less than adequate consideration.
(d) Any election, or failure to elect, by a disqualified person under section 2003(c)(1)(B) of this Act shall be treated for purposes of this part (but not for purposes of section 1144 of this title) as an act or omission occurring before the effective date of this part.
(e) The preceding provisions of this section shall not apply with respect to amendments made to this part in provisions enacted after September 2, 1974.
(Pub. L. 93406, title I, § 414, Sept. 2, 1974, 88 Stat. 889; Pub. L. 101239, title VII, § 7894(e)(6), (h)(4), Dec. 19, 1989, 103 Stat. 2450, 2451.)
## Notes
Editorial Notes
References in TextSection 2003(c)(1)(B) of this Act, referred to in subsec. (d), is section 2003(c)(1)(B) of Pub. L. 93406, which is set out as an Effective Date; Savings Provisions note under section 4975 of Title 26, Internal Revenue Code.
Amendments1989—Subsec. (c)(2). Pub. L. 101239, § 7894(e)(6), substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text, and substituted “or the corresponding provisions of prior law)” for “) or the corresponding provisions of prior law”. Subsec. (e). Pub. L. 101239, § 7894(h)(4), added subsec. (e).
Statutory Notes and Related Subsidiaries
Effective Date of 1989 AmendmentAmendment by Pub. L. 101239 effective, except as otherwise provided, as if originally included in the provision of the Employee Retirement Income Security Act of 1974, Pub. L. 93406, to which such amendment relates, see section 7894(i) of Pub. L. 101239, set out as a note under section 1002 of this title.
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# 29 U.S.C. § 1131 - Criminal penalties
## Text
(a) Any person who willfully violates any provision of part 1 of this subtitle, or any regulation or order issued under any such provision, shall upon conviction be fined not more than $100,000 or imprisoned not more than 10 years, or both; except that in the case of such violation by a person not an individual, the fine imposed upon such person shall be a fine not exceeding $500,000.
(b) Any person that violates section 1149 of this title shall upon conviction be imprisoned not more than 10 years or fined under title 18, or both.
(Pub. L. 93406, title I, § 501, Sept. 2, 1974, 88 Stat. 891; Pub. L. 107204, title IX, § 904, July 30, 2002, 116 Stat. 805; Pub. L. 111148, title VI, § 6601(b), Mar. 23, 2010, 124 Stat. 779.)
## Notes
Editorial Notes
Amendments2010—Pub. L. 111148 designated existing provisions as subsec. (a) and added subsec. (b). 2002—Pub. L. 107204 substituted “$100,000” for “$5,000”, “10 years” for “one year”, and “$500,000” for “$100,000”.
Statutory Notes and Related Subsidiaries
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1133 - Claims procedure
## Text
In accordance with regulations of the Secretary, every employee benefit plan shall—
(1) provide adequate notice in writing to any participant or beneficiary whose claim for benefits under the plan has been denied, setting forth the specific reasons for such denial, written in a manner calculated to be understood by the participant, and
(2) afford a reasonable opportunity to any participant whose claim for benefits has been denied for a full and fair review by the appropriate named fiduciary of the decision denying the claim.
(Pub. L. 93406, title I, § 503, Sept. 2, 1974, 88 Stat. 893.)
## Notes
Statutory Notes and Related Subsidiaries
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1134 - Investigative authority
## Text
(a) Investigation and submission of reports, books, etc. The Secretary shall have the power, in order to determine whether any person has violated or is about to violate any provision of this subchapter or any regulation or order thereunder—
(1) to make an investigation, and in connection therewith to require the submission of reports, books, and records, and the filing of data in support of any information required to be filed with the Secretary under this subchapter, and
(2) to enter such places, inspect such books and records and question such persons as he may deem necessary to enable him to determine the facts relative to such investigation, if he has reasonable cause to believe there may exist a violation of this subchapter or any rule or regulation issued thereunder or if the entry is pursuant to an agreement with the plan.
The Secretary may make available to any person actually affected by any matter which is the subject of an investigation under this section, and to any department or agency of the United States, information concerning any matter which may be the subject of such investigation; except that any information obtained by the Secretary pursuant to section 6103(g) of title 26 shall be made available only in accordance with regulations prescribed by the Secretary of the Treasury.
(b) Frequency of submission of books and records The Secretary may not under the authority of this section require any plan to submit to the Secretary any books or records of the plan more than once in any 12 month period, unless the Secretary has reasonable cause to believe there may exist a violation of this subchapter or any regulation or order thereunder.
(c) Other provisions applicable relating to attendance of witnesses and production of books, records, etc. For the purposes of any investigation provided for in this subchapter, the provisions of sections 49 and 50 of title 15 (relating to the attendance of witnesses and the production of books, records, and documents) are hereby made applicable (without regard to any limitation in such sections respecting persons, partnerships, banks, or common carriers) to the jurisdiction, powers, and duties of the Secretary or any officers designated by him. To the extent he considers appropriate, the Secretary may delegate his investigative functions under this section with respect to insured banks acting as fiduciaries of employee benefit plans to the appropriate Federal banking agency (as defined in section 1813(q) of title 12).
(d) Evidentiary privilege; confidentiality of communications The Secretary may promulgate a regulation that provides an evidentiary privilege for, and provides for the confidentiality of communications between or among, any of the following entities or their agents, consultants, or employees:
(1) A State insurance department.
(2) A State attorney general.
(3) The National Association of Insurance Commissioners.
(4) The Department of Labor.
(5) The Department of the Treasury.
(6) The Department of Justice.
(7) The Department of Health and Human Services.
(8) Any other Federal or State authority that the Secretary determines is appropriate for the purposes of enforcing the provisions of this subchapter.
(e) Application of privilege The privilege established under subsection (d) shall apply to communications related to any investigation, audit, examination, or inquiry conducted or coordinated by any of the agencies. A communication that is privileged under subsection (d) shall not waive any privilege otherwise available to the communicating agency or to any person who provided the information that is communicated.
(Pub. L. 93406, title I, § 504, Sept. 2, 1974, 88 Stat. 893; Pub. L. 101239, title VII, § 7891(a)(1), Dec. 19, 1989, 103 Stat. 2445; Pub. L. 111148, title VI, § 6607, Mar. 23, 2010, 124 Stat. 781.)
## Notes
Editorial Notes
Amendments2010—Subsecs. (d), (e). Pub. L. 111148 added subsecs. (d) and (e). 1989—Subsec. (a). Pub. L. 101239 substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text.
Statutory Notes and Related Subsidiaries
Effective Date of 1989 AmendmentAmendment by Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1136 - Coordination and responsibility of agencies enforcing this subchapter and related Federal laws
## Text
(a) Coordination with other agencies and departments In order to avoid unnecessary expense and duplication of functions among Government agencies, the Secretary may make such arrangements or agreements for cooperation or mutual assistance in the performance of his functions under this subchapter and the functions of any such agency as he may find to be practicable and consistent with law. The Secretary may utilize, on a reimbursable or other basis, the facilities or services of any department, agency, or establishment of the United States or of any State or political subdivision of a State, including the services of any of its employees, with the lawful consent of such department, agency, or establishment; and each department, agency, or establishment of the United States is authorized and directed to cooperate with the Secretary and, to the extent permitted by law, to provide such information and facilities as he may request for his assistance in the performance of his functions under this subchapter. The Attorney General or his representative shall receive from the Secretary for appropriate action such evidence developed in the performance of his functions under this subchapter as may be found to warrant consideration for criminal prosecution under the provisions of this subchapter or other Federal law.
(b) Responsibility for detecting and investigating civil and criminal violations of this subchapter and related Federal laws The Secretary shall have the responsibility and authority to detect and investigate and refer, where appropriate, civil and criminal violations related to the provisions of this subchapter and other related Federal laws, including the detection, investigation, and appropriate referrals of related violations of title 18. Nothing in this subsection shall be construed to preclude other appropriate Federal agencies from detecting and investigating civil and criminal violations of this subchapter and other related Federal laws.
(c) Coordination of enforcement with States with respect to certain arrangements A State may enter into an agreement with the Secretary for delegation to the State of some or all of the Secretarys authority under sections 1132 and 1134 of this title to enforce the requirements under part 7 in connection with multiple employer welfare arrangements, providing medical care (within the meaning of section 1191b(a)(2) of this title), which are not group health plans.
(Pub. L. 93406, title I, § 506, Sept. 2, 1974, 88 Stat. 894; Pub. L. 98473, title II, § 805, Oct. 12, 1984, 98 Stat. 2134; Pub. L. 104191, title I, § 101(e)(3), Aug. 21, 1996, 110 Stat. 1953; Pub. L. 104204, title VI, § 603(b)(3)(F), Sept. 26, 1996, 110 Stat. 2938.)
## Notes
Editorial Notes
Amendments1996—Subsec. (c). Pub. L. 104204 made technical amendment to reference in original act which appears in text as reference to section 1191b of this title. Pub. L. 104191 added subsec. (c). 1984—Pub. L. 98473 designated existing provisions as subsec. (a), added subsec. (b), and amended section catchline.
Statutory Notes and Related Subsidiaries
Effective Date of 1996 AmendmentsAmendment by Pub. L. 104204 applicable with respect to group health plans for plan years beginning on or after Jan. 1, 1998, see section 603(c) of Pub. L. 104204 set out as a note under section 1003 of this title. Amendment by Pub. L. 104191 applicable with respect to group health plans for plan years beginning after June 30, 1997, except as otherwise provided, see section 101(g) of Pub. L. 104191, set out as a note under section 1181 of this title.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
Relation of Subtitle E of Title II of Pub. L. 104191 to ERISA AuthorityPub. L. 104191, title II, § 250, Aug. 21, 1996, 110 Stat. 2021, provided that: “Nothing in this subtitle [subtitle E (§§ 241250) of title II of Pub. L. 104191, enacting sections 24, 669, 1035, 1347, 1518, and 3486 of Title 18, Crimes and Criminal Procedure, amending sections 982, 1345, 1510, and 1956 of Title 18, and enacting provisions set out as notes under section 1395i of Title 42, The Public Health and Welfare] shall be construed as affecting the authority of the Secretary of Labor under section 506(b) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1136(b)], including the Secretarys authority with respect to violations of title 18, United States Code (as amended by this subtitle).”
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# 29 U.S.C. § 1137 - Administration
## Text
(a) Subchapter II of chapter 5, and chapter 7, of title 5 (relating to administrative procedure), shall be applicable to this subchapter.
(b) Omitted.
(c) No employee of the Department of Labor or the Department of the Treasury shall administer or enforce this subchapter or title 26 with respect to any employee benefit plan under which he is a participant or beneficiary, any employee organization of which he is a member, or any employer organization in which he has an interest. This subsection does not apply to an employee benefit plan which covers only employees of the United States.
(Pub. L. 93406, title I, § 507, Sept. 2, 1974, 88 Stat. 894; Pub. L. 101239, title VII, § 7891(a), Dec. 19, 1989, 103 Stat. 2445.)
## Notes
Editorial Notes
Codification Subsec. (b) of this section amended section 5108 of Title 5, Government Organization and Employees.
Amendments1989—Subsec. (c). Pub. L. 101239 substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text.
Statutory Notes and Related Subsidiaries
Effective Date of 1989 AmendmentAmendment by Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1138 - Appropriations
## Text
There are hereby authorized to be appropriated such sums as may be necessary to enable the Secretary to carry out his functions and duties under this chapter.
(Pub. L. 93406, title I, § 508, Sept. 2, 1974, 88 Stat. 895.)
## Notes
Editorial Notes
References in TextThis chapter, referred to in text, was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
Statutory Notes and Related Subsidiaries
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1139 - Separability
## Text
If any provision of this chapter, or the application of such provision to any person or circumstances, shall be held invalid, the remainder of this chapter, or the application of such provision to persons or circumstances other than those as to which it is held invalid, shall not be affected thereby.
(Pub. L. 93406, title I, § 509, Sept. 2, 1974, 88 Stat. 895.)
## Notes
Editorial Notes
References in TextThis chapter, referred to in text, was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
Statutory Notes and Related Subsidiaries
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1140 - Interference with protected rights
## Text
It shall be unlawful for any person to discharge, fine, suspend, expel, discipline, or discriminate against a participant or beneficiary for exercising any right to which he is entitled under the provisions of an employee benefit plan, this subchapter, section 1201 of this title, or the Welfare and Pension Plans Disclosure Act [29 U.S.C. 301 et seq.], or for the purpose of interfering with the attainment of any right to which such participant may become entitled under the plan, this subchapter, or the Welfare and Pension Plans Disclosure Act. It shall be unlawful for any person to discharge, fine, suspend, expel, or discriminate against any person because he has given information or has testified or is about to testify in any inquiry or proceeding relating to this chapter or the Welfare and Pension Plans Disclosure Act. In the case of a multiemployer plan, it shall be unlawful for the plan sponsor or any other person to discriminate against any contributing employer for exercising rights under this chapter or for giving information or testifying in any inquiry or proceeding relating to this chapter before Congress. The provisions of section 1132 of this title shall be applicable in the enforcement of this section.
(Pub. L. 93406, title I, § 510, Sept. 2, 1974, 88 Stat. 895; Pub. L. 109280, title II, § 205, Aug. 17, 2006, 120 Stat. 889.)
## Notes
Editorial Notes
References in TextThe Welfare and Pension Plans Disclosure Act, referred to in text, is Pub. L. 85836, Aug. 28, 1958, 72 Stat. 997, which was classified generally to chapter 10 (§ 301 et seq.) of this title, and was repealed by Pub. L. 93406, title I, § 111(a)(1), Sept. 2, 1974, 88 Stat. 851 (Employee Retirement Income Security Act of 1974), effective Jan. 1, 1975. Such section 111(a)(1) also provided that the Welfare and Pension Plans Disclosure Act should continue to apply to any conduct and events which occurred before Jan. 1, 1975 (see section 1031 of this title). For complete classification of the Welfare and Pension Plans Disclosure Act to the Code prior to such repeal, see Tables. This chapter, referred to in text, was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
Amendments2006—Pub. L. 109280 inserted before last sentence “In the case of a multiemployer plan, it shall be unlawful for the plan sponsor or any other person to discriminate against any contributing employer for exercising rights under this chapter or for giving information or testifying in any inquiry or proceeding relating to this chapter before Congress.”
Statutory Notes and Related Subsidiaries
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1141 - Coercive interference
## Text
It shall be unlawful for any person through the use of fraud, force, violence, or threat of the use of force or violence, to restrain, coerce, intimidate, or attempt to restrain, coerce, or intimidate any participant or beneficiary for the purpose of interfering with or preventing the exercise of any right to which he is or may become entitled under the plan, this subchapter, section 1201 of this title, or the Welfare and Pension Plans Disclosure Act [29 U.S.C. 301 et seq.]. Any person who willfully violates this section shall be fined $100,000 or imprisoned for not more than 10 years, or both.
(Pub. L. 93406, title I, § 511, Sept. 2, 1974, 88 Stat. 895; Pub. L. 109280, title VI, § 623(a), Aug. 17, 2006, 120 Stat. 979.)
## Notes
Editorial Notes
References in TextThe Welfare and Pension Plans Disclosure Act, referred to in text, is Pub. L. 85836, Aug. 28, 1958, 72 Stat. 997, which was classified generally to chapter 10 (§ 301 et seq.) of this title, and was repealed by Pub. L. 93406, title I, § 111(a)(1), Sept. 2, 1974, 88 Stat. 851 (Employee Retirement Income Security Act of 1974), effective Jan. 1, 1975. Such section 111(a)(1) also provided that the Welfare and Pension Plans Disclosure Act should continue to apply to any conduct and events which occurred before Jan. 1, 1975 (see section 1031 of this title). For complete classification of the Welfare and Pension Plans Disclosure Act to the Code prior to such repeal, see Tables.
Amendments2006—Pub. L. 109280 substituted “$100,000” for “$10,000” and “10 years” for “one year”.
Statutory Notes and Related Subsidiaries
Effective Date of 2006 AmendmentPub. L. 109280, title VI, § 623(b), Aug. 17, 2006, 120 Stat. 979, provided that: “The amendments made by this section [amending this section] shall apply to violations occurring on and after the date of the enactment of this Act [Aug. 17, 2006].”
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1142 - Advisory Council on Employee Welfare and Pension Benefit Plans
## Text
(a) Establishment; membership; terms; appointment and reappointment; vacancies; quorum (1) There is hereby established an Advisory Council on Employee Welfare and Pension Benefit Plans (hereinafter in this section referred to as the “Council”) consisting of fifteen members appointed by the Secretary. Not more than eight members of the Council shall be members of the same political party.
(2) Members shall be persons qualified to appraise the programs instituted under this chapter.
(3) Of the members appointed, three shall be representatives of employee organizations (at least one of whom shall be representative of any organization members of which are participants in a multiemployer plan); three shall be representatives of employers (at least one of whom shall be representative of employers maintaining or contributing to multi-employer plans); three representatives shall be appointed from the general public, one of whom shall be a person representing those receiving benefits from a pension plan; and there shall be one representative each from the fields of insurance, corporate trust, actuarial counseling, investment counseling, investment management, and the accounting field.
(4) Members shall serve for terms of three years except that of those first appointed, five shall be appointed for terms of one year, five shall be appointed for terms of two years, and five shall be appointed for terms of three years. A member may be reappointed. A member appointed to fill a vacancy shall be appointed only for the remainder of such term. A majority of members shall constitute a quorum and action shall be taken only by a majority vote of those present and voting.
(b) Duties and functions It shall be the duty of the Council to advise the Secretary with respect to the carrying out of his functions under this chapter and to submit to the Secretary recommendations with respect thereto. The Council shall meet at least four times each year and at such other times as the Secretary requests. In his annual report submitted pursuant to section 1143(b) 11 See References in Text note below. of this title, the Secretary shall include each recommendation which he has received from the Council during the preceding calendar year.
(c) Executive secretary; secretarial and clerical services The Secretary shall furnish to the Council an executive secretary and such secretarial, clerical, and other services as are deemed necessary to conduct its business. The Secretary may call upon other agencies of the Government for statistical data, reports, and other information which will assist the Council in the performance of its duties.
(d) Compensation (1) Members of the Council shall each be entitled to receive the daily equivalent of the annual rate of basic pay in effect for grade GS18 of the General Schedule for each day (including travel time) during which they are engaged in the actual performance of duties vested in the Council.
(2) While away from their homes or regular places of business in the performance of services for Council,22 So in original. Probably should be “for the Council,”. members of the Council shall be allowed travel expenses, including per diem in lieu of subsistence, in the same manner as persons employed intermittently in the Government service are allowed expenses under section 5703(b) of title 5.1
(e) Termination Section 1013(a) of title 5 (relating to termination) shall not apply to the Council.
(Pub. L. 93406, title I, § 512, Sept. 2, 1974, 88 Stat. 895; Pub. L. 117286, § 4(a)(189), Dec. 27, 2022, 136 Stat. 4326.)
## Notes
Editorial Notes
References in TextThis chapter, referred to in subsecs. (a)(2), (b), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables. Section 1143(b) of this title, referred to in subsec. (b), was omitted from the Code. Section 5703 of title 5, referred to in subsec. (d)(2), was amended generally by Pub. L. 9422, § 4, May 19, 1975, 89 Stat. 85, and, as so amended, does not contain a subsec. (b).
Amendments2022—Subsec. (e). Pub. L. 117286 substituted “Section 1013(a) of title 5 (relating to termination)” for “Section 14(a) of the Federal Advisory Committee Act (relating to termination)”.
Statutory Notes and Related Subsidiaries
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
References in Other Laws to GS16, 17, or 18 Pay RatesReferences in laws to the rates of pay for GS16, 17, or 18, or to maximum rates of pay under the General Schedule, to be considered references to rates payable under specified sections of Title 5, Government Organization and Employees, see section 529 [title I, § 101(c)(1)] of Pub. L. 101509, set out in a note under section 5376 of Title 5.
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# 29 U.S.C. § 1143 - Research, studies, and reports
## Text
(a) Authorization to undertake research and surveys (1) The Secretary is authorized to undertake research and surveys and in connection therewith to collect, compile, analyze and publish data, information, and statistics relating to employee benefit plans, including retirement, deferred compensation, and welfare plans, and types of plans not subject to this chapter.
(2) The Secretary is authorized and directed to undertake research studies relating to pension plans, including but not limited to (A) the effects of this subchapter upon the provisions and costs of pension plans, (B) the role of private pensions in meeting the economic security needs of the Nation, and (C) the operation of private pension plans including types and levels of benefits, degree of reciprocity or portability, and financial and actuarial characteristics and practices, and methods of encouraging the growth of the private pension system.
(3) The Secretary may, as he deems appropriate or necessary, undertake other studies relating to employee benefit plans, the matters regulated by this subchapter, and the enforcement procedures provided for under this subchapter.
(4) The research, surveys, studies, and publications referred to in this subsection may be conducted directly, or indirectly through grant or contract arrangements.
(b) Omitted
(c) Cooperation with Congress The Secretary is authorized and directed to cooperate with the Congress and its appropriate committees, subcommittees, and staff in supplying data and any other information, and personnel and services, required by the Congress in any study, examination, or report by the Congress relating to pension benefit plans established or maintained by States or their political subdivisions.
(Pub. L. 93406, title I, § 513, Sept. 2, 1974, 88 Stat. 896.)
## Notes
Editorial Notes
References in TextThis chapter, referred to in subsec. (a)(1), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
Codification Subsec. (b) of this section, which required the Secretary to submit annually a report to Congress on the administration of this subchapter, terminated, effective May 15, 2000, pursuant to section 3003 of Pub. L. 10466, as amended, set out as a note under section 1113 of Title 31, Money and Finance. See, also, page 123 of House Document No. 1037.
Statutory Notes and Related Subsidiaries
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
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# 29 U.S.C. § 1143a - Studies by Comptroller General
## Text
(1) In general The Comptroller General of the United States may, pursuant to the request of any Member of Congress, study employee benefit plans, including the effects of such plans on employees, participants, and their beneficiaries.
(2) Access to books, documents, etc. For the purpose of conducting studies under this section, the Comptroller General, or any of his duly authorized representatives, shall have access to and the right to examine and copy any books, documents, papers, records, or other recorded information—
(A) within the possession or control of the administrator, sponsor, or employer of and persons providing services to any employee benefit plan, and
(B) which the Comptroller General or his representative finds, in his own judgment, pertinent to such study.
The Comptroller General shall not disclose the identity of any individual or employer in making any information obtained under this section available to the public.
(3) Definitions For purposes of this section, the terms “employee benefit plan”, “participant”, “administrator”, “beneficiary”, “plan sponsor”, “employee”, and “employer” are defined in section 1002 of this title.
(4) Effective date The preceding provisions of this section shall be effective on April 7, 1986.
(Pub. L. 99272, title XI, § 11016(d), Apr. 7, 1986, 100 Stat. 275.)
## Notes
Editorial Notes
Codification Section was enacted as part of the Single-Employer Pension Plan Amendments Act of 1986, and also as part of the Consolidated Omnibus Budget Reconciliation Act of 1985, and not as part of the Employee Retirement Income Security Act of 1974 which comprises this chapter.
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# 29 U.S.C. § 1144 - Other laws
## Text
(a) Supersedure; effective date Except as provided in subsection (b) of this section, the provisions of this subchapter and subchapter III shall supersede any and all State laws insofar as they may now or hereafter relate to any employee benefit plan described in section 1003(a) of this title and not exempt under section 1003(b) of this title. This section shall take effect on January 1, 1975.
(b) Construction and application (1) This section shall not apply with respect to any cause of action which arose, or any act or omission which occurred, before January 1, 1975.
(2) (A) Except as provided in subparagraph (B), nothing in this subchapter shall be construed to exempt or relieve any person from any law of any State which regulates insurance, banking, or securities.
(B) Neither an employee benefit plan described in section 1003(a) of this title, which is not exempt under section 1003(b) of this title (other than a plan established primarily for the purpose of providing death benefits), nor any trust established under such a plan, shall be deemed to be an insurance company or other insurer, bank, trust company, or investment company or to be engaged in the business of insurance or banking for purposes of any law of any State purporting to regulate insurance companies, insurance contracts, banks, trust companies, or investment companies.
(3) Nothing in this section shall be construed to prohibit use by the Secretary of services or facilities of a State agency as permitted under section 1136 of this title.
(4) Subsection (a) shall not apply to any generally applicable criminal law of a State.
(5) (A) Except as provided in subparagraph (B), subsection (a) shall not apply to the Hawaii Prepaid Health Care Act (Haw. Rev. Stat. §§ 3931 through 39351).
(B) Nothing in subparagraph (A) shall be construed to exempt from subsection (a)—
(i) any State tax law relating to employee benefit plans, or
(ii) any amendment of the Hawaii Prepaid Health Care Act enacted after September 2, 1974, to the extent it provides for more than the effective administration of such Act as in effect on such date.
(C) Notwithstanding subparagraph (A), parts 1 and 4 of this subtitle, and the preceding sections of this part to the extent they govern matters which are governed by the provisions of such parts 1 and 4, shall supersede the Hawaii Prepaid Health Care Act (as in effect on or after January 14, 1983), but the Secretary may enter into cooperative arrangements under this paragraph and section 1136 of this title with officials of the State of Hawaii to assist them in effectuating the policies of provisions of such Act which are superseded by such parts 1 and 4 and the preceding sections of this part.
(6) (A) Notwithstanding any other provision of this section—
(i) in the case of an employee welfare benefit plan which is a multiple employer welfare arrangement and is fully insured (or which is a multiple employer welfare arrangement subject to an exemption under subparagraph (B)), any law of any State which regulates insurance may apply to such arrangement to the extent that such law provides—
(I) standards, requiring the maintenance of specified levels of reserves and specified levels of contributions, which any such plan, or any trust established under such a plan, must meet in order to be considered under such law able to pay benefits in full when due, and
(II) provisions to enforce such standards, and
(ii) in the case of any other employee welfare benefit plan which is a multiple employer welfare arrangement, in addition to this subchapter, any law of any State which regulates insurance may apply to the extent not inconsistent with the preceding sections of this subchapter.
(B) The Secretary may, under regulations which may be prescribed by the Secretary, exempt from subparagraph (A)(ii), individually or by class, multiple employer welfare arrangements which are not fully insured. Any such exemption may be granted with respect to any arrangement or class of arrangements only if such arrangement or each arrangement which is a member of such class meets the requirements of section 1002(1) and section 1003 of this title necessary to be considered an employee welfare benefit plan to which this subchapter applies.
(C) Nothing in subparagraph (A) shall affect the manner or extent to which the provisions of this subchapter apply to an employee welfare benefit plan which is not a multiple employer welfare arrangement and which is a plan, fund, or program participating in, subscribing to, or otherwise using a multiple employer welfare arrangement to fund or administer benefits to such plans participants and beneficiaries.
(D) For purposes of this paragraph, a multiple employer welfare arrangement shall be considered fully insured only if the terms of the arrangement provide for benefits the amount of all of which the Secretary determines are guaranteed under a contract, or policy of insurance, issued by an insurance company, insurance service, or insurance organization, qualified to conduct business in a State.
(7) Subsection (a) shall not apply to qualified domestic relations orders (within the meaning of section 1056(d)(3)(B)(i) of this title), qualified medical child support orders (within the meaning of section 1169(a)(2)(A) of this title), and the provisions of law referred to in section 1169(a)(2)(B)(ii) of this title to the extent they apply to qualified medical child support orders.
(8) Subsection (a) of this section shall not be construed to preclude any State cause of action—
(A) with respect to which the State exercises its acquired rights under section 1169(b)(3) of this title with respect to a group health plan (as defined in section 1167(1) of this title), or
(B) for recoupment of payment with respect to items or services pursuant to a State plan for medical assistance approved under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] which would not have been payable if such acquired rights had been executed before payment with respect to such items or services by the group health plan.
(9) For additional provisions relating to group health plans, see section 1191 of this title.
(c) Definitions For purposes of this section:
(1) The term “State law” includes all laws, decisions, rules, regulations, or other State action having the effect of law, of any State. A law of the United States applicable only to the District of Columbia shall be treated as a State law rather than a law of the United States.
(2) The term “State” includes a State, any political subdivisions thereof, or any agency or instrumentality of either, which purports to regulate, directly or indirectly, the terms and conditions of employee benefit plans covered by this subchapter.
(d) Alteration, amendment, modification, invalidation, impairment, or supersedure of any law of the United States prohibited Nothing in this subchapter shall be construed to alter, amend, modify, invalidate, impair, or supersede any law of the United States (except as provided in sections 1031 and 1137(b) of this title) or any rule or regulation issued under any such law.
(e) Automatic contribution arrangements (1) Notwithstanding any other provision of this section, this subchapter shall supersede any law of a State which would directly or indirectly prohibit or restrict the inclusion in any plan of an automatic contribution arrangement. The Secretary may prescribe regulations which would establish minimum standards that such an arrangement would be required to satisfy in order for this subsection to apply in the case of such arrangement.
(2) For purposes of this subsection, the term “automatic contribution arrangement” means an arrangement—
(A) under which a participant may elect to have the plan sponsor make payments as contributions under the plan on behalf of the participant, or to the participant directly in cash,
(B) under which a participant is treated as having elected to have the plan sponsor make such contributions in an amount equal to a uniform percentage of compensation provided under the plan until the participant specifically elects not to have such contributions made (or specifically elects to have such contributions made at a different percentage), and
(C) under which such contributions are invested in accordance with regulations prescribed by the Secretary under section 1104(c)(5) of this title.
(3) (A) The plan administrator of an automatic contribution arrangement shall, within a reasonable period before such plan year, provide to each participant to whom the arrangement applies for such plan year notice of the participants rights and obligations under the arrangement which—
(i) is sufficiently accurate and comprehensive to apprise the participant of such rights and obligations, and
(ii) is written in a manner calculated to be understood by the average participant to whom the arrangement applies.
(B) A notice shall not be treated as meeting the requirements of subparagraph (A) with respect to a participant unless—
(i) the notice includes an explanation of the participants right under the arrangement not to have elective contributions made on the participants behalf (or to elect to have such contributions made at a different percentage),
(ii) the participant has a reasonable period of time, after receipt of the notice described in clause (i) and before the first elective contribution is made, to make such election, and
(iii) the notice explains how contributions made under the arrangement will be invested in the absence of any investment election by the participant.
(Pub. L. 93406, title I, § 514, Sept. 2, 1974, 88 Stat. 897; Pub. L. 97473, title III, §§ 301(a), 302(b), Jan. 14, 1983, 96 Stat. 2611, 2613; Pub. L. 98397, title I, § 104(b), Aug. 23, 1984, 98 Stat. 1436; Pub. L. 99272, title IX, § 9503(d)(1), Apr. 7, 1986, 100 Stat. 207; Pub. L. 101239, title VII, § 7894(f)(2)(A), (3)(A), Dec. 19, 1989, 103 Stat. 2450, 2451; Pub. L. 10366, title IV, § 4301(c)(4), Aug. 10, 1993, 107 Stat. 377; Pub. L. 104191, title I, § 101(f)(1), Aug. 21, 1996, 110 Stat. 1953; Pub. L. 104204, title VI, § 603(b)(3)(G), Sept. 26, 1996, 110 Stat. 2938; Pub. L. 105200, title IV, § 401(h)(2)(A)(i), (ii), July 16, 1998, 112 Stat. 668; Pub. L. 109280, title IX, § 902(f)(1), Aug. 17, 2006, 120 Stat. 1039.)
## Notes
Editorial Notes
References in TextThe Social Security Act, referred to in subsec. (b)(8)(B), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Social Security Act is classified generally to subchapter XIX (§ 1396 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.
Amendments2006—Subsec. (e). Pub. L. 109280 added subsec. (e). 1998—Subsec. (b)(7). Pub. L. 105200, § 401(h)(2)(A)(ii), substituted “they apply to” for “enforced by”. Pub. L. 105200, § 401(h)(2)(A)(i), amended directory language of Pub. L. 10366, § 4301(c)(4)(A). See 1993 Amendment note below. 1996—Subsec. (b)(9). Pub. L. 104204 made technical amendment to reference in original act which appears in text as reference to section 1191 of this title. Pub. L. 104191 added par. (9). 1993—Subsec. (b)(7). Pub. L. 10366, § 4301(c)(4)(A), as amended by Pub. L. 105200, § 401(h)(1)(A)(i), inserted “, qualified medical child support orders (within the meaning of section 1169(a)(2)(A) of this title), and the provisions of law referred to in section 1169(a)(2)(B)(ii) of this title to the extent enforced by qualified medical child support orders” before period at end. Subsec. (b)(8). Pub. L. 10366, § 4301(c)(4)(B), added par. (8) and struck out former par. (8) which read as follows: “Subsection (a) of this section shall not apply to any State law mandating that an employee benefit plan not include any provision which has the effect of limiting or excluding coverage or payment for any health care for an individual who would otherwise be covered or entitled to benefits or services under the terms of the employee benefit plan, because that individual is provided, or is eligible for, benefits or services pursuant to a plan under title XIX of the Social Security Act, to the extent such law is necessary for the State to be eligible to receive reimbursement under title XIX of that Act.” 1989—Subsec. (b)(5)(C). Pub. L. 101239, § 7894(f)(2)(A), substituted “by such parts 1 and 4 and the preceding sections of this part” for “by such parts”. Subsec. (b)(6)(B). Pub. L. 101239, § 7894(f)(3)(A), substituted “section 1002(1)” for “section 1002(l)”. 1986—Subsec. (b)(8). Pub. L. 99272 added par. (8). 1984—Subsec. (b)(7). Pub. L. 98397 added par. (7). 1983—Subsec. (b)(5). Pub. L. 97473, § 301(a), added par. (5). Subsec. (b)(6). Pub. L. 97473, § 302(b), added par. (6).
Statutory Notes and Related Subsidiaries
Effective Date of 1998 AmendmentPub. L. 105200, title IV, § 401(h)(2)(C), July 16, 1998, 112 Stat. 668, provided that: “The amendments made by subparagraph (A) [amending this section and section 1169 of this title] shall be effective as if included in the enactment of section 4301(c)(4)(A) of the Omnibus Budget Reconciliation Act of 1993 [Pub. L. 10366].”
Effective Date of 1996 AmendmentsAmendment by Pub. L. 104204 applicable with respect to group health plans for plan years beginning on or after Jan. 1, 1998, see section 603(c) of Pub. L. 104204, set out as a note under section 1003 of this title. Amendment by Pub. L. 104191 applicable with respect to group health plans for plan years beginning after June 30, 1997, except as otherwise provided, see section 101(g) of Pub. L. 104191, set out as a note under section 1181 of this title.
Effective Date of 1989 AmendmentPub. L. 101239, title VII, § 7894(f)(2)(B), Dec. 19, 1989, 103 Stat. 2451, provided that: “The amendment made by this paragraph [amending this section] shall take effect as if included in section 301 of Public Law 97473.” Pub. L. 101239, title VII, § 7894(f)(3)(B), Dec. 19, 1989, 103 Stat. 2451, provided that: “The amendments made by this paragraph [amending this section] shall take effect as if included in section 302 of Public Law 97473.”
Effective Date of 1986 AmendmentPub. L. 99272, title IX, § 9503(d)(2), Apr. 7, 1986, 100 Stat. 207, provided that: “(2)(A) Except as provided in subparagraph (B), the amendment made by paragraph (1) [amending this section] shall become effective on October 1, 1986. “(B) In the case of a plan maintained pursuant to one or more collective bargaining agreements between employee representatives and one or more employers ratified on or before the date of the enactment of this Act [Apr. 7, 1986], the amendment made by paragraph (1) shall become effective on the later of—“(i) October 1, 1986; or “(ii) the earlier of—“(I) the date on which the last of the collective bargaining agreements under which the plan is maintained, which were in effect on the date of the enactment of this Act, terminates (determined without regard to any extension thereof agreed to after the date of the enactment of this Act); or “(II) three years after the date of the enactment of this Act.”
Effective Date of 1984 AmendmentAmendment by Pub. L. 98397 effective Jan. 1, 1985, except as otherwise provided, see section 303(d) of Pub. L. 98397, set out as a note under section 1001 of this title.
Effective Date of 1983 AmendmentPub. L. 97473, title III, § 301(c), Jan. 14, 1983, 96 Stat. 2612, provided that: “The amendment made by this section [amending this section] shall take effect on the date of the enactment of this Act [Jan. 14, 1983].” Amendment by section 302(b) of Pub. L. 97473 effective Jan. 14, 1983, see section 302(c) of Pub. L. 97473, set out as a note under section 1002 of this title.
RegulationsSecretary authorized, effective Sept. 2, 1974, to promulgate regulations wherever provisions of this subchapter call for the promulgation of regulations, see section 1031 of this title.
Plan Amendments Not Required Until January 1, 1994For provisions setting forth circumstances under which any amendment to a plan required to be made by an amendment made by section 4301 of Pub. L. 10366 shall not be required to be made before the first plan year beginning on or after Jan. 1, 1994, see section 4301(d) of Pub. L. 10366, set out as an Effective Date of 1993 Amendment note under section 1021 of this title.
Treatment of Other State LawsPub. L. 97473, title III, § 301(b), Jan. 14, 1983, 96 Stat. 2612, provided that: “The amendment made by this section [amending this section] shall not be considered a precedent with respect to extending such amendment to any other State law.”
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# 29 U.S.C. § 1144a - Clarification of church welfare plan status under State insurance law
## Text
(a) In general For purposes of determining the status of a church plan that is a welfare plan under provisions of a State insurance law described in subsection (b), such a church plan (and any trust under such plan) shall be deemed to be a plan sponsored by a single employer that reimburses costs from general church assets, or purchases insurance coverage with general church assets, or both.
(b) State insurance law A State insurance law described in this subsection is a law that—
(1) requires a church plan, or an organization described in section 414(e)(3)(A) of title 26 and section 1002(33)(C)(i) of this title to the extent that it is administering or funding such a plan, to be licensed; or
(2) relates solely to the solvency or insolvency of a church plan (including participation in State guaranty funds and associations).
(c) Definitions For purposes of this section:
(1) Church plan The term “church plan” has the meaning given such term by section 414(e) of title 26 and section 1002(33) of this title.
(2) Reimburses costs from general church assets The term “reimburses costs from general church assets” means engaging in an activity that is not the spreading of risk solely for the purposes of the provisions of State insurance laws described in subsection (b).
(3) Welfare plan The term “welfare plan”—
(A) means any church plan to the extent that such plan provides medical, surgical, or hospital care or benefits, or benefits in the event of sickness, accident, disability, death or unemployment, or vacation benefits, apprenticeship or other training programs, or day care centers, scholarship funds, or prepaid legal services; and
(B) does not include any entity, such as a health insurance issuer described in section 9832(b)(2) of title 26 or a health maintenance organization described in section 9832(b)(3) of title 26, or any other organization that does business with the church plan or organization sponsoring or maintaining such a plan.
(d) Enforcement authority Notwithstanding any other provision of this section, for purposes of enforcing provisions of State insurance laws that apply to a church plan that is a welfare plan, the church plan shall be subject to State enforcement as if the church plan were an insurer licensed by the State.
(e) Application of section Except as provided in subsection (d), the application of this section is limited to determining the status of a church plan that is a welfare plan under the provisions of State insurance laws described in subsection (b). This section shall not otherwise be construed to recharacterize the status, or modify or affect the rights, of any plan participant or beneficiary, including participants or beneficiaries who make plan contributions.
(Pub. L. 106244, § 2, July 10, 2000, 114 Stat. 499.)
## Notes
Editorial Notes
Codification Section was not enacted as part of the Employee Retirement Income Security Act of 1974 which comprises this chapter.
PurposePub. L. 106244, § 1, July 10, 2000, 114 Stat. 499, provided that: “The purpose of this Act [enacting this section] is only to clarify the application to a church plan that is a welfare plan of State insurance laws that require or solely relate to licensing, solvency, insolvency, or the status of such plan as a single employer plan.”
@@ -0,0 +1,41 @@
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# 29 U.S.C. § 1145 - Delinquent contributions
## Text
Every employer who is obligated to make contributions to a multiemployer plan under the terms of the plan or under the terms of a collectively bargained agreement shall, to the extent not inconsistent with law, make such contributions in accordance with the terms and conditions of such plan or such agreement.
(Pub. L. 93406, title I, § 515, as added Pub. L. 96364, title III, § 306(a), Sept. 26, 1980, 94 Stat. 1295.)
## Notes
Editorial Notes
Effective DateSection effective Sept. 26, 1980, except as specifically provided, see section 1461(e) of this title.
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# 29 U.S.C. § 1146 - Outreach to promote retirement income savings
## Text
(a) In general The Secretary shall maintain an ongoing program of outreach to the public designed to effectively promote retirement income savings by the public.
(b) Methods The Secretary shall carry out the requirements of subsection (a) by means which shall ensure effective communication to the public, including publication of public service announcements, public meetings, creation of educational materials, and establishment of a site on the Internet.
(c) Information to be made available The information to be made available by the Secretary as part of the program of outreach required under subsection (a) shall include the following:
(1) a description of the vehicles currently available to individuals and employers for creating and maintaining retirement income savings, specifically including information explaining to employers, in simple terms, the characteristics and operation of the different retirement savings vehicles, including the steps to establish each such vehicle; and
(2) information regarding matters relevant to establishing retirement income savings, such as—
(A) the forms of retirement income savings;
(B) the concept of compound interest;
(C) the importance of commencing savings early in life;
(D) savings principles;
(E) the importance of prudence and diversification in investing;
(F) the importance of the timing of investments; and
(G) the impact on retirement savings of lifes uncertainties, such as living beyond ones life expectancy.
(d) Establishment of site on Internet The Secretary shall establish a permanent site on the Internet concerning retirement income savings. The site shall contain at least the following information:
(1) a means for individuals to calculate their estimated retirement savings needs, based on their retirement income goal as a percentage of their preretirement income;
(2) a description in simple terms of the common types of retirement income savings arrangements available to both individuals and employers (specifically including small employers), including information on the amount of money that can be placed into a given vehicle, the tax treatment of the money, the amount of accumulation possible through different typical investment options and interest rate projections, and a directory of resources of more descriptive information;
(3) materials explaining to employers in simple terms, the characteristics and operation of the different retirement savings arrangements for their workers and what the basic legal requirements are under this chapter and title 26, including the steps to establish each such arrangement;
(4) copies of all educational materials developed by the Department of Labor, and by other Federal agencies in consultation with such Department, to promote retirement income savings by workers and employers; and
(5) links to other sites maintained on the Internet by governmental agencies and nonprofit organizations that provide additional detail on retirement income savings arrangements and related topics on savings or investing.
(e) Coordination The Secretary shall coordinate the outreach program under this section with similar efforts undertaken by other public and private entities.
(Pub. L. 93406, title I, § 516, as added Pub. L. 10592, § 3(a), Nov. 19, 1997, 111 Stat. 2139.)
## Notes
Editorial Notes
References in TextThis chapter, referred to in subsec. (d)(3), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
Statutory Notes and Related Subsidiaries
Findings and PurposePub. L. 10592, § 2, Nov. 19, 1997, 111 Stat. 2139, provided that: “(a) Findings.—The Congress finds as follows:“(1) The impending retirement of the baby boom generation will severely strain our already overburdened entitlement system, necessitating increased reliance on pension and other personal savings. “(2) Studies have found that less than a third of Americans have even tried to calculate how much they will need to have saved by retirement, and that less than 20 percent are very confident they will have enough money to live comfortably throughout their retirement. “(3) A leading obstacle to expanding retirement savings is the simple fact that far too many Americans—particularly the young—are either unaware of, or without the knowledge and resources necessary to take advantage of, the extensive benefits offered by our retirement savings system. “(b) Purpose.—It is the purpose of this Act [see Short Title of 1997 Amendment note, set out under section 1001 of this title]—“(1) to advance the publics knowledge and understanding of retirement savings and its critical importance to the future well-being of American workers and their families; “(2) to provide for a periodic, bipartisan national retirement savings summit in conjunction with the White House to elevate the issue of savings to national prominence; and “(3) to initiate the development of a broad-based, public education program to encourage and enhance individual commitment to a personal retirement savings strategy.”
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# 29 U.S.C. § 1147 - National Summit on Retirement Savings
## Text
(a) Authority to call Summit Not later than July 15, 1998, the President shall convene a National Summit on Retirement Income Savings at the White House, to be co-hosted by the President and the Speaker and the Minority Leader of the House of Representatives and the Majority Leader and Minority Leader of the Senate. Such a National Summit shall be convened thereafter in 2001 and 2005 on or after September 1 of each year involved. Such a National Summit shall—
(1) advance the publics knowledge and understanding of retirement savings and its critical importance to the future well-being of American workers and their families;
(2) facilitate the development of a broad-based, public education program to encourage and enhance individual commitment to a personal retirement savings strategy;
(3) develop recommendations for additional research, reforms, and actions in the field of private pensions and individual retirement savings; and
(4) disseminate the report of, and information obtained by, the National Summit and exhibit materials and works of the National Summit.
(b) Planning and direction The National Summit shall be planned and conducted under the direction of the Secretary, in consultation with, and with the assistance of, the heads of such other Federal departments and agencies as the President may designate. Such assistance may include the assignment of personnel. The Secretary shall, in planning and conducting the National Summit, consult with the congressional leaders specified in subsection (e)(2). The Secretary shall also, in carrying out the Secretarys duties under this subsection, consult and coordinate with at least one organization made up of private sector businesses and associations partnered with Government entities to promote long-term financial security in retirement through savings.
(c) Purpose of National Summit The purpose of the National Summit shall be—
(1) to increase the public awareness of the value of personal savings for retirement;
(2) to advance the publics knowledge and understanding of retirement savings and its critical importance to the future well-being of American workers and their families;
(3) to facilitate the development of a broad-based, public education program to encourage and enhance individual commitment to a personal retirement savings strategy;
(4) to identify the problems workers have in setting aside adequate savings for retirement;
(5) to identify the barriers which employers, especially small employers, face in assisting their workers in accumulating retirement savings;
(6) to examine the impact and effectiveness of individual employers to promote personal savings for retirement among their workers and to promote participation in company savings options;
(7) to examine the impact and effectiveness of government programs at the Federal, State, and local levels to educate the public about, and to encourage, retirement income savings;
(8) to develop such specific and comprehensive recommendations for the legislative and executive branches of the Government and for private sector action as may be appropriate for promoting private pensions and individual retirement savings; and
(9) to develop recommendations for the coordination of Federal, State, and local retirement income savings initiatives among the Federal, State, and local levels of government and for the coordination of such initiatives.
(d) Scope of National Summit The scope of the National Summit shall consist of issues relating to individual and employer-based retirement savings and shall not include issues relating to the old-age, survivors, and disability insurance program under title II of the Social Security Act [42 U.S.C. 401 et seq.].
(e) National Summit participants (1) In general To carry out the purposes of the National Summit, the National Summit shall bring together—
(A) professionals and other individuals working in the fields of employee benefits and retirement savings;
(B) Members of Congress and officials in the executive branch;
(C) representatives of State and local governments;
(D) representatives of private sector institutions, including individual employers, concerned about promoting the issue of retirement savings and facilitating savings among American workers; and
(E) representatives of the general public.
(2) Statutorily required participation The participants in the National Summit shall include the following individuals or their designees:
(A) the Speaker and the Minority Leader of the House of Representatives;
(B) the Majority Leader and the Minority Leader of the Senate;
(C) the Chairman and ranking Member of the Committee on Education and the Workforce of the House of Representatives;
(D) the Chairman and ranking Member of the Committee on Labor and Human Resources of the Senate;
(E) the Chairman and ranking Member of the Special Committee on Aging of the Senate;
(F) the Chairman and ranking Member of the Subcommittees on Labor, Health and Human Services, and Education of the Senate and House of Representatives; and
(G) the parties referred to in subsection (b).
(3) Additional participants (A) In general There shall be not more than 200 additional participants. Of such additional participants—
(i) one-half shall be appointed by the President, in consultation with the elected leaders of the Presidents party in Congress (either the Speaker of the House of Representatives or the Minority Leader of the House of Representatives, and either the Majority Leader or the Minority Leader of the Senate; 11 So in original. A closing parenthesis probably should precede the semicolon. and
(ii) one-half shall be appointed by the elected leaders of Congress of the party to which the President does not belong (one-half of that allotment to be appointed by either the Speaker of the House of Representatives or the Minority Leader of the House of Representatives, and one-half of that allotment to be appointed by either the Majority Leader or the Minority Leader of the Senate).
(B) Appointment requirements The additional participants described in subparagraph (A) shall be—
(i) appointed not later than January 31, 1998;
(ii) selected without regard to political affiliation or past partisan activity; and
(iii) representative of the diversity of thought in the fields of employee benefits and retirement income savings.
(4) Presiding officers The National Summit shall be presided over equally by representatives of the executive and legislative branches.
(f) National Summit administration (1) Administration In administering this section, the Secretary shall—
(A) request the cooperation and assistance of such other Federal departments and agencies and other parties referred to in subsection (b) as may be appropriate in the carrying out of this section;
(B) furnish all reasonable assistance to State agencies, area agencies, and other appropriate organizations to enable them to organize and conduct conferences in conjunction with the National Summit;
(C) make available for public comment a proposed agenda for the National Summit that reflects to the greatest extent possible the purposes for the National Summit set out in this section;
(D) prepare and make available background materials for the use of participants in the National Summit that the Secretary considers necessary; and
(E) appoint and fix the pay of such additional personnel as may be necessary to carry out the provisions of this section without regard to provisions of title 5 governing appointments in the competitive service, and without regard to chapter 51 and subchapter III of chapter 53 of such title relating to classification and General Schedule pay rates.
(2) Duties The Secretary shall, in carrying out the responsibilities and functions of the Secretary under this section, and as part of the National Summit, ensure that—
(A) the National Summit shall be conducted in a manner that ensures broad participation of Federal, State, and local agencies and private organizations, professionals, and others involved in retirement income savings and provides a strong basis for assistance to be provided under paragraph (1)(B);
(B) the agenda prepared under paragraph (1)(C) for the National Summit is published in the Federal Register; and
(C) the personnel appointed under paragraph (1)(E) shall be fairly balanced in terms of points of views represented and shall be appointed without regard to political affiliation or previous partisan activities.
(3) Nonapplication of chapter 10 of title 5 The provisions of chapter 10 of title 5 shall not apply to the National Summit.
(g) Report The Secretary shall prepare a report describing the activities of the National Summit and shall submit the report to the President, the Speaker and Minority Leader of the House of Representatives, the Majority and Minority Leaders of the Senate, and the chief executive officers of the States not later than 90 days after the date on which the National Summit is adjourned.
(h) “State” defined For purposes of this section, the term “State” means a State, the District of Columbia, the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands, Guam, the Virgin Islands, American Samoa, and any other territory or possession of the United States.
(i) Authorization of appropriations (1) In general There is authorized to be appropriated for fiscal years beginning on or after October 1, 1997, such sums as are necessary to carry out this section.
(2) Authorization to accept private contributions In order to facilitate the National Summit as a public-private partnership, the Secretary may accept private contributions, in the form of money, supplies, or services, to defray the costs of the National Summit.
(j) Financial obligation for fiscal year 1998 The financial obligation for the Department of Labor for fiscal year 1998 shall not exceed the lesser of—
(1) one-half of the costs of the National Summit; or
(2) $250,000.
The private sector organization described in subsection (b) and contracted with by the Secretary shall be obligated for the balance of the cost of the National Summit.
(k) Contracts The Secretary may enter into contracts to carry out the Secretarys responsibilities under this section. The Secretary shall enter into a contract on a sole-source basis to ensure the timely completion of the National Summit in fiscal year 1998.
(Pub. L. 93406, title I, § 517, as added Pub. L. 10592, § 4(a), Nov. 19, 1997, 111 Stat. 2141; amended Pub. L. 117286, § 4(a)(190), Dec. 27, 2022, 136 Stat. 4327.)
## Notes
Editorial Notes
References in TextThe Social Security Act, referred to in subsec. (d), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title II of the Act is classified generally to subchapter II (§ 401 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.
Amendments2022—Subsec. (f)(3). Pub. L. 117286 substituted “chapter 10 of title 5” for “FACA” in heading and “chapter 10 of title 5” for “the Federal Advisory Committee Act (5 U.S.C. App.)” in text.
Statutory Notes and Related Subsidiaries
Change of Name Committee on Labor and Human Resources of Senate changed to Committee on Health, Education, Labor, and Pensions of Senate by Senate Resolution No. 20, One Hundred Sixth Congress, Jan. 19, 1999.
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# 29 U.S.C. § 1148 - Authority to postpone certain deadlines by reason of Presidentially declared disaster or terroristic or military actions
## Text
In the case of a pension or other employee benefit plan, or any sponsor, administrator, participant, beneficiary, or other person with respect to such plan, affected by a Presidentially declared disaster (as defined in section 1033(h)(3) of title 26) 11 So in original. Probably should be followed by a comma. a terroristic or military action (as defined in section 692(c)(2) of such title), or a public health emergency declared by the Secretary of Health and Human Services pursuant to section 247d of title 42, the Secretary may, notwithstanding any other provision of law, prescribe, by notice or otherwise, a period of up to 1 year which may be disregarded in determining the date by which any action is required or permitted to be completed under this chapter. No plan shall be treated as failing to be operated in accordance with the terms of the plan solely as the result of disregarding any period by reason of the preceding sentence.
(Pub. L. 93406, title I, § 518, as added Pub. L. 107134, title I, § 112(c)(1), Jan. 23, 2002, 115 Stat. 2434; amended Pub. L. 116136, div. A, title III, § 3607, Mar. 27, 2020, 134 Stat. 412.)
## Notes
Editorial Notes
References in TextThis chapter, referred to in text, was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
Amendments2020—Pub. L. 116136 substituted “a terroristic or military action (as defined in section 692(c)(2) of such title), or a public health emergency declared by the Secretary of Health and Human Services pursuant to section 247d of title 42, the Secretary may” for “or a terroristic or military action (as defined in section 692(c)(2) of such title), the Secretary may”.
Statutory Notes and Related Subsidiaries
Effective DateSection applicable to disasters and terroristic or military actions occurring on or after Sept. 11, 2001, with respect to any action of the Secretary of the Treasury, the Secretary of Labor, or the Pension Benefit Guaranty Corporation occurring on or after Jan. 23, 2002, see section 112(f) of Pub. L. 107134, set out as an Effective Date of 2002 Amendment note under section 6081 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1149 - Prohibition on false statements and representations
## Text
No person, in connection with a plan or other arrangement that is 11 So in original. Probably should be followed by “a”. multiple employer welfare arrangement described in section 1002(40) of this title, shall make a false statement or false representation of fact, knowing it to be false, in connection with the marketing or sale of such plan or arrangement, to any employee, any member of an employee organization, any beneficiary, any employer, any employee organization, the Secretary, or any State, or the representative or agent of any such person, State, or the Secretary, concerning—
(1) the financial condition or solvency of such plan or arrangement;
(2) the benefits provided by such plan or arrangement;
(3) the regulatory status of such plan or other arrangement under any Federal or State law governing collective bargaining, labor management relations, or intern union affairs; or
(4) the regulatory status of such plan or other arrangement regarding exemption from state 22 So in original. Probably should be capitalized. regulatory authority under this chapter.
This section shall not apply to any plan or arrangement that does not fall within the meaning of the term “multiple employer welfare arrangement” under section 1002(40)(A) of this title.
(Pub. L. 93406, title I, § 519, as added Pub. L. 111148, title VI, § 6601(a), Mar. 23, 2010, 124 Stat. 779.)
## Notes
Editorial Notes
References in TextThis chapter, referred to in par. (4), was in the original “this Act”, meaning Pub. L. 93406, known as the Employee Retirement Income Security Act of 1974. Titles I, III, and IV of such Act are classified principally to this chapter. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of this title and Tables.
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# 29 U.S.C. § 1150 - Applicability of State law to combat fraud and abuse
## Text
The Secretary may, for the purpose of identifying, preventing, or prosecuting fraud and abuse, adopt regulatory standards establishing, or issue an order relating to a specific person establishing, that a person engaged in the business of providing insurance through a multiple employer welfare arrangement described in section 1002(40) of this title is subject to the laws of the States in which such person operates which regulate insurance in such State, notwithstanding section 1144(b)(6) of this title or the Liability Risk Retention Act of 1986 [15 U.S.C. 3901 et seq.], and regardless of whether the law of the State is otherwise preempted under any of such provisions. This section shall not apply to any plan or arrangement that does not fall within the meaning of the term “multiple employer welfare arrangement” under section 1002(40)(A) of this title.
(Pub. L. 93406, title I, § 520, as added Pub. L. 111148, title VI, § 6604(a), Mar. 23, 2010, 124 Stat. 780.)
## Notes
Editorial Notes
References in TextThe Liability Risk Retention Act of 1986, referred to in text, is Pub. L. 9745, Sept. 25, 1981, 95 Stat. 949, which is classified generally to chapter 65 (§ 3901 et seq.) of Title 15, Commerce and Trade. For complete classification of this Act to the Code, see Short Title note set out under section 3901 of Title 15 and Tables.
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# 29 U.S.C. § 1151 - Administrative summary cease and desist orders and summary seizure orders against multiple employer welfare arrangements in financially hazardous condition
## Text
(a) In general The Secretary may issue a cease and desist (ex parte) order under this subchapter if it appears to the Secretary that the alleged conduct of a multiple employer welfare arrangement described in section 1002(40) of this title, other than a plan or arrangement described in subsection (g), is fraudulent, or creates an immediate danger to the public safety or welfare, or is causing or can be reasonably expected to cause significant, imminent, and irreparable public injury.
(b) Hearing A person that is adversely affected by the issuance of a cease and desist order under subsection (a) may request a hearing by the Secretary regarding such order. The Secretary may require that a proceeding under this section, including all related information and evidence, be conducted in a confidential manner.
(c) Burden of proof The burden of proof in any hearing conducted under subsection (b) shall be on the party requesting the hearing to show cause why the cease and desist order should be set aside.
(d) Determination Based upon the evidence presented at a hearing under subsection (b), the cease and desist order involved may be affirmed, modified, or set aside by the Secretary in whole or in part.
(e) Seizure The Secretary may issue a summary seizure order under this subchapter if it appears that a multiple employer welfare arrangement is in a financially hazardous condition.
(f) Regulations The Secretary may promulgate such regulations or other guidance as may be necessary or appropriate to carry out this section.
(g) Exception This section shall not apply to any plan or arrangement that does not fall within the meaning of the term “multiple employer welfare arrangement” under section 1002(40)(A) of this title.
(Pub. L. 93406, title I, § 521, as added Pub. L. 111148, title VI, § 6605(a), Mar. 23, 2010, 124 Stat. 780.)
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# 29 U.S.C. § 1152 - Coordination of enforcement regarding violations of certain health care provider requirements; complaint process
## Text
(a) Investigating violations Upon receiving a notice from a State or the Secretary of Health and Human Services of violations of sections 300gg131, 300gg132, or 300gg135 of title 42, the Secretary of Labor shall identify patterns of such violations with respect to participants or beneficiaries under a group health plan or group health insurance coverage offered by a health insurance issuer and conduct an investigation pursuant to section 1134 of this title where appropriate, as determined by the Secretary. The Secretary shall coordinate with States and the Secretary of Health and Human Services, in accordance with section 1136 of this title and with section 104 of Health Insurance Portability and Accountability Act of 1996, where appropriate, as determined by the Secretary, to ensure that appropriate measures have been taken to correct such violations retrospectively and prospectively with respect to participants or beneficiaries under a group health plan or group health insurance coverage offered by a health insurance issuer.
(b) Complaint process Not later than January 1, 2022, the Secretary shall ensure a process under which the Secretary—
(1) may receive complaints from participants and beneficiaries of group health plans or group health insurance coverage offered by a health insurance issuer relating to alleged violations of the sections specified in subsection (a); and
(2) transmits such complaints to States or the Secretary of Health and Human Services (as determined appropriate by the Secretary) for potential enforcement actions.
(Pub. L. 93406, title I, § 522, as added Pub. L. 116260, div. BB, title I, § 104(b)(1), Dec. 27, 2020, 134 Stat. 2830.)
## Notes
Editorial Notes
References in TextSection 104 of Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (a), is section 104 of Pub. L. 104191, which is set out as a note under section 300gg92 of Title 42, The Public Health and Welfare.
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# 29 U.S.C. § 1153 - Retirement Savings Lost and Found
## Text
(a) Establishment (1) In general Not later than 2 years after December 29, 2022, the Secretary, in consultation with the Secretary of the Treasury, shall establish an online searchable database (to be managed by the Secretary in accordance with this section) to be known as the “Retirement Savings Lost and Found”. The Retirement Savings Lost and Found shall—
(A) allow an individual to search for information that enables the individual to locate the administrator of any plan described in paragraph (2) with respect to which the individual is or was a participant or beneficiary, and provide contact information for the administrator of any such plan;
(B) allow the Secretary to assist such an individual in locating any such plan of the individual; and
(C) allow the Secretary to make any necessary changes to contact information on record for the administrator based on any changes to the plan due to merger or consolidation of the plan with any other plan, division of the plan into two or more plans, bankruptcy, termination, change in name of the plan, change in name or address of the administrator, or other causes.
(2) Plans described A plan described in this paragraph is a plan to which the vesting standards of section 1053 of this title apply.
(b) Administration The Retirement Savings Lost and Found established under subsection (a) shall provide individuals described in subsection (a)(1) only with the ability to search for information that enables the individual to locate the administrator and contact information for the administrator of any plan with respect to which the individual is or was a participant or beneficiary, sufficient to allow the individual to locate the individuals plan in order to make a claim for benefits owing to the individual under the plan.
(c) Safeguarding participant privacy and security In establishing the Retirement Savings Lost and Found under subsection (a), the Secretary, in consultation with the Secretary of the Treasury, shall take all necessary and proper precautions to—
(1) ensure that individuals plan and personal information maintained by the Retirement Savings Lost and Found is protected; and
(2) allow any individual to contact the Secretary to opt out of inclusion in the Retirement Savings Lost and Found.
(d) Definition of administrator For purposes of this section, the term “administrator” has the meaning given such term in section 1002(16)(A) of this title.
(e) Information collection from plans Effective with respect to plan years beginning after the second December 31 occurring after the date of the enactment of this subsection, the administrator of a plan to which the vesting standards of section 1053 of this title apply shall submit to the Secretary, at such time and in such form and manner as is prescribed in regulations—
(1) the information described in paragraphs (1) through (4) of section 6057(b) of title 26;
(2) the information described in subparagraphs (A) and (B) of section 6057(a)(2) of title 26;
(3) the name and taxpayer identifying number of each participant or former participant in the plan—
(A) who, during the current plan year or any previous plan year, was reported under section 6057(a)(2)(C) of title 26, and with respect to whom the benefits described in clause (ii) thereof were fully paid during the plan year;
(B) with respect to whom any amount was distributed under section 401(a)(31)(B) of title 26 during the plan year; or
(C) with respect to whom a deferred annuity contract was distributed during the plan year; and
(4) in the case of a participant or former participant to whom paragraph (3) applies—
(A) in the case of a participant described in subparagraph (B) thereof, the name and address of the designated trustee or issuer described in section 401(a)(31)(B)(i) of title 26 and the account number of the individual retirement plan to which the amount was distributed; and
(B) in the case of a participant described in subparagraph (C) thereof, the name and address of the issuer of such annuity contract and the contract or certificate number.
(f) Use of information collected The Secretary—
(1) may use or disclose information collected under this section only for the purpose described in subsection (a)(1)(B), and
(2) may disclose such information only to such employees of the Department of Labor whose official duties relate to the purpose described in such subsection.
(g) Program integrity audit On an annual basis for each of the first 5 years beginning one year after the establishment of the database in subsection (a)(1) and every 5 years thereafter, the Inspector General of the Department of Labor shall—
(1) conduct an audit of the administration of the Retirement Savings Lost and Found; and
(2) submit a report on such audit to the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate and the Committee on Ways and Means and the Committee on Education and Labor of the House of Representatives.
(Pub. L. 93406, title I, § 523, as added Pub. L. 117328, div. T, title III, § 303(a), Dec. 29, 2022, 136 Stat. 5339.)
## Notes
Statutory Notes and Related Subsidiaries
Change of Name Committee on Education and Labor of House of Representatives changed to Committee on Education and the Workforce of House of Representatives by House Resolution No. 5, One Hundred Eighteenth Congress, Jan. 9, 2023.
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# 29 U.S.C. § 1161 - Plans must provide continuation coverage to certain individuals
## Text
(a) In general The plan sponsor of each group health plan shall provide, in accordance with this part, that each qualified beneficiary who would lose coverage under the plan as a result of a qualifying event is entitled, under the plan, to elect, within the election period, continuation coverage under the plan.
(b) Exception for certain plans Subsection (a) shall not apply to any group health plan for any calendar year if all employers maintaining such plan normally employed fewer than 20 employees on a typical business day during the preceding calendar year.
(Pub. L. 93406, title I, § 601, as added Pub. L. 99272, title X, § 10002(a), Apr. 7, 1986, 100 Stat. 227; amended Pub. L. 101239, title VII, §§ 7862(c)(1)(B), 7891(a)(1), Dec. 19, 1989, 103 Stat. 2432, 2445.)
## Notes
Editorial Notes
Amendments1989—Subsec. (b). Pub. L. 101239 struck out at end “Under regulations, rules similar to the rules of subsections (a) and (b) of section 52 of title 26 (relating to employers under common control) shall apply for purposes of this subsection.” Pub. L. 101239, § 7891(a)(1), substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text.
Statutory Notes and Related Subsidiaries
Effective Date of 1989 AmendmentAmendment by section 7862(c)(1)(B) of Pub. L. 101239 applicable to years beginning after Dec. 31, 1986, see section 7862(c)(1)(C) of Pub. L. 101239, set out as a note under section 106 of Title 26, Internal Revenue Code. Amendment by section 7891(a)(1) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title.
Effective DatePub. L. 99272, title X, § 10002(d), Apr. 7, 1986, 100 Stat. 231, provided that: “(1) General rule.—The amendments made by this section [enacting this part and amending section 1132 of this title] shall apply to plan years beginning on or after July 1, 1986. “(2) Special rule for collective bargaining agreements.—In the case of a group health plan maintained pursuant to one or more collective bargaining agreements between employee representatives and one or more employers ratified before the date of the enactment of this Act [Apr. 7, 1986], 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), or “(B) January 1, 1987. 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.”
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# 29 U.S.C. § 1163 - Qualifying event
## Text
For purposes of this part, the term “qualifying event” means, with respect to any covered employee, any of the following events which, but for the continuation coverage required under this part, would result in the loss of coverage of a qualified beneficiary:
(1) The death of the covered employee.
(2) The termination (other than by reason of such employees gross misconduct), or reduction of hours, of the covered employees employment.
(3) The divorce or legal separation of the covered employee from the employees spouse.
(4) The covered employee becoming entitled to benefits under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.].
(5) A dependent child ceasing to be a dependent child under the generally applicable requirements of the plan.
(6) A proceeding in a case under title 11, commencing on or after July 1, 1986, with respect to the employer from whose employment the covered employee retired at any time.
In the case of an event described in paragraph (6), a loss of coverage includes a substantial elimination of coverage with respect to a qualified beneficiary described in section 1167(3)(C) of this title within one year before or after the date of commencement of the proceeding.
(Pub. L. 93406, title I, § 603, as added Pub. L. 99272, title X, § 10002(a), Apr. 7, 1986, 100 Stat. 229; amended Pub. L. 99509, title IX, § 9501(a)(2), Oct. 21, 1986, 100 Stat. 2076.)
## Notes
Editorial Notes
References in TextThe Social Security Act, referred to in par. (4), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XVIII of the Social Security Act is classified generally to subchapter XVIII (§ 1395 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.
Amendments1986—Pub. L. 99509 added par. (6) and last sentence.
Statutory Notes and Related Subsidiaries
Effective Date of 1986 AmendmentAmendment by Pub. L. 99509 effective, except as otherwise provided, as if included in title X of the Consolidated Omnibus Budget Reconciliation Act of 1985, Pub. L. 99272, see section 9501(e) of Pub. L. 99509, set out as a note under section 162 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1164 - Applicable premium
## Text
For purposes of this part—
(1) In general The term “applicable premium” means, with respect to any period of continuation coverage of qualified beneficiaries, the cost to the plan for such period of the coverage for similarly situated beneficiaries with respect to whom a qualifying event has not occurred (without regard to whether such cost is paid by the employer or employee).
(2) Special rule for self-insured plans To the extent that a plan is a self-insured plan—
(A) In general Except as provided in subparagraph (B), the applicable premium for any period of continuation coverage of qualified beneficiaries shall be equal to a reasonable estimate of the cost of providing coverage for such period for similarly situated beneficiaries which—
(i) is determined on an actuarial basis, and
(ii) takes into account such factors as the Secretary may prescribe in regulations.
(B) Determination on basis of past cost If an administrator elects to have this subparagraph apply, the applicable premium for any period of continuation coverage of qualified beneficiaries shall be equal to—
(i) the cost to the plan for similarly situated beneficiaries for the same period occurring during the preceding determination period under paragraph (3), adjusted by
(ii) the percentage increase or decrease in the implicit price deflator of the gross national product (calculated by the Department of Commerce and published in the Survey of Current Business) for the 12-month period ending on the last day of the sixth month of such preceding determination period.
(C) Subparagraph (B) not to apply where significant change An administrator may not elect to have subparagraph (B) apply in any case in which there is any significant difference, between the determination period and the preceding determination period, in coverage under, or in employees covered by, the plan. The determination under the preceding sentence for any determination period shall be made at the same time as the determination under paragraph (3).
(3) Determination period The determination of any applicable premium shall be made for a period of 12 months and shall be made before the beginning of such period.
(Pub. L. 93406, title I, § 604, as added Pub. L. 99272, title X, § 10002(a), Apr. 7, 1986, 100 Stat. 229.)
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# 29 U.S.C. § 1165 - Election
## Text
(a) In general For purposes of this part—
(1) Election period The term “election period” means the period which—
(A) begins not later than the date on which coverage terminates under the plan by reason of a qualifying event,
(B) is of at least 60 days duration, and
(C) ends not earlier than 60 days after the later of—
(i) the date described in subparagraph (A), or
(ii) in the case of any qualified beneficiary who receives notice under section 1166(4) 11 See References in Text note below. of this title, the date of such notice.
(2) Effect of election on other beneficiaries Except as otherwise specified in an election, any election of continuation coverage by a qualified beneficiary described in subparagraph (A)(i) or (B) of section 1167(3) of this title shall be deemed to include an election of continuation coverage on behalf of any other qualified beneficiary who would lose coverage under the plan by reason of the qualifying event. If there is a choice among types of coverage under the plan, each qualified beneficiary is entitled to make a separate selection among such types of coverage.
(b) Temporary extension of COBRA election period for certain individuals (1) In general In the case of a nonelecting TAA-eligible individual and notwithstanding subsection (a), such individual may elect continuation coverage under this part during the 60-day period that begins on the first day of the month in which the individual becomes a TAA-eligible individual, but only if such election is made not later than 6 months after the date of the TAA-related loss of coverage.
(2) Commencement of coverage; no reach-back Any continuation coverage elected by a TAA-eligible individual under paragraph (1) shall commence at the beginning of the 60-day election period described in such paragraph and shall not include any period prior to such 60-day election period.
(3) Preexisting conditions With respect to an individual who elects continuation coverage pursuant to paragraph (1), the period—
(A) beginning on the date of the TAA-related loss of coverage, and
(B) ending on the first day of the 60-day election period described in paragraph (1),
shall be disregarded for purposes of determining the 63-day periods referred to in section 1181(c)(2) of this title, section 2701(c)(2) of the Public Health Service Act,1 and section 9801(c)(2) of title 26.
(4) Definitions For purposes of this subsection:
(A) Nonelecting TAA-eligible individual The term “nonelecting TAA-eligible individual” means a TAA-eligible individual who—
(i) has a TAA-related loss of coverage; and
(ii) did not elect continuation coverage under this part during the TAA-related election period.
(B) TAA-eligible individual The term “TAA-eligible individual” means—
(i) an eligible TAA recipient (as defined in paragraph (2) of section 35(c) of title 26), and
(ii) an eligible alternative TAA recipient (as defined in paragraph (3) of such section).
(C) TAA-related election period The term “TAA-related election period” means, with respect to a TAA-related loss of coverage, the 60-day election period under this part which is a direct consequence of such loss.
(D) TAA-related loss of coverage The term “TAA-related loss of coverage” means, with respect to an individual whose separation from employment gives rise to being an TAA-eligible individual, the loss of health benefits coverage associated with such separation.
(Pub. L. 93406, title I, § 605, as added Pub. L. 99272, title X, § 10002(a), Apr. 7, 1986, 100 Stat. 230; amended Pub. L. 99514, title XVIII, § 1895(d)(5)(B), Oct. 22, 1986, 100 Stat. 2939; Pub. L. 107210, div. A, title II, § 203(e)(1), Aug. 6, 2002, 116 Stat. 969.)
## Notes
Editorial Notes
References in TextSection 1166(4) of this title, referred to in subsec. (a)(1)(C)(ii), was redesignated as section 1166(a)(4) of this title by Pub. L. 101239, title VII, § 7891(d)(1)(A)(ii)(I), Dec. 19, 1989, 103 Stat. 2445. Section 2701 of the Public Health Service Act, referred to in subsec. (b)(3), was classified to section 300gg of Title 42, The Public Health and Welfare, was renumbered section 2704, effective for plan years beginning on or after Jan. 1, 2014, with certain exceptions, and amended, by Pub. L. 111148, title I, §§ 1201(2), 1563(c)(1), formerly § 1562(c)(1), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 154, 264, 911, and was transferred to section 300gg3 of Title 42. A new section 2701, related to fair health insurance premiums, was added and amended by Pub. L. 111148, title I, § 1201(4), title X, § 10103(a), Mar. 23, 2010, 124 Stat. 155, 892, and is classified to section 300gg of Title 42.
Amendments2002—Pub. L. 107210 designated existing provisions as subsec. (a), inserted heading, and added subsec. (b). 1986—Par. (2). Pub. L. 99514 inserted “of continuation coverage” after “any election” and inserted at end “If there is a choice among types of coverage under the plan, each qualified beneficiary is entitled to make a separate selection among such types of coverage.”
Statutory Notes and Related Subsidiaries
Effective Date of 2002 AmendmentAmendment by Pub. L. 107210 applicable to petitions for certification filed under part 2 or 3 of subchapter II of chapter 12 of Title 19, Customs Duties, on or after the date that is 90 days after Aug. 6, 2002, except as otherwise provided, see section 151 of Pub. L. 107210, set out as a note preceding section 2271 of Title 19.
Effective Date of 1986 AmendmentAmendment by Pub. L. 99514 effective, except as otherwise provided, as if included in enactment of the Consolidated Omnibus Budget Reconciliation Act of 1985, Pub. L. 99272, see section 1895(e) of Pub. L. 99514, set out as a note under section 162 of Title 26, Internal Revenue Code.
Construction of 2002 AmendmentNothing in amendment by Pub. L. 107210, other than provisions relating to COBRA continuation coverage and reporting requirements, to be construed as creating new mandate on any party regarding health insurance coverage, see section 203(f) of Pub. L. 107210, set out as a Construction note under section 35 of Title 26, Internal Revenue Code.
Plan Amendments Not Required Until January 1, 1989For provisions directing that if any amendments made by subtitle A or subtitle C of title XI [§§ 11011147 and 11711177] or title XVIII [§§ 18001899A] of Pub. L. 99514 require an amendment to any plan, such plan amendment shall not be required to be made before the first plan year beginning on or after Jan. 1, 1989, see section 1140 of Pub. L. 99514, as amended, set out as a note under section 401 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1166 - Notice requirements
## Text
(a) In general In accordance with regulations prescribed by the Secretary—
(1) the group health plan shall provide, at the time of commencement of coverage under the plan, written notice to each covered employee and spouse of the employee (if any) of the rights provided under this subsection,
(2) the employer of an employee under a plan must notify the administrator of a qualifying event described in paragraph (1), (2), (4), or (6) of section 1163 of this title within 30 days (or, in the case of a group health plan which is a multiemployer plan, such longer period of time as may be provided in the terms of the plan) of the date of the qualifying event,
(3) each covered employee or qualified beneficiary is responsible for notifying the administrator of the occurrence of any qualifying event described in paragraph (3) or (5) of section 1163 of this title within 60 days after the date of the qualifying event and each qualified beneficiary who is determined, under title II or XVI of the Social Security Act [42 U.S.C. 401 et seq., 1381 et seq.], to have been disabled at any time during the first 60 days of continuation coverage under this part is responsible for notifying the plan administrator of such determination within 60 days after the date of the determination and for notifying the plan administrator within 30 days after the date of any final determination under such title or titles that the qualified beneficiary is no longer disabled, and
(4) the administrator shall notify—
(A) in the case of a qualifying event described in paragraph (1), (2), (4), or (6) of section 1163 of this title, any qualified beneficiary with respect to such event, and
(B) in the case of a qualifying event described in paragraph (3) or (5) of section 1163 of this title where the covered employee notifies the administrator under paragraph (3), any qualified beneficiary with respect to such event,
of such beneficiarys rights under this subsection.
(b) Alternative means of compliance with requirements for notification of multiemployer plans by employers The requirements of subsection (a)(2) shall be considered satisfied in the case of a multiemployer plan in connection with a qualifying event described in paragraph (2) of section 1163 of this title if the plan provides that the determination of the occurrence of such qualifying event will be made by the plan administrator.
(c) Rules relating to notification of qualified beneficiaries by plan administrator For purposes of subsection (a)(4), any notification shall be made within 14 days (or, in the case of a group health plan which is a multiemployer plan, such longer period of time as may be provided in the terms of the plan) of the date on which the administrator is notified under paragraph (2) or (3), whichever is applicable, and any such notification to an individual who is a qualified beneficiary as the spouse of the covered employee shall be treated as notification to all other qualified beneficiaries residing with such spouse at the time such notification is made.
(Pub. L. 93406, title I, § 606, as added Pub. L. 99272, title X, § 10002(a), Apr. 7, 1986, 100 Stat. 230; amended Pub. L. 99509, title IX, § 9501(d)(2), Oct. 21, 1986, 100 Stat. 2077; Pub. L. 99514, title XVIII, § 1895(d)(6)(B), Oct. 22, 1986, 100 Stat. 2939; Pub. L. 101239, title VI, § 6703(c), title VII, § 7891(d)(1)(A), Dec. 19, 1989, 103 Stat. 2296, 2445; Pub. L. 104191, title IV, § 421(b)(2), Aug. 21, 1996, 110 Stat. 2088.)
## Notes
Editorial Notes
References in TextThe Social Security Act, referred to in subsec. (a)(3), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Titles II and XVI of the Social Security Act are classified generally to subchapters II (§ 401 et seq.) and XVI (§ 1381 et seq.), respectively, of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.
Amendments1996—Subsec. (a)(3). Pub. L. 104191 substituted “at any time during the first 60 days of continuation coverage under this part” for “at the time of a qualifying event described in section 1163(2) of this title”. 1989—Pub. L. 101239, § 7891(d)(1)(A)(ii), designated first sentence as subsec. (a), added subsec. (b), designated second sentence as subsec. (c), and substituted “For purposes of subsection (a)(4)” for “For purposes of paragraph (4)”. Pub. L. 101239, § 7891(d)(1)(A)(i)(II), inserted in last sentence “(or, in the case of a group health plan which is a multiemployer plan, such longer period of time as may be provided in the terms of the plan)” after “14 days”. Pub. L. 101239, § 7891(d)(1)(A)(i)(I), inserted “(or, in the case of a group health plan which is a multiemployer plan, such longer period of time as may be provided in the terms of the plan)” after “30 days” in par. (2). Pub. L. 101239, § 6703(c), inserted “and each qualified beneficiary who is determined, under title II or XVI of the Social Security Act, to have been disabled at the time of a qualifying event described in section 1163(2) of this title is responsible for notifying the plan administrator of such determination within 60 days after the date of the determination and for notifying the plan administrator within 30 days after the date of any final determination under such title or titles that the qualified beneficiary is no longer disabled” before comma in par. (3). 1986—Par. (2). Pub. L. 99509 substituted “(4), or (6)” for “or (4)”. Par. (3). Pub. L. 99514 inserted “within 60 days after the date of the qualifying event”. Par. (4)(A). Pub. L. 99509 substituted “(4), or (6)” for “or (4)”.
Statutory Notes and Related Subsidiaries
Effective Date of 1996 AmendmentAmendment by Pub. L. 104191 effective Jan. 1, 1997, regardless of whether qualifying event occurred before, on, or after such date, see section 421(d) of Pub. L. 104191 set out as a note under section 4980B of Title 26, Internal Revenue Code.
Effective Date of 1989 AmendmentAmendment by section 6703(c) of Pub. L. 101239 applicable to plan years beginning on or after Dec. 19, 1989, regardless of whether the qualifying event occurred before, on, or after such date, see section 6703(d) of Pub. L. 101239, set out as a note under section 1162 of this title. Amendment by section 7891(d)(1)(A) of Pub. L. 101239 applicable with respect to plan years beginning on or after Jan. 1, 1990, see section 7891(d)(1)(C) of Pub. L. 101239, set out as a note under section 4980B of Title 26, Internal Revenue Code.
Effective Date of 1986 AmendmentsAmendment by Pub. L. 99514 applicable only with respect to qualifying events occurring after Oct. 22, 1986, see section 1895(d)(6)(D) of Pub. L. 99514, set out as a note under section 162 of Title 26, Internal Revenue Code. Amendment by Pub. L. 99509 effective, except as otherwise provided, as if included in title X of the Consolidated Omnibus Budget Reconciliation Act of 1985, Pub. L. 99272, see section 9501(e) of Pub. L. 99509, set out as a note under section 162 of Title 26.
Plan Amendments Not Required Until January 1, 1989For provisions directing that if any amendments made by subtitle A or subtitle C of title XI [§§ 11011147 and 11711177] or title XVIII [§§ 18001899A] of Pub. L. 99514 require an amendment to any plan, such plan amendment shall not be required to be made before the first plan year beginning on or after Jan. 1, 1989, see section 1140 of Pub. L. 99514, as amended, set out as a note under section 401 of Title 26, Internal Revenue Code.
Notification to Covered EmployeesPub. L. 99272, title X, § 10002(e), Apr. 7, 1986, 100 Stat. 232, provided that: “At the time that the amendments made by this section [enacting this part and amending section 1132 of this title] apply to a group health plan (within the meaning of section 607(1) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1167(1)]), the plan shall notify each covered employee, and spouse of the employee (if any), who is covered under the plan at that time of the continuation coverage required under part 6 of subtitle B of title I of such Act [this part]. The notice furnished under this subsection is in lieu of notice that may otherwise be required under section 606(1) of such Act [29 U.S.C. 1166(1)] with respect to such individuals.”
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# 29 U.S.C. § 1167 - Definitions and special rules
## Text
For purposes of this part—
(1) Group health plan The term “group health plan” means an employee welfare benefit plan providing medical care (as defined in section 213(d) of title 26) to participants or beneficiaries directly or through insurance, reimbursement, or otherwise. Such term shall not include any plan substantially all of the coverage under which is for qualified long-term care services (as defined in section 7702B(c) of title 26). Such term shall not include any qualified small employer health reimbursement arrangement (as defined in section 9831(d)(2) of title 26).
(2) Covered employee The term “covered employee” means an individual who is (or was) provided coverage under a group health plan by virtue of the performance of services by the individual for 1 or more persons maintaining the plan (including as an employee defined in section 401(c)(1) of title 26).
(3) Qualified beneficiary (A) In general The term “qualified beneficiary” means, with respect to a covered employee under a group health plan, any other individual who, on the day before the qualifying event for that employee, is a beneficiary under the plan—
(i) as the spouse of the covered employee, or
(ii) as the dependent child of the employee.
Such term shall also include a child who is born to or placed for adoption with the covered employee during the period of continuation coverage under this part.
(B) Special rule for terminations and reduced employment In the case of a qualifying event described in section 1163(2) of this title, the term “qualified beneficiary” includes the covered employee.
(C) Special rule for retirees and widows In the case of a qualifying event described in section 1163(6) of this title, the term “qualified beneficiary” includes a covered employee who had retired on or before the date of substantial elimination of coverage and any other individual who, on the day before such qualifying event, is a beneficiary under the plan—
(i) as the spouse of the covered employee,
(ii) as the dependent child of the employee, or
(iii) as the surviving spouse of the covered employee.
(4) Employer Subsection (n) (relating to leased employees) and subsection (t) (relating to application of controlled group rules to certain employee benefits) of section 414 of title 26 shall apply for purposes of this part in the same manner and to the same extent as such subsections apply for purposes of section 106 of title 26. Any regulations prescribed by the Secretary pursuant to the preceding sentence shall be consistent and coextensive with any regulations prescribed for similar purposes by the Secretary of the Treasury (or such Secretarys delegate) under such subsections.
(5) Optional extension of required periods A group health plan shall not be treated as failing to meet the requirements of this part solely because the plan provides both—
(A) that the period of extended coverage referred to in section 1162(2) of this title commences with the date of the loss of coverage, and
(B) that the applicable notice period provided under section 1166(a)(2) of this title commences with the date of the loss of coverage.
(Pub. L. 93406, title I, § 607, as added Pub. L. 99272, title X, § 10002(a), Apr. 7, 1986, 100 Stat. 231; amended Pub. L. 99509, title IX, § 9501(c)(2), Oct. 21, 1986, 100 Stat. 2077; Pub. L. 99514, title XVIII, § 1895(d)(8), (9)(A), Oct. 22, 1986, 100 Stat. 2940; Pub. L. 100647, title III, § 3011(b)(6), Nov. 10, 1988, 102 Stat. 3625; Pub. L. 101239, title VII, §§ 7862(c)(2)(A), (6)(A), 7891(a)(1), (d)(2)(B)(i), Dec. 19, 1989, 103 Stat. 2432, 2433, 2445, 2446; Pub. L. 104191, title III, § 321(d)(2), title IV, § 421(b)(3), Aug. 21, 1996, 110 Stat. 2058, 2088; Pub. L. 114255, div. C, title XVIII, § 18001(b)(2), Dec. 13, 2016, 130 Stat. 1344.)
## Notes
Editorial Notes
Amendments2016—Par. (1). Pub. L. 114255 inserted at end “Such term shall not include any qualified small employer health reimbursement arrangement (as defined in section 9831(d)(2) of title 26).” 1996—Par. (1). Pub. L. 104191, § 321(d)(2), inserted at end “Such term shall not include any plan substantially all of the coverage under which is for qualified long-term care services (as defined in section 7702B(c) of title 26).” Par. (3)(A). Pub. L. 104191, § 421(b)(3), inserted at end “Such term shall also include a child who is born to or placed for adoption with the covered employee during the period of continuation coverage under this part.” 1989—Pub. L. 101239, § 7891(d)(2)(B)(i)(I), inserted “and special rules” after “Definitions” in section catchline. Par. (1). Pub. L. 101239, § 7862(c)(6)(A), repealed Pub. L. 100647, § 3011(b)(6), see 1988 Amendment note below. Pub. L. 101239, § 7891(a)(1), substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”, which for purposes of codification was translated as “title 26” thus requiring no change in text. Par. (2). Pub. L. 101239, § 7862(c)(2)(A), substituted “the performance of services by the individual for 1 or more persons maintaining the plan (including as an employee defined in section 401(c)(1) of title 26)” for “the individuals employment or previous employment with an employer”. Par. (5). Pub. L. 101239, § 7891(d)(2)(B)(i)(II), added par. (5). 1988—Par. (1). Pub. L. 100647, § 3011(b)(6), which directed amendment of par. (1) by substituting “section 162(i)(2) of title 26” for “section 162(i)(3) of title 26”, was repealed by Pub. L. 101239, § 7862(c)(6)(A). Pub. L. 99514, § 1895(d)(8), amended par. (1) generally. Prior to amendment, par. (1) read as follows: “The term group health plan means an employee welfare benefit plan that is a group health plan (within the meaning of section 162(i)(3) of title 26).” Par. (3)(C). Pub. L. 99509 added subpar. (C). Par. (4). Pub. L. 99514, § 1895(d)(9)(A), added par. (4).
Statutory Notes and Related Subsidiaries
Effective Date of 2016 AmendmentPub. L. 114255, div. C, title XVIII, § 18001(b)(3), Dec. 13, 2016, 130 Stat. 1344, provided that: “The amendments made by this subsection [amending this section and section 1191b of this title] shall apply to plan years beginning after December 31, 2016.”
Effective Date of 1996 AmendmentAmendment by section 321(d)(2) of Pub. L. 104191 applicable to contracts issued after Dec. 31, 1996, see section 321(f) of Pub. L. 104191, set out as an Effective Date note under section 7702B of Title 26, Internal Revenue Code. Amendment by section 421(b)(3) of Pub. L. 104191 effective Jan. 1, 1997, regardless of whether qualifying event occurred before, on, or after such date, see section 421(d) of Pub. L. 104191 set out as a note under section 4980B of Title 26.
Effective Date of 1989 AmendmentAmendment by section 7862(c)(2)(A) of Pub. L. 101239 applicable to plan years beginning after Dec. 31, 1989, see section 7862(c)(2)(C) of Pub. L. 101239, set out as a note under section 4980B of Title 26, Internal Revenue Code. Pub. L. 101239, title VII, § 7862(c)(6)(B), Dec. 19, 1989, 103 Stat. 2433, provided that: “Subparagraph (A) [repealing section 3011(b)(6) of Pub. L. 100647, which amended this section] shall be effective as if included in the enactment of section 3011(b) of the Technical and Miscellaneous Revenue Act of 1988 [Pub. L. 100647].” Amendment by section 7891(a)(1) of Pub. L. 101239 effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, Pub. L. 99514, to which such amendment relates, see section 7891(f) of Pub. L. 101239, set out as a note under section 1002 of this title. Amendment by section 7891(d)(2)(B)(i) of Pub. L. 101239 applicable with respect to plan years beginning on or after Jan. 1, 1990, see section 7891(d)(2)(C) of Pub. L. 101239, set out as a note under section 4980B of Title 26, Internal Revenue Code.
Effective Date of 1988 AmendmentAmendment by Pub. L. 100647 applicable to taxable years beginning after Dec. 31, 1988, but not applicable to any plan for any plan year to which section 162(k) of Title 26, Internal Revenue Code (as in effect on the day before Nov. 10, 1988) did not apply by reason of section 10001(e)(2) of Pub. L. 99272, see section 3011(d) of Pub. L. 100647, set out as a note under section 162 of Title 26.
Effective Date of 1986 AmendmentsPub. L. 99514, title XVIII, § 1895(d)(9)(B), Oct. 22, 1986, 100 Stat. 2940, provided that: “The amendment made by subparagraph (A) [amending this section] shall take effect in the same manner and to the same extent as the amendments made by subsections (e) and (i) of section 1151 of this Act [amending sections 132 and 414 of Title 26, Internal Revenue Code, see section 1151(k) of Pub. L. 99514, set out as an Effective Date note under section 89 of Title 26].” Amendment by section 1895(d)(8) of Pub. L. 99514 effective, except as otherwise provided, as if included in enactment of the Consolidated Omnibus Budget Reconciliation Act of 1985, Pub. L. 99272, see section 1895(e) of Pub. L. 99514, set out as a note under section 162 of Title 26. Amendment by Pub. L. 99509 effective, except as otherwise provided, as if included in title X of the Consolidated Omnibus Budget Reconciliation Act of 1985, Pub. L. 99272, see section 9501(e) of Pub. L. 99509, set out as a note under section 162 of Title 26.
Plan Amendments Not Required Until January 1, 1989For provisions directing that if any amendments made by subtitle A or subtitle C of title XI [§§ 11011147 and 11711177] or title XVIII [§§ 18001899A] of Pub. L. 99514 require an amendment to any plan, such plan amendment shall not be required to be made before the first plan year beginning on or after Jan. 1, 1989, see section 1140 of Pub. L. 99514, as amended, set out as a note under section 401 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1168 - Regulations
## Text
The Secretary may prescribe regulations to carry out the provisions of this part.
(Pub. L. 93406, title I, § 608, as added Pub. L. 99272, title X, § 10002(a), Apr. 7, 1986, 100 Stat. 231.)
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# 29 U.S.C. § 1181 - Increased portability through limitation on preexisting condition exclusions
## Text
(a) Limitation on preexisting condition exclusion period; crediting for periods of previous coverage Subject to subsection (d), a group health plan, and a health insurance issuer offering group health insurance coverage, may, with respect to a participant or beneficiary, impose a preexisting condition exclusion only if—
(1) such exclusion relates to a condition (whether physical or mental), regardless of the cause of the condition, for which medical advice, diagnosis, care, or treatment was recommended or received within the 6-month period ending on the enrollment date;
(2) such exclusion extends for a period of not more than 12 months (or 18 months in the case of a late enrollee) after the enrollment date; and
(3) the period of any such preexisting condition exclusion is reduced by the aggregate of the periods of creditable coverage (if any, as defined in subsection (c)(1)) applicable to the participant or beneficiary as of the enrollment date.
(b) Definitions For purposes of this part—
(1) Preexisting condition exclusion (A) In general The term “preexisting condition exclusion” means, with respect to coverage, a limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the date of enrollment for such coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before such date.
(B) Treatment of genetic information Genetic information shall not be treated as a condition described in subsection (a)(1) in the absence of a diagnosis of the condition related to such information.
(2) Enrollment date The term “enrollment date” means, with respect to an individual covered under a group health plan or health insurance coverage, the date of enrollment of the individual in the plan or coverage or, if earlier, the first day of the waiting period for such enrollment.
(3) Late enrollee The term “late enrollee” means, with respect to coverage under a group health plan, a participant or beneficiary who enrolls under the plan other than during—
(A) the first period in which the individual is eligible to enroll under the plan, or
(B) a special enrollment period under subsection (f).
(4) Waiting period The term “waiting period” means, with respect to a group health plan and an individual who is a potential participant or beneficiary in the plan, the period that must pass with respect to the individual before the individual is eligible to be covered for benefits under the terms of the plan.
(c) Rules relating to crediting previous coverage (1) “Creditable coverage” defined For purposes of this part, the term “creditable coverage” means, with respect to an individual, coverage of the individual under any of the following:
(A) A group health plan.
(B) Health insurance coverage.
(C) Part A or part B of title XVIII of the Social Security Act [42 U.S.C. 1395c et seq.; 1395j et seq.].
(D) Title XIX of the Social Security Act [42 U.S.C. 1396 et seq.], other than coverage consisting solely of benefits under section 1928 [42 U.S.C. 1396s].
(E) Chapter 55 of title 10.
(F) A medical care program of the Indian Health Service or of a tribal organization.
(G) A State health benefits risk pool.
(H) A health plan offered under chapter 89 of title 5.
(I) A public health plan (as defined in regulations).
(J) A health benefit plan under section 2504(e) of title 22.
Such term does not include coverage consisting solely of coverage of excepted benefits (as defined in section 1191b(c) of this title).
(2) Not counting periods before significant breaks in coverage (A) In general A period of creditable coverage shall not be counted, with respect to enrollment of an individual under a group health plan, if, after such period and before the enrollment date, there was a 63-day period during all of which the individual was not covered under any creditable coverage.
(B) Waiting period not treated as a break in coverage For purposes of subparagraph (A) and subsection (d)(4), any period that an individual is in a waiting period for any coverage under a group health plan (or for group health insurance coverage) or is in an affiliation period (as defined in subsection (g)(2)) shall not be taken into account in determining the continuous period under subparagraph (A).
(C) TAA-eligible individuals In the case of plan years beginning before January 1, 2014—
(i) TAA pre-certification period rule In the case of a TAA-eligible individual, the period beginning on the date the individual has a TAA-related loss of coverage and ending on the date that is 7 days after the date of the issuance by the Secretary (or by any person or entity designated by the Secretary) of a qualified health insurance costs credit eligibility certificate for such individual for purposes of section 7527 of title 26 shall not be taken into account in determining the continuous period under subparagraph (A).
(ii) Definitions The terms “TAA-eligible individual” and “TAA-related loss of coverage” have the meanings given such terms in section 1165(b)(4) of this title.
(3) Method of crediting coverage (A) Standard method Except as otherwise provided under subparagraph (B), for purposes of applying subsection (a)(3), a group health plan, and a health insurance issuer offering group health insurance coverage, shall count a period of creditable coverage without regard to the specific benefits covered during the period.
(B) Election of alternative method A group health plan, or a health insurance issuer offering group health insurance coverage, may elect to apply subsection (a)(3) based on coverage of benefits within each of several classes or categories of benefits specified in regulations rather than as provided under subparagraph (A). Such election shall be made on a uniform basis for all participants and beneficiaries. Under such election a group health plan or issuer shall count a period of creditable coverage with respect to any class or category of benefits if any level of benefits is covered within such class or category.
(C) Plan notice In the case of an election with respect to a group health plan under subparagraph (B) (whether or not health insurance coverage is provided in connection with such plan), the plan shall—
(i) prominently state in any disclosure statements concerning the plan, and state to each enrollee at the time of enrollment under the plan, that the plan has made such election, and
(ii) include in such statements a description of the effect of this election.
(4) Establishment of period Periods of creditable coverage with respect to an individual shall be established through presentation of certifications described in subsection (e) or in such other manner as may be specified in regulations.
(d) Exceptions (1) Exclusion not applicable to certain newborns Subject to paragraph (4), a group health plan, and a health insurance issuer offering group health insurance coverage, may not impose any preexisting condition exclusion in the case of an individual who, as of the last day of the 30-day period beginning with the date of birth, is covered under creditable coverage.
(2) Exclusion not applicable to certain adopted children Subject to paragraph (4), a group health plan, and a health insurance issuer offering group health insurance coverage, may not impose any preexisting condition exclusion in the case of a child who is adopted or placed for adoption before attaining 18 years of age and who, as of the last day of the 30-day period beginning on the date of the adoption or placement for adoption, is covered under creditable coverage. The previous sentence shall not apply to coverage before the date of such adoption or placement for adoption.
(3) Exclusion not applicable to pregnancy A group health plan, and health insurance issuer offering group health insurance coverage, may not impose any preexisting condition exclusion relating to pregnancy as a preexisting condition.
(4) Loss if break in coverage Paragraphs (1) and (2) shall no longer apply to an individual after the end of the first 63-day period during all of which the individual was not covered under any creditable coverage.
(e) Certifications and disclosure of coverage (1) Requirement for certification of period of creditable coverage (A) In general A group health plan, and a health insurance issuer offering group health insurance coverage, shall provide the certification described in subparagraph (B)—
(i) at the time an individual ceases to be covered under the plan or otherwise becomes covered under a COBRA continuation provision,
(ii) in the case of an individual becoming covered under such a provision, at the time the individual ceases to be covered under such provision, and
(iii) on the request on behalf of an individual made not later than 24 months after the date of cessation of the coverage described in clause (i) or (ii), whichever is later.
The certification under clause (i) may be provided, to the extent practicable, at a time consistent with notices required under any applicable COBRA continuation provision.
(B) Certification The certification described in this subparagraph is a written certification of—
(i) the period of creditable coverage of the individual under such plan and the coverage (if any) under such COBRA continuation provision, and
(ii) the waiting period (if any) (and affiliation period, if applicable) imposed with respect to the individual for any coverage under such plan.
(C) Issuer compliance To the extent that medical care under a group health plan consists of group health insurance coverage, the plan is deemed to have satisfied the certification requirement under this paragraph if the health insurance issuer offering the coverage provides for such certification in accordance with this paragraph.
(2) Disclosure of information on previous benefits In the case of an election described in subsection (c)(3)(B) by a group health plan or health insurance issuer, if the plan or issuer enrolls an individual for coverage under the plan and the individual provides a certification of coverage of the individual under paragraph (1)—
(A) upon request of such plan or issuer, the entity which issued the certification provided by the individual shall promptly disclose to such requesting plan or issuer information on coverage of classes and categories of health benefits available under such entitys plan or coverage, and
(B) such entity may charge the requesting plan or issuer for the reasonable cost of disclosing such information.
(3) Regulations The Secretary shall establish rules to prevent an entitys failure to provide information under paragraph (1) or (2) with respect to previous coverage of an individual from adversely affecting any subsequent coverage of the individual under another group health plan or health insurance coverage.
(f) Special enrollment periods (1) Individuals losing other coverage A group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan if each of the following conditions is met:
(A) The employee or dependent was covered under a group health plan or had health insurance coverage at the time coverage was previously offered to the employee or dependent.
(B) The employee stated in writing at such time that coverage under a group health plan or health insurance coverage was the reason for declining enrollment, but only if the plan sponsor or issuer (if applicable) required such a statement at such time and provided the employee with notice of such requirement (and the consequences of such requirement) at such time.
(C) The employees or dependents coverage described in subparagraph (A)—
(i) was under a COBRA continuation provision and the coverage under such provision was exhausted; or
(ii) was not under such a provision and either the coverage was terminated as a result of loss of eligibility for the coverage (including as a result of legal separation, divorce, death, termination of employment, or reduction in the number of hours of employment) or employer contributions toward such coverage were terminated.
(D) Under the terms of the plan, the employee requests such enrollment not later than 30 days after the date of exhaustion of coverage described in subparagraph (C)(i) or termination of coverage or employer contribution described in subparagraph (C)(ii).
(2) For dependent beneficiaries (A) In general If—
(i) a group health plan makes coverage available with respect to a dependent of an individual,
(ii) the individual is a participant under the plan (or has met any waiting period applicable to becoming a participant under the plan and is eligible to be enrolled under the plan but for a failure to enroll during a previous enrollment period), and
(iii) a person becomes such a dependent of the individual through marriage, birth, or adoption or placement for adoption,
the group health plan shall provide for a dependent special enrollment period described in subparagraph (B) during which the person (or, if not otherwise enrolled, the individual) may be enrolled under the plan as a dependent of the individual, and in the case of the birth or adoption of a child, the spouse of the individual may be enrolled as a dependent of the individual if such spouse is otherwise eligible for coverage.
(B) Dependent special enrollment period A dependent special enrollment period under this subparagraph shall be a period of not less than 30 days and shall begin on the later of—
(i) the date dependent coverage is made available, or
(ii) the date of the marriage, birth, or adoption or placement for adoption (as the case may be) described in subparagraph (A)(iii).
(C) No waiting period If an individual seeks to enroll a dependent during the first 30 days of such a dependent special enrollment period, the coverage of the dependent shall become effective—
(i) in the case of marriage, not later than the first day of the first month beginning after the date the completed request for enrollment is received;
(ii) in the case of a dependents birth, as of the date of such birth; or
(iii) in the case of a dependents adoption or placement for adoption, the date of such adoption or placement for adoption.
(3) Special rules for application in case of Medicaid and CHIP (A) In general A group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, shall permit an employee who is eligible, but not enrolled, for coverage under the terms of the plan (or a dependent of such an employee if the dependent is eligible, but not enrolled, for coverage under such terms) to enroll for coverage under the terms of the plan if either of the following conditions is met:
(i) Termination of Medicaid or CHIP coverage The employee or dependent is covered under a Medicaid plan under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] or under a State child health plan under title XXI of such Act [42 U.S.C. 1397aa et seq.] and coverage of the employee or dependent under such a plan is terminated as a result of loss of eligibility for such coverage and the employee requests coverage under the group health plan (or health insurance coverage) not later than 60 days after the date of termination of such coverage.
(ii) Eligibility for employment assistance under Medicaid or CHIP The employee or dependent becomes eligible for assistance, with respect to coverage under the group health plan or health insurance coverage, under such Medicaid plan or State child health plan (including under any waiver or demonstration project conducted under or in relation to such a plan), if the employee requests coverage under the group health plan or health insurance coverage not later than 60 days after the date the employee or dependent is determined to be eligible for such assistance.
(B) Coordination with Medicaid and CHIP (i) Outreach to employees regarding availability of Medicaid and CHIP coverage (I) In general Each employer that maintains a group health plan in a State that provides medical assistance under a State Medicaid plan under title XIX of the Social Security Act, or child health assistance under a State child health plan under title XXI of such Act, in the form of premium assistance for the purchase of coverage under a group health plan, shall provide to each employee a written notice informing the employee of potential opportunities then currently available in the State in which the employee resides for premium assistance under such plans for health coverage of the employee or the employees dependents.
(II) Model notice Not later than 1 year after February 4, 2009, the Secretary and the Secretary of Health and Human Services, in consultation with Directors of State Medicaid agencies under title XIX of the Social Security Act and Directors of State CHIP agencies under title XXI of such Act, shall jointly develop national and State-specific model notices for purposes of subparagraph (A). The Secretary shall provide employers with such model notices so as to enable employers to timely comply with the requirements of subparagraph (A). Such model notices shall include information regarding how an employee may contact the State in which the employee resides for additional information regarding potential opportunities for such premium assistance, including how to apply for such assistance.
(III) Option to provide concurrent with provision of plan materials to employee An employer may provide the model notice applicable to the State in which an employee resides concurrent with the furnishing of materials notifying the employee of health plan eligibility, concurrent with materials provided to the employee in connection with an open season or election process conducted under the plan, or concurrent with the furnishing of the summary plan description as provided in section 1024(b) of this title.
(ii) Disclosure about group health plan benefits to States for Medicaid and CHIP eligible individuals In the case of a participant or beneficiary of a group health plan who is covered under a Medicaid plan of a State under title XIX of the Social Security Act or under a State child health plan under title XXI of such Act, the plan administrator of the group health plan shall disclose to the State, upon request, information about the benefits available under the group health plan in sufficient specificity, as determined under regulations of the Secretary of Health and Human Services in consultation with the Secretary that require use of the model coverage coordination disclosure form developed under section 311(b)(1)(C) of the Childrens Health Insurance Program Reauthorization Act of 2009, so as to permit the State to make a determination (under paragraph (2)(B), (3), or (10) of section 2105(c) of the Social Security Act [42 U.S.C. 1397ee(c)(2)(B), (3), (10)] or otherwise) concerning the cost-effectiveness of the State providing medical or child health assistance through premium assistance for the purchase of coverage under such group health plan and in order for the State to provide supplemental benefits required under paragraph (10)(E) of such section or other authority.
(g) Use of affiliation period by HMOs as alternative to preexisting condition exclusion (1) In general In the case of a group health plan that offers medical care through health insurance coverage offered by a health maintenance organization, the plan may provide for an affiliation period with respect to coverage through the organization only if—
(A) no preexisting condition exclusion is imposed with respect to coverage through the organization,
(B) the period is applied uniformly without regard to any health status-related factors, and
(C) such period does not exceed 2 months (or 3 months in the case of a late enrollee).
(2) Affiliation period (A) Defined For purposes of this part, the term “affiliation period” means a period which, under the terms of the health insurance coverage offered by the health maintenance organization, must expire before the health insurance coverage becomes effective. The organization is not required to provide health care services or benefits during such period and no premium shall be charged to the participant or beneficiary for any coverage during the period.
(B) Beginning Such period shall begin on the enrollment date.
(C) Runs concurrently with waiting periods An affiliation period under a plan shall run concurrently with any waiting period under the plan.
(3) Alternative methods A health maintenance organization described in paragraph (1) may use alternative methods, from those described in such paragraph, to address adverse selection as approved by the State insurance commissioner or official or officials designated by the State to enforce the requirements of part A of title XXVII of the Public Health Service Act [42 U.S.C. 300gg et seq.] for the State involved with respect to such issuer.
(Pub. L. 93406, title I, § 701, as added Pub. L. 104191, title I, § 101(a), Aug. 21, 1996, 110 Stat. 1939; amended Pub. L. 104204, title VI, § 603(b)(3)(H), Sept. 26, 1996, 110 Stat. 2938; Pub. L. 1113, title III, § 311(b)(1)(A), Feb. 4, 2009, 123 Stat. 65; Pub. L. 1115, div. B, title I, § 1899D(b), Feb. 17, 2009, 123 Stat. 426; Pub. L. 111344, title I, § 114(b), Dec. 29, 2010, 124 Stat. 3615; Pub. L. 11240, title II, § 242(a)(2), Oct. 21, 2011, 125 Stat. 419.)
## Notes
Editorial Notes
References in TextThe Social Security Act, referred to in subsecs. (c)(1)(C), (D), (f)(3)(A)(i), (B)(i)(I), (II), (ii), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Parts A and B of title XVIII of the Act are classified generally to parts A (§ 1395c et seq.) and B (§ 1395j et seq.) of subchapter XVIII of chapter 7 of Title 42, The Public Health and Welfare. Titles XIX and XXI of the Act are classified generally to subchapters XIX (§ 1396 et seq.) and XXI (§ 1397aa et seq.), respectively, of chapter 7 of Title 42. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables. Section 311(b)(1)(C) of the Childrens Health Insurance Program Reauthorization Act of 2009, referred to in subsec. (f)(3)(B)(ii), is section 311(b)(1)(C) of Pub. L. 1113, which is set out as a note under this section. The Public Health Service Act, referred to in subsec. (g)(3), is act July 1, 1944, ch. 373, 58 Stat. 682. Part A of title XXVII of the Act is classified generally to part A (§ 300gg et seq.) of subchapter XXV 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.
Amendments2011—Subsec. (c)(2)(C). Pub. L. 11240 substituted “January 1, 2014” for “February 13, 2011” in introductory provisions. 2010—Subsec. (c)(2)(C). Pub. L. 111344 substituted “February 13, 2011” for “January 1, 2011” in introductory provisions. 2009—Subsec. (c)(2)(C). Pub. L. 1115 added subpar. (C). Subsec. (f)(3). Pub. L. 1113 added par. (3). 1996—Subsec. (c)(1). Pub. L. 104204 made technical amendment to reference in original act which appears in text as reference to section 1191b of this title.
Statutory Notes and Related Subsidiaries
Effective Date of 2011 AmendmentAmendment by Pub. L. 11240 applicable to plan years beginning after Feb. 12, 2011, with transitional rules, see section 242(b) of Pub. L. 11240, set out as a note under section 9801 of Title 26, Internal Revenue Code.
Effective Date of 2010 AmendmentAmendment by Pub. L. 111344 applicable to plan years beginning after Dec. 31, 2010, see section 114(d) of Pub. L. 111344, set out as a note under section 9801 of Title 26, Internal Revenue Code.
Effective Date of 2009 AmendmentExcept as otherwise provided and subject to certain applicability provisions, amendment by Pub. L. 1115 effective upon the expiration of the 90-day period beginning on Feb. 17, 2009, see section 1891 of Pub. L. 1115, set out as an Effective and Termination Dates of 2009 Amendment note under section 2271 of Title 19, Customs Duties. Amendment by Pub. L. 1115 applicable to plan years beginning after Feb. 17, 2009, see section 1899D(d) of Pub. L. 1115, set out as a note under section 9801 of Title 26, Internal Revenue Code. Amendment by Pub. L. 1113 effective Apr. 1, 2009, and applicable to child health assistance and medical assistance provided on or after that date, with certain exceptions, see section 3 of Pub. L. 1113, set out as an Effective Date note under section 1396 of Title 42, The Public Health and Welfare.
Effective Date of 1996 AmendmentAmendment by Pub. L. 104204 applicable with respect to group health plans for plan years beginning on and after Jan. 1, 1998, see section 603(c) of Pub. L. 104204, set out as a note under section 1003 of this title.
Effective DatePub. L. 104191, title I, § 101(g), Aug. 21, 1996, 110 Stat. 1953, provided that: “(1) In general.—Except as provided in this section, this section [enacting this part and amending sections 1003, 1021, 1022, 1024, 1132, 1136, and 1144 of this title] (and the amendments made by this section) shall apply with respect to group health plans for plan years beginning after June 30, 1997. “(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 part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (as added by this section) [this part] in determining creditable coverage. “(ii) Special rule for certain periods.—The Secretary of Labor, consistent with section 104 [42 U.S.C. 300gg92 note], 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 701 of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1181(e)](as added by this section) shall apply to events occurring after June 30, 1996. “(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 plans or issuers crediting (or not crediting) 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 [enacting this part and amending sections 1003, 1021, 1022, 1024, 1132, 1136, and 1144 of this title]. “(3) Special rule for collective bargaining agreements.—Except as provided in paragraph (2), in the case of a group health plan maintained pursuant to one 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], part 7 of subtitle B of title I of Employee Retirement Income Security Act of 1974 [this part] (other than section 701(e) thereof [29 U.S.C. 1181(e)]) 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), 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 of such part shall not be treated as a termination of such collective bargaining agreement. “(4) Timely regulations.—The Secretary of Labor, consistent with section 104 [42 U.S.C. 300gg92 note], 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.”
Working Group to Develop Model Coverage Coordination Disclosure FormPub. L. 1113, title III, § 311(b)(1)(C), Feb. 4, 2009, 123 Stat. 68, provided that: “(i) Medicaid, chip, and employer-sponsored coverage coordination working group.—“(I) In general.—Not later than 60 days after the date of enactment of this Act [Feb. 4, 2009], the Secretary of Health and Human Services and the Secretary of Labor shall jointly establish a Medicaid, CHIP, and Employer-Sponsored Coverage Coordination Working Group (in this subparagraph referred to as the Working Group). The purpose of the Working Group shall be to develop the model coverage coordination disclosure form described in subclause (II) and to identify the impediments to the effective coordination of coverage available to families that include employees of employers that maintain group health plans and members who are eligible for medical assistance under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] or child health assistance or other health benefits coverage under title XXI of such Act [42 U.S.C. 1397aa et seq.]. “(II) Model coverage coordination disclosure form described.—The model form described in this subclause is a form for plan administrators of group health plans to complete for purposes of permitting a State to determine the availability and cost-effectiveness of the coverage available under such plans to employees who have family members who are eligible for premium assistance offered under a State plan under title XIX or XXI of such Act and to allow for coordination of coverage for enrollees of such plans. Such form shall provide the following information in addition to such other information as the Working Group determines appropriate:“(aa) A determination of whether the employee is eligible for coverage under the group health plan. “(bb) The name and contract information of the plan administrator of the group health plan. “(cc) The benefits offered under the plan. “(dd) The premiums and cost-sharing required under the plan. “(ee) Any other information relevant to coverage under the plan. “(ii) Membership.—The Working Group shall consist of not more than 30 members and shall be composed of representatives of—“(I) the Department of Labor; “(II) the Department of Health and Human Services; “(III) State directors of the Medicaid program under title XIX of the Social Security Act; “(IV) State directors of the State Childrens Health Insurance Program under title XXI of the Social Security Act; “(V) employers, including owners of small businesses and their trade or industry representatives and certified human resource and payroll professionals; “(VI) plan administrators and plan sponsors of group health plans (as defined in section 607(1) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1167(1)]); “(VII) health insurance issuers; and “(VIII) children and other beneficiaries of medical assistance under title XIX of the Social Security Act or child health assistance or other health benefits coverage under title XXI of such Act. “(iii) Compensation.—The members of the Working Group shall serve without compensation. “(iv) Administrative support.—The Department of Health and Human Services and the Department of Labor shall jointly provide appropriate administrative support to the Working Group, including technical assistance. The Working Group may use the services and facilities of either such Department, with or without reimbursement, as jointly determined by such Departments. “(v) Report.—“(I) Report by working group to the secretaries.—Not later than 18 months after the date of the enactment of this Act, the Working Group shall submit to the Secretary of Labor and the Secretary of Health and Human Services the model form described in clause (i)(II) along with a report containing recommendations for appropriate measures to address the impediments to the effective coordination of coverage between group health plans and the State plans under titles XIX and XXI of the Social Security Act. “(II) Report by secretaries to the congress.—Not later than 2 months after receipt of the report pursuant to subclause (I), the Secretaries shall jointly submit a report to each House of the Congress regarding the recommendations contained in the report under such subclause. “(vi) Termination.—The Working Group shall terminate 30 days after the date of the issuance of its report under clause (v).” [For definitions of “CHIP” and “Medicaid” as used in section 311(b)(1)(C) of Pub. L. 1113, set out above, see section 1(c)(1), (2) of Pub. L. 1113, set out as a Definitions note under section 1396 of Title 42, The Public Health and Welfare.]
Implementation of 2009 AmendmentPub. L. 1113, title III, § 311(b)(1)(D), Feb. 4, 2009, 123 Stat. 69, provided that: “The Secretary of Labor and the Secretary of Health and Human Services shall develop the initial model notices under section 701(f)(3)(B)(i)(II) of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1181(f)(3)(B)(i)(II)], and the Secretary of Labor shall provide such notices to employers, not later than the date that is 1 year after the date of enactment of this Act [Feb. 4, 2009], and each employer shall provide the initial annual notices to such employers employees beginning with the first plan year that begins after the date on which such initial model notices are first issued. The model coverage coordination disclosure form developed under subparagraph (C) [set out above] shall apply with respect to requests made by States beginning with the first plan year that begins after the date on which such model coverage coordination disclosure form is first issued.”
@@ -0,0 +1,121 @@
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# 29 U.S.C. § 1182 - Prohibiting discrimination against individual participants and beneficiaries based on health status
## Text
(a) In eligibility to enroll (1) In general Subject to paragraph (2), a group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan based on any of the following health status-related factors in relation to the individual or a dependent of the individual:
(A) Health status.
(B) Medical condition (including both physical and mental illnesses).
(C) Claims experience.
(D) Receipt of health care.
(E) Medical history.
(F) Genetic information.
(G) Evidence of insurability (including conditions arising out of acts of domestic violence).
(H) Disability.
(2) No application to benefits or exclusions To the extent consistent with section 1181 of this title, paragraph (1) shall not be construed—
(A) to require a group health plan, or group health insurance coverage, to provide particular benefits other than those provided under the terms of such plan or coverage, or
(B) to prevent such a plan or coverage from establishing limitations or restrictions on the amount, level, extent, or nature of the benefits or coverage for similarly situated individuals enrolled in the plan or coverage.
(3) Construction For purposes of paragraph (1), rules for eligibility to enroll under a plan include rules defining any applicable waiting periods for such enrollment.
(b) In premium contributions (1) In general A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, may not require any individual (as a condition of enrollment or continued enrollment under the plan) to pay a premium or contribution which is greater than such premium or contribution for a similarly situated individual enrolled in the plan on the basis of any health status-related factor in relation to the individual or to an individual enrolled under the plan as a dependent of the individual.
(2) Construction Nothing in paragraph (1) shall be construed—
(A) to restrict the amount that an employer may be charged for coverage under a group health plan except as provided in paragraph (3); or
(B) to prevent a group health plan, and a health insurance issuer offering group health insurance coverage, from establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention.
(3) No group-based discrimination on basis of genetic information (A) In general For purposes of this section, a group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not adjust premium or contribution amounts for the group covered under such plan on the basis of genetic information.
(B) Rule of construction Nothing in subparagraph (A) or in paragraphs (1) and (2) of subsection (d) shall be construed to limit the ability of a health insurance issuer offering health insurance coverage in connection with a group health plan to increase the premium for an employer based on the manifestation of a disease or disorder of an individual who is enrolled in the plan. In such case, the manifestation of a disease or disorder in one individual cannot also be used as genetic information about other group members and to further increase the premium for the employer.
(c) Genetic testing (1) Limitation on requesting or requiring genetic testing A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, shall not request or require an individual or a family member of such individual to undergo a genetic test.
(2) Rule of construction Paragraph (1) shall not be construed to limit the authority of a health care professional who is providing health care services to an individual to request that such individual undergo a genetic test.
(3) Rule of construction regarding payment (A) In general Nothing in paragraph (1) shall be construed to preclude a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, from obtaining and using the results of a genetic test in making a determination regarding payment (as such term is defined for the purposes of applying the regulations promulgated by the Secretary of Health and Human Services under part C of title XI of the Social Security Act [42 U.S.C. 1320d et seq.] and section 264 of the Health Insurance Portability and Accountability Act of 1996, as may be revised from time to time) consistent with subsection (a).
(B) Limitation For purposes of subparagraph (A), a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, may request only the minimum amount of information necessary to accomplish the intended purpose.
(4) Research exception Notwithstanding paragraph (1), a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, may request, but not require, that a participant or beneficiary undergo a genetic test if each of the following conditions is met:
(A) The request is made, in writing, pursuant to research that complies with part 46 of title 45, Code of Federal Regulations, or equivalent Federal regulations, and any applicable State or local law or regulations for the protection of human subjects in research.
(B) The plan or issuer clearly indicates to each participant or beneficiary, or in the case of a minor child, to the legal guardian of such beneficiary, to whom the request is made that—
(i) compliance with the request is voluntary; and
(ii) non-compliance will have no effect on enrollment status or premium or contribution amounts.
(C) No genetic information collected or acquired under this paragraph shall be used for underwriting purposes.
(D) The plan or issuer notifies the Secretary in writing that the plan or issuer is conducting activities pursuant to the exception provided for under this paragraph, including a description of the activities conducted.
(E) The plan or issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this paragraph.
(d) Prohibition on collection of genetic information (1) In general A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, shall not request, require, or purchase genetic information for underwriting purposes (as defined in section 1191b of this title).
(2) Prohibition on collection of genetic information prior to enrollment A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, shall not request, require, or purchase genetic information with respect to any individual prior to such individuals enrollment under the plan or coverage in connection with such enrollment.
(3) Incidental collection If a group health plan, or a health insurance issuer offering health insurance coverage in connection with a group health plan, obtains genetic information incidental to the requesting, requiring, or purchasing of other information concerning any individual, such request, requirement, or purchase shall not be considered a violation of paragraph (2) if such request, requirement, or purchase is not in violation of paragraph (1).
(e) Application to all plans The provisions of subsections (a)(1)(F), (b)(3), (c), and (d), and subsection (b)(1) and section 1181 of this title with respect to genetic information, shall apply to group health plans and health insurance issuers without regard to section 1191a(a) of this title.
(f) Genetic information of a fetus or embryo Any reference in this part to genetic information concerning an individual or family member of an individual shall—
(1) with respect to such an individual or family member of an individual who is a pregnant woman, include genetic information of any fetus carried by such pregnant woman; and
(2) with respect to an individual or family member utilizing an assisted reproductive technology, include genetic information of any embryo legally held by the individual or family member.
(Pub. L. 93406, title I, § 702, as added Pub. L. 104191, title I, § 101(a), Aug. 21, 1996, 110 Stat. 1945; amended Pub. L. 110233, title I, § 101(a)(c), May 21, 2008, 122 Stat. 883, 885.)
## Notes
Editorial Notes
References in TextThe Social Security Act, referred to in subsec. (c)(3)(A), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Part C of title XI of the Act is classified generally to part C (§ 1320d et seq.) of subchapter XI of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables. Section 264 of the Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (c)(3)(A), is section 264 of Pub. L. 104191, which is set out as a note under section 1320d2 of Title 42, The Public Health and Welfare.
Amendments2008—Subsec. (b)(2)(A). Pub. L. 110233, § 101(a)(1), inserted “except as provided in paragraph (3)” before semicolon. Subsec. (b)(3). Pub. L. 110233, § 101(a)(2), added par. (3). Subsecs. (c) to (e). Pub. L. 110233, § 101(b), added subsecs. (c) to (e). Subsec. (f). Pub. L. 110233, § 101(c), added subsec. (f).
Statutory Notes and Related Subsidiaries
Effective Date of 2008 AmendmentAmendment by Pub. L. 110233 applicable with respect to group health plans for plan years beginning after the date that is one year after May 21, 2008, see section 101(f)(2) of Pub. L. 110233, set out as a note under section 1132 of this title.
@@ -0,0 +1,47 @@
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# 29 U.S.C. § 1183 - Guaranteed renewability in multiemployer plans and multiple employer welfare arrangements
## Text
A group health plan which is a multiemployer plan or which is a multiple employer welfare arrangement may not deny an employer whose employees are covered under such a plan continued access to the same or different coverage under the terms of such a plan, other than—
(1) for nonpayment of contributions;
(2) for fraud or other intentional misrepresentation of material fact by the employer;
(3) for noncompliance with material plan provisions;
(4) because the plan is ceasing to offer any coverage in a geographic area;
(5) in the case of a plan that offers benefits through a network plan, 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 any health status-related factor in relation to such individuals or their dependents; and
(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.
(Pub. L. 93406, title I, § 703, as added Pub. L. 104191, title I, § 101(a), Aug. 21, 1996, 110 Stat. 1946.)
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# 29 U.S.C. § 1185 - Standards relating to benefits for mothers and newborns
## Text
(a) Requirements for minimum hospital stay following birth (1) In general A group health plan, and a health insurance issuer offering group health insurance coverage, may not—
(A) except as provided in paragraph (2)—
(i) restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child, following a normal vaginal delivery, to less than 48 hours, or
(ii) restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child, following a cesarean section, to less than 96 hours; or
(B) require that a provider obtain authorization from the plan or the issuer for prescribing any length of stay required under subparagraph (A) (without regard to paragraph (2)).
(2) Exception Paragraph (1)(A) shall not apply in connection with any group health plan or health insurance issuer in any case in which the decision to discharge the mother or her newborn child prior to the expiration of the minimum length of stay otherwise required under paragraph (1)(A) is made by an attending provider in consultation with the mother.
(b) Prohibitions A group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not—
(1) deny to the mother or her newborn child eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan, solely for the purpose of avoiding the requirements of this section;
(2) provide monetary payments or rebates to mothers to encourage such mothers to accept less than the minimum protections available under this section;
(3) penalize or otherwise reduce or limit the reimbursement of an attending provider because such provider provided care to an individual participant or beneficiary in accordance with this section;
(4) provide incentives (monetary or otherwise) to an attending provider to induce such provider to provide care to an individual participant or beneficiary in a manner inconsistent with this section; or
(5) subject to subsection (c)(3), restrict benefits for any portion of a period within a hospital length of stay required under subsection (a) in a manner which is less favorable than the benefits provided for any preceding portion of such stay.
(c) Rules of construction (1) Nothing in this section shall be construed to require a mother who is a participant or beneficiary—
(A) to give birth in a hospital; or
(B) to stay in the hospital for a fixed period of time following the birth of her child.
(2) This section shall not apply with respect to any group health plan, or any group health insurance coverage offered by a health insurance issuer, which does not provide benefits for hospital lengths of stay in connection with childbirth for a mother or her newborn child.
(3) Nothing in this section shall be construed as preventing a group health plan or issuer from imposing deductibles, coinsurance, or other cost-sharing in relation to benefits for hospital lengths of stay in connection with childbirth for a mother or newborn child under the plan (or under health insurance coverage offered in connection with a group health plan), except that such coinsurance or other cost-sharing for any portion of a period within a hospital length of stay required under subsection (a) may not be greater than such coinsurance or cost-sharing for any preceding portion of such stay.
(d) Notice under group health plan The imposition of the requirements of this section shall be treated as a material modification in the terms of the plan described in section 1022(a)(1) 11 See References in Text note below. of this title, for purposes of assuring notice of such requirements under the plan; except that the summary description required to be provided under the last sentence of section 1024(b)(1) of this title with respect to such modification shall be provided by not later than 60 days after the first day of the first plan year in which such requirements apply.
(e) Level and type of reimbursements Nothing in this section shall be construed to prevent a group health plan or a health insurance issuer offering group health insurance coverage from negotiating the level and type of reimbursement with a provider for care provided in accordance with this section.
(f) Preemption; exception for health insurance coverage in certain States (1) In general The requirements of this section shall not apply with respect to health insurance coverage if there is a State law (as defined in section 1191(d)(1) of this title) for a State that regulates such coverage that is described in any of the following subparagraphs:
(A) Such State law requires such coverage to provide for at least a 48-hour hospital length of stay following a normal vaginal delivery and at least a 96-hour hospital length of stay following a cesarean section.
(B) Such State law requires such coverage to provide for maternity and pediatric care in accordance with guidelines established by the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, or other established professional medical associations.
(C) Such State law requires, in connection with such coverage for maternity care, that the hospital length of stay for such care is left to the decision of (or required to be made by) the attending provider in consultation with the mother.
(2) Construction Section 1191(a)(1) of this title shall not be construed as superseding a State law described in paragraph (1).
(Pub. L. 93406, title I, § 711, as added Pub. L. 104204, title VI, § 603(a)(5), Sept. 26, 1996, 110 Stat. 2935.)
## Notes
Editorial Notes
References in TextSection 1022(a)(1) of this title, referred to in subsec. (d), was redesignated section 1022(a) of this title by Pub. L. 10534, title XV, § 1503(b)(1)(B), Aug. 5, 1997, 111 Stat. 1061.
Statutory Notes and Related Subsidiaries
Effective DateSection applicable with respect to group health plans for plan years beginning on and after Jan. 1, 1998, see section 603(c) of Pub. L. 104204, set out as an Effective Date of 1996 Amendment note under section 1003 of this title.
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# 29 U.S.C. § 1185a - Parity in mental health and substance use disorder benefits
## Text
(a) In general (1) Aggregate lifetime limits In the case of a group health plan (or health insurance coverage offered in connection with such a plan) that provides both medical and surgical benefits and mental health or substance use disorder benefits—
(A) No lifetime limit If the plan or coverage does not include an aggregate lifetime limit on substantially all medical and surgical benefits, the plan or coverage may not impose any aggregate lifetime limit on mental health or substance use disorder benefits.
(B) Lifetime limit If the plan or coverage includes an aggregate lifetime limit on substantially all medical and surgical benefits (in this paragraph referred to as the “applicable lifetime limit”), the plan or coverage shall either—
(i) apply the applicable lifetime limit both to the medical and surgical benefits to which it otherwise would apply and to mental health and substance use disorder benefits and not distinguish in the application of such limit between such medical and surgical benefits and mental health and substance use disorder benefits; or
(ii) not include any aggregate lifetime limit on mental health or substance use disorder benefits that is less than the applicable lifetime limit.
(C) Rule in case of different limits In the case of a plan or coverage that is not described in subparagraph (A) or (B) and that includes no or different aggregate lifetime limits on different categories of medical and surgical benefits, the Secretary shall establish rules under which subparagraph (B) is applied to such plan or coverage with respect to mental health and substance use disorder benefits by substituting for the applicable lifetime limit an average aggregate lifetime limit that is computed taking into account the weighted average of the aggregate lifetime limits applicable to such categories.
(2) Annual limits In the case of a group health plan (or health insurance coverage offered in connection with such a plan) that provides both medical and surgical benefits and mental health or substance use disorder benefits—
(A) No annual limit If the plan or coverage does not include an annual limit on substantially all medical and surgical benefits, the plan or coverage may not impose any annual limit on mental health or substance use disorder benefits.
(B) Annual limit If the plan or coverage includes an annual limit on substantially all medical and surgical benefits (in this paragraph referred to as the “applicable annual limit”), the plan or coverage shall either—
(i) apply the applicable annual limit both to medical and surgical benefits to which it otherwise would apply and to mental health and substance use disorder benefits and not distinguish in the application of such limit between such medical and surgical benefits and mental health and substance use disorder benefits; or
(ii) not include any annual limit on mental health or substance use disorder benefits that is less than the applicable annual limit.
(C) Rule in case of different limits In the case of a plan or coverage that is not described in subparagraph (A) or (B) and that includes no or different annual limits on different categories of medical and surgical benefits, the Secretary shall establish rules under which subparagraph (B) is applied to such plan or coverage with respect to mental health and substance use disorder benefits by substituting for the applicable annual limit an average annual limit that is computed taking into account the weighted average of the annual limits applicable to such categories.
(3) Financial requirements and treatment limitations (A) In general In the case of a group health plan (or health insurance coverage offered in connection with such a plan) that provides both medical and surgical benefits and mental health or substance use disorder benefits, such plan or coverage shall ensure that—
(i) the financial requirements applicable to such mental health or substance use disorder benefits are no more restrictive than the predominant financial requirements applied to substantially all medical and surgical benefits covered by the plan (or coverage), and there are no separate cost sharing requirements that are applicable only with respect to mental health or substance use disorder benefits; and
(ii) the treatment limitations applicable to such mental health or substance use disorder benefits are no more restrictive than the predominant treatment limitations applied to substantially all medical and surgical benefits covered by the plan (or coverage) and there are no separate treatment limitations that are applicable only with respect to mental health or substance use disorder benefits.
(B) Definitions In this paragraph:
(i) Financial requirement The term “financial requirement” includes deductibles, copayments, coinsurance, and out-of-pocket expenses, but excludes an aggregate lifetime limit and an annual limit subject to paragraphs (1) and (2),11 So in original. The comma probably should be a period.
(ii) Predominant A financial requirement or treatment limit is considered to be predominant if it is the most common or frequent of such type of limit or requirement.
(iii) Treatment limitation The term “treatment limitation” includes limits on the frequency of treatment, number of visits, days of coverage, or other similar limits on the scope or duration of treatment.
(4) Availability of plan information The criteria for medical necessity determinations made under the plan with respect to mental health or substance use disorder benefits (or the health insurance coverage offered in connection with the plan with respect to such benefits) shall be made available by the plan administrator (or the health insurance issuer offering such coverage) in accordance with regulations to any current or potential participant, beneficiary, or contracting provider upon request. The reason for any denial under the plan (or coverage) of reimbursement or payment for services with respect to mental health or substance use disorder benefits in the case of any participant or beneficiary shall, on request or as otherwise required, be made available by the plan administrator (or the health insurance issuer offering such coverage) to the participant or beneficiary in accordance with regulations.
(5) Out-of-network providers In the case of a plan or coverage that provides both medical and surgical benefits and mental health or substance use disorder benefits, if the plan or coverage provides coverage for medical or surgical benefits provided by out-of-network providers, the plan or coverage shall provide coverage for mental health or substance use disorder benefits provided by out-of-network providers in a manner that is consistent with the requirements of this section.
(6) Compliance program guidance document (A) In general The Secretary, the Secretary of Health and Human Services, and the Secretary of the Treasury, in consultation with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury, shall issue a compliance program guidance document to help improve compliance with this section, section 300gg26 of title 42, and section 9812 of title 26, as applicable. In carrying out this paragraph, the Secretaries may take into consideration the 2016 publication of the Department of Health and Human Services and the Department of Labor, entitled “Warning Signs - Plan or Policy Non-Quantitative Treatment Limitations (NQTLs) that Require Additional Analysis to Determine Mental Health Parity Compliance”.
(B) Examples illustrating compliance and noncompliance (i) In general The compliance program guidance document required under this paragraph shall provide illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 300gg26 of title 42, or section 9812 of title 26, as applicable, based on investigations of violations of such sections, including—
(I) examples illustrating requirements for information disclosures and nonquantitative treatment limitations; and
(II) descriptions of the violations uncovered during the course of such investigations.
(ii) Nonquantitative treatment limitations To the extent that any example described in clause (i) involves a finding of compliance or noncompliance with regard to any requirement for nonquantitative treatment limitations, the example shall provide sufficient detail to fully explain such finding, including a full description of the criteria involved for approving medical and surgical benefits and the criteria involved for approving mental health and substance use disorder benefits.
(iii) Access to additional information regarding compliance In developing and issuing the compliance program guidance document required under this paragraph, the Secretaries specified in subparagraph (A)—
(I) shall enter into interagency agreements with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury to share findings of compliance and noncompliance with this section, section 300gg26 of title 42, or section 9812 of title 26, as applicable; and
(II) shall seek to enter into an agreement with a State to share information on findings of compliance and noncompliance with this section, section 300gg26 of title 42, or section 9812 of title 26, as applicable.
(C) Recommendations The compliance program guidance document shall include recommendations to advance compliance with this section, section 300gg26 of title 42, or section 9812 of title 26, as applicable, and encourage the development and use of internal controls to monitor adherence to applicable statutes, regulations, and program requirements. Such internal controls may include illustrative examples of nonquantitative treatment limitations on mental health and substance use disorder benefits, which may fail to comply with this section, section 300gg26 of title 42, or section 9812 of title 26, as applicable, in relation to nonquantitative treatment limitations on medical and surgical benefits.
(D) Updating the compliance program guidance document The Secretary, the Secretary of Health and Human Services, and the Secretary of the Treasury, in consultation with the Inspector General of the Department of Health and Human Services, the Inspector General of the Department of Labor, and the Inspector General of the Department of the Treasury, shall update the compliance program guidance document every 2 years to include illustrative, de-identified examples (that do not disclose any protected health information or individually identifiable information) of previous findings of compliance and noncompliance with this section, section 300gg26 of title 42, or section 9812 of title 26, as applicable.
(7) Additional guidance (A) In general The Secretary, the Secretary of Health and Human Services, and the Secretary of the Treasury shall issue guidance to group health plans and health insurance issuers offering group health insurance coverage to assist such plans and issuers in satisfying the requirements of this section, section 300gg26 of title 42, or section 9812 of title 26, as applicable.
(B) Disclosure (i) Guidance for plans and issuers The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group or individual health insurance coverage may use for disclosing information to ensure compliance with the requirements under this section, section 300gg26 of title 42, or section 9812 of title 26, as applicable, (and any regulations promulgated pursuant to such sections, as applicable).
(ii) Documents for participants, beneficiaries, contracting providers, or authorized representatives The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods that group health plans and health insurance issuers offering group health insurance coverage may use to provide any participant, beneficiary, contracting provider, or authorized representative, as applicable, with documents containing information that the health plans or issuers are required to disclose to participants, beneficiaries, contracting providers, or authorized representatives to ensure compliance with this section, section 300gg26 of title 42, or section 9812 of title 26, as applicable, compliance with any regulation issued pursuant to such respective section, or compliance with any other applicable law or regulation. Such guidance shall include information that is comparative in nature with respect to—
(I) nonquantitative treatment limitations for both medical and surgical benefits and mental health and substance use disorder benefits;
(II) the processes, strategies, evidentiary standards, and other factors used to apply the limitations described in subclause (I); and
(III) the application of the limitations described in subclause (I) to ensure that such limitations are applied in parity with respect to both medical and surgical benefits and mental health and substance use disorder benefits.
(C) Nonquantitative treatment limitations The guidance issued under this paragraph shall include clarifying information and illustrative examples of methods, processes, strategies, evidentiary standards, and other factors that group health plans and health insurance issuers offering group health insurance coverage may use regarding the development and application of nonquantitative treatment limitations to ensure compliance with this section, section 300gg26 of title 42, or section 9812 of title 26, as applicable, (and any regulations promulgated pursuant to such respective section), including—
(i) examples of methods of determining appropriate types of nonquantitative treatment limitations with respect to both medical and surgical benefits and mental health and substance use disorder benefits, including nonquantitative treatment limitations pertaining to—
(I) medical management standards based on medical necessity or appropriateness, or whether a treatment is experimental or investigative;
(II) limitations with respect to prescription drug formulary design; and
(III) use of fail-first or step therapy protocols;
(ii) examples of methods of determining—
(I) network admission standards (such as credentialing); and
(II) factors used in provider reimbursement methodologies (such as service type, geographic market, demand for services, and provider supply, practice size, training, experience, and licensure) as such factors apply to network adequacy;
(iii) examples of sources of information that may serve as evidentiary standards for the purposes of making determinations regarding the development and application of nonquantitative treatment limitations;
(iv) examples of specific factors, and the evidentiary standards used to evaluate such factors, used by such plans or issuers in performing a nonquantitative treatment limitation analysis;
(v) examples of how specific evidentiary standards may be used to determine whether treatments are considered experimental or investigative;
(vi) examples of how specific evidentiary standards may be applied to each service category or classification of benefits;
(vii) examples of methods of reaching appropriate coverage determinations for new mental health or substance use disorder treatments, such as evidence-based early intervention programs for individuals with a serious mental illness and types of medical management techniques;
(viii) examples of methods of reaching appropriate coverage determinations for which there is an indirect relationship between the covered mental health or substance use disorder benefit and a traditional covered medical and surgical benefit, such as residential treatment or hospitalizations involving voluntary or involuntary commitment; and
(ix) additional illustrative examples of methods, processes, strategies, evidentiary standards, and other factors for which the Secretary determines that additional guidance is necessary to improve compliance with this section, section 300gg26 of title 42, or section 9812 of title 26, as applicable.
(D) Public comment Prior to issuing any final guidance under this paragraph, the Secretary shall provide a public comment period of not less than 60 days during which any member of the public may provide comments on a draft of the guidance.
(8) Compliance requirements (A) Nonquantitative treatment limitation (NQTL) requirements In the case of a group health plan or a health insurance issuer offering group health insurance coverage that provides both medical and surgical benefits and mental health or substance use disorder benefits and that imposes nonquantitative treatment limitations (referred to in this section as “NQTLs”) on mental health or substance use disorder benefits, such plan or issuer shall perform and document comparative analyses of the design and application of NQTLs and, beginning 45 days after December 27, 2020, make available to the Secretary, upon request, the comparative analyses and the following information:
(i) The specific plan or coverage terms or other relevant terms regarding the NQTLs, that applies to such plan or coverage, and a description of all mental health or substance use disorder and medical or surgical benefits to which each such term applies in each respective benefits classification.
(ii) The factors used to determine that the NQTLs will apply to mental health or substance use disorder benefits and medical or surgical benefits.
(iii) The evidentiary standards used for the factors identified in clause (ii), when applicable, provided that every factor shall be defined, and any other source or evidence relied upon to design and apply the NQTLs to mental health or substance use disorder benefits and medical or surgical benefits.
(iv) The comparative analyses demonstrating that the processes, strategies, evidentiary standards, and other factors used to apply the NQTLs to mental health or substance use disorder benefits, as written and in operation, are comparable to, and are applied no more stringently than, the processes, strategies, evidentiary standards, and other factors used to apply the NQTLs to medical or surgical benefits in the benefits classification.
(v) The specific findings and conclusions reached by the group health plan or health insurance issuer with respect to the health insurance coverage, including any results of the analyses described in this subparagraph that indicate that the plan or coverage is or is not in compliance with this section.
(B) Secretary request process (i) Submission upon request The Secretary shall request that a group health plan or a health insurance issuer offering group health insurance coverage submit the comparative analyses described in subparagraph (A) for plans that involve potential violations of this section or complaints regarding noncompliance with this section that concern NQTLs and any other instances in which the Secretary determines appropriate. The Secretary shall request not fewer than 20 such analyses per year.
(ii) Additional information In instances in which the Secretary has concluded that the group health plan or health insurance issuer with respect to group health insurance coverage has not submitted sufficient information for the Secretary to review the comparative analyses described in subparagraph (A), as requested under clause (i), the Secretary shall specify to the plan or issuer the information the plan or issuer must submit to be responsive to the request under clause (i) for the Secretary to review the comparative analyses described in subparagraph (A) for compliance with this section. Nothing in this paragraph shall require the Secretary to conclude that a group health plan or health insurance issuer is in compliance with this section solely based upon the inspection of the comparative analyses described in subparagraph (A), as requested under clause (i).
(iii) Required action (I) In general In instances in which the Secretary has reviewed the comparative analyses described in subparagraph (A), as requested under clause (i), and determined that the group health plan or health insurance issuer is not in compliance with this section, the plan or issuer—
(aa) shall specify to the Secretary the actions the plan or issuer will take to be in compliance with this section and provide to the Secretary additional comparative analyses described in subparagraph (A) that demonstrate compliance with this section not later than 45 days after the initial determination by the Secretary that the plan or issuer is not in compliance; and
(bb) following the 45-day corrective action period under item (aa), if the Secretary makes a final determination that the plan or issuer still is not in compliance with this section, not later than 7 days after such determination, shall notify all individuals enrolled in the plan or applicable health insurance coverage offered by the issuer that the plan or issuer, with respect to such coverage, has been determined to be not in compliance with this section.
(II) Exemption from disclosure Documents or communications produced in connection with the Secretarys recommendations to a group health plan or health insurance issuer shall not be subject to disclosure pursuant to section 552 of title 5.
(iv) Report Not later than 1 year after December 27, 2020, and not later than October 1 of each year thereafter, the Secretary shall submit to Congress, and make publicly available, a report that contains—
(I) a summary of the comparative analyses requested under clause (i), including the identity of each group health plan or health insurance issuer, with respect to certain health insurance coverage that is determined to be not in compliance after the final determination by the Secretary described in clause (iii)(I)(bb);
(II) the Secretarys conclusions as to whether each group health plan or health insurance issuer submitted sufficient information for the Secretary to review the comparative analyses requested under clause (i) for compliance with this section;
(III) for each group health plan or health insurance issuer that did submit sufficient information for the Secretary to review the comparative analyses requested under clause (i), the Secretarys conclusions as to whether and why the plan or issuer is in compliance with the disclosure requirements under this section;
(IV) the Secretarys specifications described in clause (ii) for each group health plan or health insurance issuer that the Secretary determined did not submit sufficient information for the Secretary to review the comparative analyses requested under clause (i) for compliance with this section; and
(V) the Secretarys specifications described in clause (iii) of the actions each group health plan or health insurance issuer that the Secretary determined is not in compliance with this section must take to be in compliance with this section, including the reason why the Secretary determined the plan or issuer is not in compliance.
(C) Compliance program guidance document update process (i) In general The Secretary shall include instances of noncompliance that the Secretary discovers upon reviewing the comparative analyses requested under subparagraph (B)(i) in the compliance program guidance document described in paragraph (6), as it is updated every 2 years, except that such instances shall not disclose any protected health information or individually identifiable information.
(ii) Guidance and regulations Not later than 18 months after December 27, 2020, the Secretary shall finalize any draft or interim guidance and regulations relating to mental health parity under this section. Such draft guidance shall include guidance to clarify the process and timeline for current and potential participants and beneficiaries (and authorized representatives and health care providers of such participants and beneficiaries) with respect to plans to file complaints of such plans or issuers being in violation of this section, including guidance, by plan type, on the relevant State, regional, or national office with which such complaints should be filed.
(iii) State The Secretary shall share information on findings of compliance and noncompliance discovered upon reviewing the comparative analyses requested under subparagraph (B)(i) shall be shared with the State where the group health plan is located or the State where the health insurance issuer is licensed to do business for coverage offered by a health insurance issuer in the group market, in accordance with paragraph (6)(B)(iii)(II).
(b) Construction Nothing in this section shall be construed—
(1) as requiring a group health plan (or health insurance coverage offered in connection with such a plan) to provide any mental health or substance use disorder benefits; or
(2) in the case of a group health plan (or health insurance coverage offered in connection with such a plan) that provides mental health or substance use disorder benefits, as affecting the terms and conditions of the plan or coverage relating to such benefits under the plan or coverage, except as provided in subsection (a).
(c) Exemptions (1) Small employer exemption (A) In general This section shall not apply to any group health plan (and group health insurance coverage offered in connection with a group health plan) for any plan year of a small employer.
(B) Small employer For purposes of subparagraph (A), the term “small employer” means, in connection with a group health plan with respect to a calendar year and a plan year, an employer who employed an average of at least 2 (or 1 in the case of an employer residing in a State that permits small groups to include a single individual) but not more than 50 employees on business days during the preceding calendar year.
(C) Application of certain rules in determination of employer size For purposes of this paragraph—
(i) Application of aggregation rule for employers Rules similar to the rules under subsections (b), (c), (m), and (o) of section 414 of title 26 shall apply for purposes of treating persons as a single employer.
(ii) Employers not in existence in preceding year In the case of an employer which was not in existence throughout the preceding calendar year, the determination of whether such employer is a small employer shall be based on the average number of employees that it is reasonably expected such employer will employ on business days in the current calendar year.
(iii) Predecessors Any reference in this paragraph to an employer shall include a reference to any predecessor of such employer.
(2) Cost exemption (A) In general With respect to a group health plan (or health insurance coverage offered in connection with such a plan), if the application of this section to such plan (or coverage) results in an increase for the plan year involved of the actual total costs of coverage with respect to medical and surgical benefits and mental health and substance use disorder benefits under the plan (as determined and certified under subparagraph (C)) by an amount that exceeds the applicable percentage described in subparagraph (B) of the actual total plan costs, the provisions of this section shall not apply to such plan (or coverage) during the following plan year, and such exemption shall apply to the plan (or coverage) for 1 plan year. An employer may elect to continue to apply mental health and substance use disorder parity pursuant to this section with respect to the group health plan (or coverage) involved regardless of any increase in total costs.
(B) Applicable percentage With respect to a plan (or coverage), the applicable percentage described in this subparagraph shall be—
(i) 2 percent in the case of the first plan year in which this section is applied; and
(ii) 1 percent in the case of each subsequent plan year.
(C) Determinations by actuaries Determinations as to increases in actual costs under a plan (or coverage) for purposes of this section shall be made and certified by a qualified and licensed actuary who is a member in good standing of the American Academy of Actuaries. All such determinations shall be in a written report prepared by the actuary. The report, and all underlying documentation relied upon by the actuary, shall be maintained by the group health plan or health insurance issuer for a period of 6 years following the notification made under subparagraph (E).
(D) 6-month determinations If a group health plan (or a health insurance issuer offering coverage in connection with a group health plan) seeks an exemption under this paragraph, determinations under subparagraph (A) shall be made after such plan (or coverage) has complied with this section for the first 6 months of the plan year involved.
(E) Notification (i) In general A group health plan (or a health insurance issuer offering coverage in connection with a group health plan) that, based upon a certification described under subparagraph (C), qualifies for an exemption under this paragraph, and elects to implement the exemption, shall promptly notify the Secretary, the appropriate State agencies, and participants and beneficiaries in the plan of such election.
(ii) Requirement A notification to the Secretary under clause (i) shall include—
(I) a description of the number of covered lives under the plan (or coverage) involved at the time of the notification, and as applicable, at the time of any prior election of the cost-exemption under this paragraph by such plan (or coverage);
(II) for both the plan year upon which a cost exemption is sought and the year prior, a description of the actual total costs of coverage with respect to medical and surgical benefits and mental health and substance use disorder benefits under the plan; and
(III) for both the plan year upon which a cost exemption is sought and the year prior, the actual total costs of coverage with respect to mental health and substance use disorder benefits under the plan.
(iii) Confidentiality A notification to the Secretary under clause (i) shall be confidential. The Secretary shall make available, upon request and on not more than an annual basis, an anonymous itemization of such notifications, that includes—
(I) a breakdown of States by the size and type of employers submitting such notification; and
(II) a summary of the data received under clause (ii).
(F) Audits by appropriate agencies To determine compliance with this paragraph, the Secretary may audit the books and records of a group health plan or health insurance issuer relating to an exemption, including any actuarial reports prepared pursuant to subparagraph (C), during the 6 year period following the notification of such exemption under subparagraph (E). A State agency receiving a notification under subparagraph (E) may also conduct such an audit with respect to an exemption covered by such notification.
(d) Separate application to each option offered In the case of a group health plan that offers a participant or beneficiary two or more benefit package options under the plan, the requirements of this section shall be applied separately with respect to each such option.
(e) Definitions For purposes of this section—
(1) Aggregate lifetime limit The term “aggregate lifetime limit” means, with respect to benefits under a group health plan or health insurance coverage, a dollar limitation on the total amount that may be paid with respect to such benefits under the plan or health insurance coverage with respect to an individual or other coverage unit.
(2) Annual limit The term “annual limit” means, with respect to benefits under a group health plan or health insurance coverage, a dollar limitation on the total amount of benefits that may be paid with respect to such benefits in a 12-month period under the plan or health insurance coverage with respect to an individual or other coverage unit.
(3) Medical or surgical benefits The term “medical or surgical benefits” means benefits with respect to medical or surgical services, as defined under the terms of the plan or coverage (as the case may be), but does not include mental health or substance use disorder benefits.
(4) Mental health benefits The term “mental health benefits” means benefits with respect to services for mental health conditions, as defined under the terms of the plan and in accordance with applicable Federal and State law.
(5) Substance use disorder benefits The term “substance use disorder benefits” means benefits with respect to services for substance use disorders, as defined under the terms of the plan and in accordance with applicable Federal and State law.
(f) Secretary report The Secretary shall, by January 1, 2012, and every two years thereafter, submit to the appropriate committees of Congress a report on compliance of group health plans (and health insurance coverage offered in connection with such plans) with the requirements of this section. Such report shall include the results of any surveys or audits on compliance of group health plans (and health insurance coverage offered in connection with such plans) with such requirements and an analysis of the reasons for any failures to comply.
(g) Notice and assistance The Secretary, in cooperation with the Secretaries of Health and Human Services and Treasury, as appropriate, shall publish and widely disseminate guidance and information for group health plans, participants and beneficiaries, applicable State and local regulatory bodies, and the National Association of Insurance Commissioners concerning the requirements of this section and shall provide assistance concerning such requirements and the continued operation of applicable State law. Such guidance and information shall inform participants and beneficiaries of how they may obtain assistance under this section, including, where appropriate, assistance from State consumer and insurance agencies.
(Pub. L. 93406, title I, § 712, as added Pub. L. 104204, title VII, § 702(a), Sept. 26, 1996, 110 Stat. 2944; amended Pub. L. 107116, title VII, § 701(a), Jan. 10, 2002, 115 Stat. 2228; Pub. L. 107313, § 2(a), Dec. 2, 2002, 116 Stat. 2457; Pub. L. 108197, § 2(a), Dec. 19, 2003, 117 Stat. 2898; Pub. L. 108311, title III, § 302(b), Oct. 4, 2004, 118 Stat. 1178; Pub. L. 109151, § 1(a), Dec. 30, 2005, 119 Stat. 2886; Pub. L. 109432, div. A, title I, § 115(b), Dec. 20, 2006, 120 Stat. 2941; Pub. L. 110245, title IV, § 401(b), June 17, 2008, 122 Stat. 1649; Pub. L. 110343, div. C, title V, § 512(a), (g)(1)(A), Oct. 3, 2008, 122 Stat. 3881, 3892; Pub. L. 116260, div. BB, title II, § 203(a)(2), Dec. 27, 2020, 134 Stat. 2903.)
## Notes
Editorial Notes
Amendments2020—Subsec. (a)(6) to (8). Pub. L. 116260 added pars. (6) to (8). 2008—Pub. L. 110343, § 512(g)(1)(A), amended section catchline generally. Prior to amendment, catchline read as follows: “Parity in application of certain limits to mental health benefits”. Subsec. (a)(1), (2). Pub. L. 110343, § 512(a)(8), substituted “mental health or substance use disorder benefits” for “mental health benefits” wherever appearing in pars. (1)(introductory provisions), (A), and (B)(ii) and (2)(introductory provisions), (A), and (B)(ii). Pub. L. 110343, § 512(a)(7), substituted “mental health and substance use disorder benefits” for “mental health benefits” wherever appearing in pars. (1)(B)(i) and (C) and (2)(B)(i) and (C). Subsec. (a)(3) to (5). Pub. L. 110343, § 512(a)(1), added pars. (3) to (5). Subsec. (b)(1). Pub. L. 110343, § 512(a)(8), substituted “mental health or substance use disorder benefits” for “mental health benefits”. Subsec. (b)(2). Pub. L. 110343, § 512(a)(2), amended par. (2) generally. Prior to amendment, par. (2) read as follows: “in the case of a group health plan (or health insurance coverage offered in connection with such a plan) that provides mental health benefits, as affecting the terms and conditions (including cost sharing, limits on numbers of visits or days of coverage, and requirements relating to medical necessity) relating to the amount, duration, or scope of mental health benefits under the plan or coverage, except as specifically provided in subsection (a) (in regard to parity in the imposition of aggregate lifetime limits and annual limits for mental health benefits).” Subsec. (c)(1)(B). Pub. L. 110343, § 512(a)(3)(A), inserted “(or 1 in the case of an employer residing in a State that permits small groups to include a single individual)” after “of at least 2” and struck out “and who employs at least 2 employees on the first day of the plan year” after “preceding calendar year”. Subsec. (c)(2). Pub. L. 110343, § 512(a)(3)(B), added par. (2) and struck out former par. (2). Prior to amendment, text read as follows: “This section shall not apply with respect to a group health plan (or health insurance coverage offered in connection with a group health plan) if the application of this section to such plan (or to such coverage) results in an increase in the cost under the plan (or for such coverage) of at least 1 percent.” Subsec. (e)(3). Pub. L. 110343, § 512(a)(8), substituted “mental health or substance use disorder benefits” for “mental health benefits”. Subsec. (e)(4). Pub. L. 110343, § 512(a)(8), which directed amendment of this section by substituting “mental health or substance use disorder benefits” for “mental health benefits” wherever appearing (except in provisions amended by Pub. L. 110343, § 512(a)(7)), was not executed to par. (4) as added by Pub. L. 110343, § 512(a)(4), to reflect the probable intent of Congress. See below. Pub. L. 110343, § 512(a)(4), added par. (4) and struck out former par. (4). Text read as follows: “The term mental health benefits means benefits with respect to mental health services, as defined under the terms of the plan or coverage (as the case may be), but does not include benefits with respect to treatment of substance abuse or chemical dependency.” Subsec. (e)(5). Pub. L. 110343, § 512(a)(4), added par. (5). Subsec. (f). Pub. L. 110343, § 512(a)(6), added subsec. (f). Pub. L. 110343, § 512(a)(5), struck out subsec. (f). Text read as follows: “This section shall not apply to benefits for services furnished— “(1) on or after January 1, 2008, and before June 17, 2008, and “(2) after December 31, 2008..” Pub. L. 110245 substituted “services furnished—” for “services furnished after December 31, 2007” and added pars. (1) and (2). Subsec. (g). Pub. L. 110343, § 512(a)(6), added subsec. (g). 2006—Subsec. (f). Pub. L. 109432 substituted “2007” for “2006”. 2005—Subsec. (f). Pub. L. 109151 substituted “December 31, 2006” for “December 31, 2005”. 2004—Subsec. (f). Pub. L. 108311 substituted “after December 31, 2005” for “on or after December 31, 2004”. 2003—Subsec. (f). Pub. L. 108197 substituted “December 31, 2004” for “December 31, 2003”. 2002—Subsec. (f). Pub. L. 107313 substituted “December 31, 2003” for “December 31, 2002”. Pub. L. 107116 substituted “December 31, 2002” for “September 30, 2001”.
Statutory Notes and Related Subsidiaries
Effective Date of 2008 AmendmentAmendment by Pub. L. 110343 applicable with respect to group health plans for plan years beginning after the date that is 1 year after Oct. 3, 2008, except that amendment by section 512(a)(5) of Pub. L. 110343 effective Jan. 1, 2009, with special rule for collective bargaining agreements, see section 512(e) of Pub. L. 110343, set out as a note under section 300gg26 of Title 42, The Public Health and Welfare.
Effective DatePub. L. 104204, title VII, § 702(c), Sept. 26, 1996, 110 Stat. 2946, provided that: “The amendments made by this section [enacting this section] shall apply with respect to group health plans for plan years beginning on or after January 1, 1998.”
@@ -0,0 +1,71 @@
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# 29 U.S.C. § 1185b - Required coverage for reconstructive surgery following mastectomies
## Text
(a) In general A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, that provides medical and surgical benefits with respect to a mastectomy shall provide, in a case of a participant or beneficiary who is receiving benefits in connection with a mastectomy and who elects breast reconstruction in connection with such mastectomy, coverage for—
(1) all stages of reconstruction of the breast on which the mastectomy has been performed;
(2) surgery and reconstruction of the other breast to produce a symmetrical appearance; and
(3) prostheses and physical complications of mastectomy, including lymphedemas;
in a manner determined in consultation with the attending physician and the patient. Such coverage may be subject to annual deductibles and coinsurance provisions as may be deemed appropriate and as are consistent with those established for other benefits under the plan or coverage. Written notice of the availability of such coverage shall be delivered to the participant upon enrollment and annually thereafter.
(b) Notice A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan shall provide notice to each participant and beneficiary under such plan regarding the coverage required by this section in accordance with regulations promulgated by the Secretary. Such notice shall be in writing and prominently positioned in any literature or correspondence made available or distributed by the plan or issuer and shall be transmitted—
(1) in the next mailing made by the plan or issuer to the participant or beneficiary;
(2) as part of any yearly informational packet sent to the participant or beneficiary; or
(3) not later than January 1, 1999;
whichever is earlier.
(c) Prohibitions A group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not—
(1) deny to a patient eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan, solely for the purpose of avoiding the requirements of this section; and
(2) penalize or otherwise reduce or limit the reimbursement of an attending provider, or provide incentives (monetary or otherwise) to an attending provider, to induce such provider to provide care to an individual participant or beneficiary in a manner inconsistent with this section.
(d) Rule of construction Nothing in this section shall be construed to prevent a group health plan or a health insurance issuer offering group health insurance coverage from negotiating the level and type of reimbursement with a provider for care provided in accordance with this section.
(e) Preemption, relation to State laws (1) In general Nothing in this section shall be construed to preempt any State law in effect on October 21, 1998, with respect to health insurance coverage that requires coverage of at least the coverage of reconstructive breast surgery otherwise required under this section.
(2) ERISA Nothing in this section shall be construed to affect or modify the provisions of section 1144 of this title with respect to group health plans.
(Pub. L. 93406, title I, § 713, as added Pub. L. 105277, div. A, § 101(f) [title IX, § 902(a)], Oct. 21, 1998, 112 Stat. 2681337, 2681436.)
## Notes
Statutory Notes and Related Subsidiaries
Effective DatePub. L. 105277, div. A, § 101(f) [title IX, § 902(c)], Oct. 21, 1998, 112 Stat. 2681337, 2681438, provided that: “(1) In general.—The amendments made by this section [enacting this section] shall apply with respect to plan years beginning on or after the date of enactment of this Act [Oct. 21, 1998]. “(2) Special rule for collective bargaining agreements.—In the case of a group health plan maintained pursuant to 1 or more collective bargaining agreements between employee representatives and 1 or more employers, 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.”
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# 29 U.S.C. § 1185c - Coverage of dependent students on medically necessary leave of absence
## Text
(a) Medically necessary leave of absence In this section, the term “medically necessary leave of absence” means, with respect to a dependent child described in subsection (b)(2) in connection with a group health plan or health insurance coverage offered in connection with such plan, a leave of absence of such child from a postsecondary educational institution (including an institution of higher education as defined in section 1002 of title 20), or any other change in enrollment of such child at such an institution, that—
(1) commences while such child is suffering from a serious illness or injury;
(2) is medically necessary; and
(3) causes such child to lose student status for purposes of coverage under the terms of the plan or coverage.
(b) Requirement to continue coverage (1) In general In the case of a dependent child described in paragraph (2), a group health plan, or a health insurance issuer that provides health insurance coverage in connection with a group health plan, shall not terminate coverage of such child under such plan or health insurance coverage due to a medically necessary leave of absence before the date that is the earlier of—
(A) the date that is 1 year after the first day of the medically necessary leave of absence; or
(B) the date on which such coverage would otherwise terminate under the terms of the plan or health insurance coverage.
(2) Dependent child described A dependent child described in this paragraph is, with respect to a group health plan or health insurance coverage offered in connection with the plan, a beneficiary under the plan who—
(A) is a dependent child, under the terms of the plan or coverage, of a participant or beneficiary under the plan or coverage; and
(B) was enrolled in the plan or coverage, on the basis of being a student at a postsecondary educational institution (as described in subsection (a)), immediately before the first day of the medically necessary leave of absence involved.
(3) Certification by physician Paragraph (1) shall apply to a group health plan or health insurance coverage offered by an issuer in connection with such plan only if the plan or issuer of the coverage has received written certification by a treating physician of the dependent child which states that the child is suffering from a serious illness or injury and that the leave of absence (or other change of enrollment) described in subsection (a) is medically necessary.
(c) Notice A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, shall include, with any notice regarding a requirement for certification of student status for coverage under the plan or coverage, a description of the terms of this section for continued coverage during medically necessary leaves of absence. Such description shall be in language which is understandable to the typical plan participant.
(d) No change in benefits A dependent child whose benefits are continued under this section shall be entitled to the same benefits as if (during the medically necessary leave of absence) the child continued to be a covered student at the institution of higher education and was not on a medically necessary leave of absence.
(e) Continued application in case of changed coverage If—
(1) a dependent child of a participant or beneficiary is in a period of coverage under a group health plan or health insurance coverage offered in connection with such a plan, pursuant to a medically necessary leave of absence of the child described in subsection (b);
(2) the manner in which the participant or beneficiary is covered under the plan changes, whether through a change in health insurance coverage or health insurance issuer, a change between health insurance coverage and self-insured coverage, or otherwise; and
(3) the coverage as so changed continues to provide coverage of beneficiaries as dependent children,
this section shall apply to coverage of the child under the changed coverage for the remainder of the period of the medically necessary leave of absence of the dependent child under the plan in the same manner as it would have applied if the changed coverage had been the previous coverage.
(Pub. L. 93406, title I, § 714, as added Pub. L. 110381, § 2(a)(1), Oct. 9, 2008, 122 Stat. 4081.)
## Notes
Statutory Notes and Related Subsidiaries
Effective DateSection applicable with respect to plan years beginning on or after the date that is one year after Oct. 9, 2008, and to medically necessary leaves of absence beginning during such plan years, see section 2(d) of Pub. L. 110381, set out as a note under section 9813 of Title 26, Internal Revenue Code.
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title: "29 U.S.C. § 1185d"
description: "Additional market reforms"
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title_number: 29
title_name: "LABOR"
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chapter_name: "EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM"
section: "1185d"
citation: "29 U.S.C. § 1185d"
status: "current"
release_point: "119-100"
release_date: "2026-06-26"
source: "official"
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---
# 29 U.S.C. § 1185d - Additional market reforms
## Text
(a) General rule Except as provided in subsection (b)—
(1) the provisions of part A of title XXVII of the Public Health Service Act [42 U.S.C. 300gg et seq.] (as amended by the Patient Protection and Affordable Care Act) shall apply to group health plans, and health insurance issuers providing health insurance coverage in connection with group health plans, as if included in this subpart; and
(2) to the extent that any provision of this part conflicts with a provision of such part A with respect to group health plans, or health insurance issuers providing health insurance coverage in connection with group health plans, the provisions of such part A shall apply.
(b) Exception Notwithstanding subsection (a), the provisions of sections 2716 and 2718 of title XXVII of the Public Health Service Act [42 U.S.C. 300gg16, 300gg18] (as amended by the Patient Protection and Affordable Care Act) shall not apply with respect to self-insured group health plans, and the provisions of this part shall continue to apply to such plans as if such sections of the Public Health Service Act (as so amended) had not been enacted.
(Pub. L. 93406, title I, § 715, as added Pub. L. 111148, title I, § 1563(e), formerly § 1562(e), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 270, 911.)
## Notes
Editorial Notes
References in TextThe Public Health Service Act, referred to in text, is act July 1, 1944, ch. 373, 58 Stat. 682. Part A of title XXVII of the Act is classified generally to part A (§ 300gg et seq.) of subchapter XXV of chapter 6A of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 201 of Title 42 and Tables. The Patient Protection and Affordable Care Act, referred to in text, is Pub. L. 111148, Mar. 23, 2010, 124 Stat. 119. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of Title 42, The Public Health and Welfare, and Tables.
CodificationPub. L. 111148, which directed amendment of subpart B of part 7 of “subtitle A” of title I of the Employee Retirement Income Security Act of 1974 by adding this section at the end, was executed by adding this section at the end of this subpart, which is subpart B of part 7 of subtitle B of title I of the Act, to reflect the probable intent of Congress.
@@ -0,0 +1,433 @@
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title: "29 U.S.C. § 1185e"
description: "Preventing surprise medical bills"
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title_name: "LABOR"
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# 29 U.S.C. § 1185e - Preventing surprise medical bills
## Text
(a) Coverage of emergency services (1) In general If a group health plan, or a health insurance issuer offering group health insurance coverage, provides or covers any benefits with respect to services in an emergency department of a hospital or with respect to emergency services in an independent freestanding emergency department (as defined in paragraph (3)(D)), the plan or issuer shall cover emergency services (as defined in paragraph (3)(C))—
(A) without the need for any prior authorization determination;
(B) whether the health care provider furnishing such services is a participating provider or a participating emergency facility, as applicable, with respect to such services;
(C) in a manner so that, if such services are provided to a participant or beneficiary by a nonparticipating provider or a nonparticipating emergency facility—
(i) such services will be provided without imposing any requirement under the plan for prior authorization of services or any limitation on coverage that is more restrictive than the requirements or limitations that apply to emergency services received from participating providers and participating emergency facilities with respect to such plan or coverage, respectively;
(ii) the cost-sharing requirement is not greater than the requirement that would apply if such services were provided by a participating provider or a participating emergency facility;
(iii) such cost-sharing requirement is calculated as if the total amount that would have been charged for such services by such participating provider or participating emergency facility were equal to the recognized amount (as defined in paragraph (3)(H)) for such services, plan or coverage, and year;
(iv) the group health plan or health insurance issuer, respectively—
(I) not later than 30 calendar days after the bill for such services is transmitted by such provider or facility, sends to the provider or facility, as applicable, an initial payment or notice of denial of payment; and
(II) pays a total plan or coverage payment directly to such provider or facility, respectively (in accordance, if applicable, with the timing requirement described in subsection (c)(6)) that is, with application of any initial payment under subclause (I), equal to the amount by which the out-of-network rate (as defined in paragraph (3)(K)) for such services exceeds the cost-sharing amount for such services (as determined in accordance with clauses (ii) and (iii)) and year; and
(v) any cost-sharing payments made by the participant or beneficiary with respect to such emergency services so furnished shall be counted toward any in-network deductible or out-of-pocket maximums applied under the plan or coverage, respectively (and such in-network deductible and out-of-pocket maximums shall be applied) in the same manner as if such cost-sharing payments were made with respect to emergency services furnished by a participating provider or a participating emergency facility; and
(D) without regard to any other term or condition of such coverage (other than exclusion or coordination of benefits, or an affiliation or waiting period, permitted under section 300gg3 of title 42, including as incorporated pursuant to section 1185d of this title and section 9815 of title 26, and other than applicable cost-sharing).
(2) Regulations for qualifying payment amounts Not later than July 1, 2021, the Secretary, in consultation with the Secretary of the Treasury and the Secretary of Health and Human Services, shall establish through rulemaking—
(A) the methodology the group health plan or health insurance issuer offering health insurance coverage in the group market shall use to determine the qualifying payment amount, differentiating by large group market, and small group market;
(B) the information such plan or issuer, respectively, shall share with the nonparticipating provider or nonparticipating facility, as applicable, when making such a determination;
(C) the geographic regions applied for purposes of this subparagraph, taking into account access to items and services in rural and underserved areas, including health professional shortage areas, as defined in section 254e of title 42; and
(D) a process to receive complaints of violations of the requirements described in subclauses (I) and (II) of subparagraph (A)(i) by group health plans and health insurance issuers offering health insurance coverage in the group market.
Such rulemaking shall take into account payments that are made by such plan or issuer, respectively, that are not on a fee-for-service basis. Such methodology may account for relevant payment adjustments that take into account quality or facility type (including higher acuity settings and the case-mix of various facility types) that are otherwise taken into account for purposes of determining payment amounts with respect to participating facilities. In carrying out clause (iii), the Secretary shall consult with the National Association of Insurance Commissioners to establish the geographic regions under such clause and shall periodically update such regions, as appropriate, taking into account the findings of the report submitted under section 109(a) of the No Surprises Act.
(3) Definitions In this subpart:
(A) Emergency department of a hospital The term “emergency department of a hospital” includes a hospital outpatient department that provides emergency services (as defined in subparagraph (C)(i)).
(B) Emergency medical condition The term “emergency medical condition” means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in a condition described in clause (i), (ii), or (iii) of section 1867(e)(1)(A) of the Social Security Act [42 U.S.C. 1395dd(e)(1)(A)].
(C) Emergency services (i) In general The term “emergency services”, with respect to an emergency medical condition, means—
(I) a medical screening examination (as required under section 1867 of the Social Security Act [42 U.S.C. 1395dd], or as would be required under such section if such section applied to an independent freestanding emergency department) that is within the capability of the emergency department of a hospital or of an independent freestanding emergency department, as applicable, including ancillary services routinely available to the emergency department to evaluate such emergency medical condition; and
(II) within the capabilities of the staff and facilities available at the hospital or the independent freestanding emergency department, as applicable, such further medical examination and treatment as are required under section 1867 of such Act [42 U.S.C. 1395dd], or as would be required under such section if such section applied to an independent freestanding emergency department, to stabilize the patient (regardless of the department of the hospital in which such further examination or treatment is furnished).
(ii) Inclusion of additional services (I) In general For purposes of this subsection and section 300gg131 of title 42, in the case of a participant or beneficiary who is enrolled in a group health plan or group health insurance coverage offered by a health insurance issuer and who is furnished services described in clause (i) with respect to an emergency medical condition, the term “emergency services” shall include, unless each of the conditions described in subclause (II) are met, in addition to the items and services described in clause (i), items and services—
(aa) for which benefits are provided or covered under the plan or coverage, respectively; and
(bb) that are furnished by a nonparticipating provider or nonparticipating emergency facility (regardless of the department of the hospital in which such items or services are furnished) after the participant or beneficiary is stabilized and as part of outpatient observation or an inpatient or outpatient stay with respect to the visit in which the services described in clause (i) are furnished.
(II) Conditions For purposes of subclause (I), the conditions described in this subclause, with respect to a participant or beneficiary who is stabilized and furnished additional items and services described in subclause (I) after such stabilization by a provider or facility described in subclause (I), are the following;
(aa) Such provider or facility determines such individual is able to travel using nonmedical transportation or nonemergency medical transportation.
(bb) Such provider furnishing such additional items and services satisfies the notice and consent criteria of section 300gg132(d) 11 See References in Text note below. of title 42 with respect to such items and services.
(cc) Such individual is in a condition to receive (as determined in accordance with guidelines issued by the Secretary pursuant to rulemaking) the information described in section 300gg132 1 of title 42 and to provide informed consent under such section, in accordance with applicable State law.
(dd) Such other conditions, as specified by the Secretary, such as conditions relating to coordinating care transitions to participating providers and facilities.
(D) Independent freestanding emergency department The term “independent freestanding emergency department” means a health care facility that—
(i) is geographically separate and distinct and licensed separately from a hospital under applicable State law; and
(ii) provides any of the emergency services (as defined in subparagraph (C)(i)).
(E) Qualifying payment amount (i) In general The term “qualifying payment amount” means, subject to clauses (ii) and (iii), with respect to a sponsor of a group health plan and health insurance issuer offering group health insurance coverage—
(I) for an item or service furnished during 2022, the median of the contracted rates recognized by the plan or issuer, respectively (determined with respect to all such plans of such sponsor or all such coverage offered by such issuer that are offered within the same insurance market (specified in subclause (I), (II), or (III) of clause (iv)) as the plan or coverage) as the total maximum payment (including the cost-sharing amount imposed for such item or service and the amount to be paid by the plan or issuer, respectively) under such plans or coverage, respectively, on January 31, 2019, for the same or a similar item or service that is provided by a provider in the same or similar specialty and provided in the geographic region in which the item or service is furnished, consistent with the methodology established by the Secretary under paragraph (2), increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over 2019, such percentage increase over 2020, and such percentage increase over 2021; and
(II) for an item or service furnished during 2023 or a subsequent year, the qualifying payment amount determined under this clause for such an item or service furnished in the previous year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year.
(ii) New plans and coverage The term “qualifying payment amount” means, with respect to a sponsor of a group health plan or health insurance issuer offering group health insurance coverage in a geographic region in which such sponsor or issuer, respectively, did not offer any group health plan or health insurance coverage during 2019—
(I) for the first year in which such group health plan or health insurance coverage, respectively, is offered in such region, a rate (determined in accordance with a methodology established by the Secretary) for items and services that are covered by such plan and furnished during such first year; and
(II) for each subsequent year such group health plan or health insurance coverage, respectively, is offered in such region, the qualifying payment amount determined under this clause for such items and services furnished in the previous year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year.
(iii) Insufficient information; newly covered items and services In the case of a sponsor of a group health plan or health insurance issuer offering group health insurance coverage that does not have sufficient information to calculate the median of the contracted rates described in clause (i)(I) in 2019 (or, in the case of a newly covered item or service (as defined in clause (v)(III)), in the first coverage year (as defined in clause (v)(I)) for such item or service with respect to such plan or coverage) for an item or service (including with respect to provider type, or amount, of claims for items or services (as determined by the Secretary) provided in a particular geographic region (other than in a case with respect to which clause (ii) applies)) the term “qualifying payment amount”—
(I) for an item or service furnished during 2022 (or, in the case of a newly covered item or service, during the first coverage year for such item or service with respect to such plan or coverage), means such rate for such item or service determined by the sponsor or issuer, respectively, through use of any database that is determined, in accordance with rulemaking described in paragraph (2), to not have any conflicts of interest and to have sufficient information reflecting allowed amounts paid to a health care provider or facility for relevant services furnished in the applicable geographic region (such as a State all-payer claims database);
(II) for an item or service furnished in a subsequent year (before the first sufficient information year (as defined in clause (v)(II)) for such item or service with respect to such plan or coverage), means the rate determined under subclause (I) or this subclause, as applicable, for such item or service for the year previous to such subsequent year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year;
(III) for an item or service furnished in the first sufficient information year for such item or service with respect to such plan or coverage, has the meaning given the term qualifying payment amount in clause (i)(I), except that in applying such clause to such item or service, the reference to “furnished during 2022” shall be treated as a reference to furnished during such first sufficient information year, the reference to “in 2019” 1 shall be treated as a reference to such sufficient information year, and the increase described in such clause shall not be applied; and
(IV) for an item or service furnished in any year subsequent to the first sufficient information year for such item or service with respect to such plan or coverage, has the meaning given such term in clause (i)(II), except that in applying such clause to such item or service, the reference to “furnished during 2023 or a subsequent year” shall be treated as a reference to furnished during the year after such first sufficient information year or a subsequent year.
(iv) Insurance market For purposes of clause (i)(I), a health insurance market specified in this clause is one of the following:
(I) The large group market (other than plans described in subclause (III)).
(II) The small group market (other than plans described in subclause (III)).
(III) In the case of a self-insured group health plan, other self-insured group health plans.
(v) Definitions For purposes of this subparagraph:
(I) First coverage year The term “first coverage year” means, with respect to a group health plan or group health insurance coverage offered by a health insurance issuer and an item or service for which coverage is not offered in 2019 under such plan or coverage, the first year after 2019 for which coverage for such item or service is offered under such plan or health insurance coverage.
(II) First sufficient information year The term “first sufficient information year” means, with respect to a group health plan or group health insurance coverage offered by a health insurance issuer—
(aa) in the case of an item or service for which the plan or coverage does not have sufficient information to calculate the median of the contracted rates described in clause (i)(I) in 2019, the first year subsequent to 2022 for which such sponsor or issuer has such sufficient information to calculate the median of such contracted rates in the year previous to such first subsequent year; and
(bb) in the case of a newly covered item or service, the first year subsequent to the first coverage year for such item or service with respect to such plan or coverage for which the sponsor or issuer has sufficient information to calculate the median of the contracted rates described in clause (i)(I) in the year previous to such first subsequent year.
(III) Newly covered item or service The term “newly covered item or service” means, with respect to a group health plan or health insurance issuer offering group health insurance coverage, an item or service for which coverage was not offered in 2019 under such plan or coverage, but is offered under such plan or coverage in a year after 2019.
(F) Nonparticipating emergency facility; participating emergency facility (i) Nonparticipating emergency facility The term “nonparticipating emergency facility” means, with respect to an item or service and a group health plan or group health insurance coverage offered by a health insurance issuer, an emergency department of a hospital, or an independent freestanding emergency department, that does not have a contractual relationship directly or indirectly with the plan or issuer, respectively, for furnishing such item or service under the plan or coverage, respectively.
(ii) Participating emergency facility The term “participating emergency facility” means, with respect to an item or service and a group health plan or group health insurance coverage offered by a health insurance issuer, an emergency department of a hospital, or an independent freestanding emergency department, that has a contractual relationship directly or indirectly with the plan or issuer, respectively, with respect to the furnishing of such an item or service at such facility.
(G) Nonparticipating providers; participating providers (i) Nonparticipating provider The term “nonparticipating provider” means, with respect to an item or service and a group health plan or group health insurance coverage offered by a health insurance issuer, a physician or other health care provider who is acting within the scope of practice of that providers license or certification under applicable State law and who does not have a contractual relationship with the plan or issuer, respectively, for furnishing such item or service under the plan or coverage, respectively.
(ii) Participating provider The term “participating provider” means, with respect to an item or service and a group health plan or group health insurance coverage offered by a health insurance issuer, a physician or other health care provider who is acting within the scope of practice of that providers license or certification under applicable State law and who has a contractual relationship with the plan or issuer, respectively, for furnishing such item or service under the plan or coverage, respectively.
(H) Recognized amount The term “recognized amount” means, with respect to an item or service furnished by a nonparticipating provider or nonparticipating emergency facility during a year and a group health plan or group health insurance coverage offered by a health insurance issuer—
(i) subject to clause (iii), in the case of such item or service furnished in a State that has in effect a specified State law with respect to such plan, coverage, or issuer, respectively; such a nonparticipating provider or nonparticipating emergency facility; and such an item or service, the amount determined in accordance with such law;
(ii) subject to clause (iii), in the case of such item or service furnished in a State that does not have in effect a specified State law, with respect to such plan, coverage, or issuer, respectively; such a nonparticipating provider or nonparticipating emergency facility; and such an item or service, the amount that is the qualifying payment amount (as defined in subparagraph (E)) 22 Closing parentheses so in original. for such year and determined in accordance with rulemaking described in paragraph (2)) 2 for such item or service; or
(iii) in the case of such item or service furnished in a State with an All-Payer Model Agreement under section 1115A of the Social Security Act [42 U.S.C. 1315a], the amount that the State approves under such system for such item or service so furnished.
(I) Specified State law The term “specified State law” means, with respect to a State, an item or service furnished by a nonparticipating provider or nonparticipating emergency facility during a year and a group health plan or group health insurance coverage offered by a health insurance issuer, a State law that provides for a method for determining the total amount payable under such a plan, coverage, or issuer, respectively (to the extent such State law applies to such plan, coverage, or issuer, subject to section 1144 of this title) in the case of a participant or beneficiary covered under such plan or coverage and receiving such item or service from such a nonparticipating provider or nonparticipating emergency facility.
(J) Stabilize The term “to stabilize”, with respect to an emergency medical condition (as defined in subparagraph (B)), has the meaning give 33 So in original. Probably should be “given”. in section 1867(e)(3) of the Social Security Act (42 U.S.C. 1395dd(e)(3)).
(K) Out-of-network rate The term “out-of-network rate” means, with respect to an item or service furnished in a State during a year to a participant or beneficiary of a group health plan or group health insurance coverage offered by a health insurance issuer receiving such item or service from a nonparticipating provider or nonparticipating emergency facility—
(i) subject to clause (iii), in the case of such item or service furnished in a State that has in effect a specified State law with respect to such plan, coverage, or issuer, respectively; such a nonparticipating provider or nonparticipating emergency facility; and such an item or service, the amount determined in accordance with such law;
(ii) subject to clause (iii), in the case such State does not have in effect such a law with respect to such item or service, plan, and provider or facility—
(I) subject to subclause (II), if the provider or facility (as applicable) and such plan or coverage agree on an amount of payment (including if such agreed on amount is the initial payment sent by the plan under subsection (a)(1)(C)(iv)(I), subsection (b)(1)(C), or section 1185f(a)(3)(A) of this title, as applicable, or is agreed on through open negotiations under subsection (c)(1)) with respect to such item or service, such agreed on amount; or
(II) if such provider or facility (as applicable) and such plan or coverage enter the independent dispute resolution process under subsection (c) and do not so agree before the date on which a certified IDR entity (as defined in paragraph (4) of such subsection) makes a determination with respect to such item or service under such subsection, the amount of such determination; or
(iii) in the case such State has an All-Payer Model Agreement under section 1115A of the Social Security Act [42 U.S.C. 1315a], the amount that the State approves under such system for such item or service so furnished.
(L) Cost-sharing The term “cost-sharing” includes copayments, coinsurance, and deductibles.
(b) Coverage of non-emergency services performed by nonparticipating providers at certain participating facilities (1) In general In the case of items or services (other than emergency services to which subsection (a) applies) for which any benefits are provided or covered by a group health plan or health insurance issuer offering group health insurance coverage furnished to a participant or beneficiary of such plan or coverage by a nonparticipating provider (as defined in subsection (a)(3)(G)(i)) (and who, with respect to such items and services, has not satisfied the notice and consent criteria of section 300gg132(d) of title 42) with respect to a visit (as defined by the Secretary in accordance with paragraph (2)(B)) at a participating health care facility (as defined in paragraph (2)(A)), with respect to such plan or coverage, respectively, the plan or coverage, respectively—
(A) shall not impose on such participant or beneficiary a cost-sharing requirement for such items and services so furnished that is greater than the cost-sharing requirement that would apply under such plan or coverage, respectively, had such items or services been furnished by a participating provider (as defined in subsection (a)(3)(G)(ii));
(B) shall calculate such cost-sharing requirement as if the total amount that would have been charged for such items and services by such participating provider were equal to the recognized amount (as defined in subsection (a)(3)(H)) for such items and services, plan or coverage, and year;
(C) not later than 30 calendar days after the bill for such items or services is transmitted by such provider, shall send to the provider an initial payment or notice of denial of payment;
(D) shall pay a total plan or coverage payment directly, in accordance, if applicable, with the timing requirement described in subsection (c)(6), to such provider furnishing such items and services to such participant or beneficiary that is, with application of any initial payment under subparagraph (C), equal to the amount by which the out-of-network rate (as defined in subsection (a)(3)(K)) for such items and services exceeds the cost-sharing amount imposed under the plan or coverage, respectively, for such items and services (as determined in accordance with subparagraphs (A) and (B)) and year; and
(E) shall count toward any in-network deductible and in-network out-of-pocket maximums (as applicable) applied under the plan or coverage, respectively, any cost-sharing payments made by the participant or beneficiary (and such in-network deductible and out-of-pocket maximums shall be applied) with respect to such items and services so furnished in the same manner as if such cost-sharing payments were with respect to items and services furnished by a participating provider.
(2) Definitions In this section:
(A) Participating health care facility (i) In general The term “participating health care facility” means, with respect to an item or service and a group health plan or health insurance issuer offering group health insurance coverage, a health care facility described in clause (ii) that has a direct or indirect contractual relationship with the plan or issuer, respectively, with respect to the furnishing of such an item or service at the facility.
(ii) Health care facility described A health care facility described in this clause, with respect to a group health plan or group health insurance coverage, is each of the following:
(I) A hospital (as defined in 1861(e) of the Social Security Act [42 U.S.C. 1395x(e)]).
(II) A hospital outpatient department.
(III) A critical access hospital (as defined in section 1861(mm)(1) of such Act [42 U.S.C. 1395x(mm)(1)]).
(IV) An ambulatory surgical center described in section 1833(i)(1)(A) of such Act [42 U.S.C. 1395l(i)(1)(A)].
(V) Any other facility, specified by the Secretary, that provides items or services for which coverage is provided under the plan or coverage, respectively.
(B) Visit The term “visit” shall, with respect to items and services furnished to an individual at a health care facility, include equipment and devices, telemedicine services, imaging services, laboratory services, preoperative and postoperative services, and such other items and services as the Secretary may specify, regardless of whether or not the provider furnishing such items or services is at the facility.
(c) Determination of out-of-network rates to be paid by health plans; independent dispute resolution process (1) Determination through open negotiation (A) In general With respect to an item or service furnished in a year by a nonparticipating provider or a nonparticipating facility, with respect to a group health plan or health insurance issuer offering group health insurance coverage, in a State described in subsection (a)(3)(K)(ii) with respect to such plan or coverage and provider or facility, and for which a payment is required to be made by the plan or coverage pursuant to subsection (a)(1) or (b)(1), the provider or facility (as applicable) or plan or coverage may, during the 30-day period beginning on the day the provider or facility receives an initial payment or a notice of denial of payment from the plan or coverage regarding a claim for payment for such item or service, initiate open negotiations under this paragraph between such provider or facility and plan or coverage for purposes of determining, during the open negotiation period, an amount agreed on by such provider or facility, respectively, and such plan or coverage for payment (including any cost-sharing) for such item or service. For purposes of this subsection, the open negotiation period, with respect to an item or service, is the 30-day period beginning on the date of initiation of the negotiations with respect to such item or service.
(B) Accessing independent dispute resolution process in case of failed negotiations In the case of open negotiations pursuant to subparagraph (A), with respect to an item or service, that do not result in a determination of an amount of payment for such item or service by the last day of the open negotiation period described in such subparagraph with respect to such item or service, the provider or facility (as applicable) or group health plan or health insurance issuer offering group health insurance coverage that was party to such negotiations may, during the 4-day period beginning on the day after such open negotiation period, initiate the independent dispute resolution process under paragraph (2) with respect to such item or service. The independent dispute resolution process shall be initiated by a party pursuant to the previous sentence by submission to the other party and to the Secretary of a notification (containing such information as specified by the Secretary) and for purposes of this subsection, the date of initiation of such process shall be the date of such submission or such other date specified by the Secretary pursuant to regulations that is not later than the date of receipt of such notification by both the other party and the Secretary.
(2) Independent dispute resolution process available in case of failed open negotiations (A) Establishment Not later than 1 year after December 27, 2020, the Secretary, jointly with the Secretary of Health and Human Services and the Secretary of the Treasury, shall establish by regulation one independent dispute resolution process (referred to in this subsection as the “IDR process”) under which, in the case of an item or service with respect to which a provider or facility (as applicable) or group health plan or health insurance issuer offering group health insurance coverage submits a notification under paragraph (1)(B) (in this subsection referred to as a “qualified IDR item or service”), a certified IDR entity under paragraph (4) determines, subject to subparagraph (B) and in accordance with the succeeding provisions of this subsection, the amount of payment under the plan or coverage for such item or service furnished by such provider or facility.
(B) Authority to continue negotiations Under the independent dispute resolution process, in the case that the parties to a determination for a qualified IDR item or service agree on a payment amount for such item or service during such process but before the date on which the entity selected with respect to such determination under paragraph (4) makes such determination under paragraph (5), such amount shall be treated for purposes of subsection (a)(3)(K)(ii) as the amount agreed to by such parties for such item or service. In the case of an agreement described in the previous sentence, the independent dispute resolution process shall provide for a method to determine how to allocate between the parties to such determination the payment of the compensation of the entity selected with respect to such determination.
(C) Clarification A nonparticipating provider may not, with respect to an item or service furnished by such provider, submit a notification under paragraph (1)(B) if such provider is exempt from the requirement under subsection (a) of section 300gg132 of title 42 with respect to such item or service pursuant to subsection (b) of such section.
(3) Treatment of batching of items and services (A) In general Under the IDR process, the Secretary shall specify criteria under which multiple qualified IDR dispute items and services are permitted to be considered jointly as part of a single determination by an entity for purposes of encouraging the efficiency (including minimizing costs) of the IDR process. Such items and services may be so considered only if—
(i) such items and services to be included in such determination are furnished by the same provider or facility;
(ii) payment for such items and services is required to be made by the same group health plan or health insurance issuer;
(iii) such items and services are related to the treatment of a similar condition; and
(iv) such items and services were furnished during the 30 day 44 So in original. Probably should be “30-day”. period following the date on which the first item or service included with respect to such determination was furnished or an alternative period as determined by the Secretary, for use in limited situations, such as by the consent of the parties or in the case of low-volume items and services, to encourage procedural efficiency and minimize health plan and provider administrative costs.
(B) Treatment of bundled payments In carrying out subparagraph (A), the Secretary shall provide that, in the case of items and services which are included by a provider or facility as part of a bundled payment, such items and services included in such bundled payment may be part of a single determination under this subsection.
(4) Certification and selection of IDR entities (A) In general The Secretary, jointly with the Secretary of Health and Human Services and Secretary of the Treasury, shall establish a process to certify (including to recertify) entities under this paragraph. Such process shall ensure that an entity so certified—
(i) has (directly or through contracts or other arrangements) sufficient medical, legal, and other expertise and sufficient staffing to make determinations described in paragraph (5) on a timely basis;
(ii) is not—
(I) a group health plan or health insurance issuer offering group health insurance coverage, provider, or facility;
(II) an affiliate or a subsidiary of such a group health plan or health insurance issuer, provider, or facility; or
(III) an affiliate or subsidiary of a professional or trade association of such group health plans or health insurance issuers or of providers or facilities;
(iii) carries out the responsibilities of such an entity in accordance with this subsection;
(iv) meets appropriate indicators of fiscal integrity;
(v) maintains the confidentiality (in accordance with regulations promulgated by the Secretary) of individually identifiable health information obtained in the course of conducting such determinations;
(vi) does not under the IDR process carry out any determination with respect to which the entity would not pursuant to subclause (I), (II), or (III) of subparagraph (F)(i) be eligible for selection; and
(vii) meets such other requirements as determined appropriate by the Secretary.
(B) Period of certification Subject to subparagraph (C), each certification (including a recertification) of an entity under the process described in subparagraph (A) shall be for a 5-year period.
(C) Revocation A certification of an entity under this paragraph may be revoked under the process described in subparagraph (A) if the entity has a pattern or practice of noncompliance with any of the requirements described in such subparagraph.
(D) Petition for denial or withdrawal The process described in subparagraph (A) shall ensure that an individual, provider, facility, or group health plan or health insurance issuer offering group health insurance coverage may petition for a denial of a certification or a revocation of a certification with respect to an entity under this paragraph for failure of meeting a requirement of this subsection.
(E) Sufficient number of entities The process described in subparagraph (A) shall ensure that a sufficient number of entities are certified under this paragraph to ensure the timely and efficient provision of determinations described in paragraph (5).
(F) Selection of certified IDR entity The Secretary shall, with respect to the determination of the amount of payment under this subsection of an item or service, provide for a method—
(i) that allows for the group health plan or health insurance issuer offering group health insurance coverage and the nonparticipating provider or the nonparticipating emergency facility (as applicable) involved in a notification under paragraph (1)(B) to jointly select, not later than the last day of the 3-business day period following the date of the initiation of the process with respect to such item or service, for purposes of making such determination, an entity certified under this paragraph that—
(I) is not a party to such determination or an employee or agent of such a party;
(II) does not have a material familial, financial, or professional relationship with such a party; and
(III) does not otherwise have a conflict of interest with such a party (as determined by the Secretary); and
(ii) that requires, in the case such parties do not make such selection by such last day, the Secretary to, not later than 6 business days after such date of initiation—
(I) select such an entity that satisfies subclauses (I) through (III) of clause (i)); and
(II) provide notification of such selection to the provider or facility (as applicable) and the plan or issuer (as applicable) party to such determination.
An entity selected pursuant to the previous sentence to make a determination described in such sentence shall be referred to in this subsection as the “certified IDR entity” with respect to such determination.
(5) Payment determination (A) In general Not later than 30 days after the date of selection of the certified IDR entity with respect to a determination for a qualified IDR item or service, the certified IDR entity shall—
(i) taking into account the considerations specified in subparagraph (C), select one of the offers submitted under subparagraph (B) to be the amount of payment for such item or service determined under this subsection for purposes of subsection (a)(1) or (b)(1), as applicable; and
(ii) notify the provider or facility and the group health plan or health insurance issuer offering group health insurance coverage party to such determination of the offer selected under clause (i).
(B) Submission of offers Not later than 10 days after the date of selection of the certified IDR entity with respect to a determination for a qualified IDR item or service, the provider or facility and the group health plan or health insurance issuer offering group health insurance coverage party to such determination—
(i) shall each submit to the certified IDR entity with respect to such determination—
(I) an offer for a payment amount for such item or service furnished by such provider or facility; and
(II) such information as requested by the certified IDR entity relating to such offer; and
(ii) may each submit to the certified IDR entity with respect to such determination any information relating to such offer submitted by either party, including information relating to any circumstance described in subparagraph (C)(ii).
(C) Considerations in determination (i) In general In determining which offer is the payment to be applied pursuant to this paragraph, the certified IDR entity, with respect to the determination for a qualified IDR item or service shall consider—
(I) the qualifying payment amounts (as defined in subsection (a)(3)(E)) for the applicable year for items or services that are comparable to the qualified IDR item or service and that are furnished in the same geographic region (as defined by the Secretary for purposes of such subsection) as such qualified IDR item or service; and
(II) subject to subparagraph (D), information on any circumstance described in clause (ii), such information as requested in subparagraph (B)(i)(II), and any additional information provided in subparagraph (B)(ii).
(ii) Additional circumstances For purposes of clause (i)(II), the circumstances described in this clause are, with respect to a qualified IDR item or service of a nonparticipating provider, nonparticipating emergency facility, group health plan, or health insurance issuer of group health insurance coverage the following:
(I) The level of training, experience, and quality and outcomes measurements of the provider or facility that furnished such item or service (such as those endorsed by the consensus-based entity authorized in section 1890 of the Social Security Act [42 U.S.C. 1395aaa]).
(II) The market share held by the nonparticipating provider or facility or that of the plan or issuer in the geographic region in which the item or service was provided.
(III) The acuity of the individual receiving such item or service or the complexity of furnishing such item or service to such individual.
(IV) The teaching status, case mix, and scope of services of the nonparticipating facility that furnished such item or service.
(V) Demonstrations of good faith efforts (or lack of good faith efforts) made by the nonparticipating provider or nonparticipating facility or the plan or issuer to enter into network agreements and, if applicable, contracted rates between the provider or facility, as applicable, and the plan or issuer, as applicable, during the previous 4 plan years.
(D) Prohibition on consideration of certain factors In determining which offer is the payment to be applied with respect to qualified IDR items and services furnished by a provider or facility, the certified IDR entity with respect to a determination shall not consider usual and customary charges, the amount that would have been billed by such provider or facility with respect to such items and services had the provisions of section 300gg131 of title 42 or section 300gg132 of such title (as applicable) not applied, or the payment or reimbursement rate for such items and services furnished by such provider or facility payable by a public payor, including under the Medicare program under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.], under the Medicaid program under title XIX of such Act [42 U.S.C. 1396 et seq.], under the Childrens Health Insurance Program under title XXI of such Act [42 U.S.C. 1397aa et seq.], under the TRICARE program under chapter 55 of title 10, or under chapter 17 of title 38.
(E) Effects of determination (i) In general A determination of a certified IDR entity under subparagraph (A)—
(I) shall be binding upon the parties involved, in the absence of a fraudulent claim or evidence of misrepresentation of facts presented to the IDR entity involved regarding such claim; and
(II) shall not be subject to judicial review, except in a case described in any of paragraphs (1) through (4) of section 10(a) of title 9.
(ii) Suspension of certain subsequent IDR requests In the case of a determination of a certified IDR entity under subparagraph (A), with respect to an initial notification submitted under paragraph (1)(B) with respect to qualified IDR items and services and the two parties involved with such notification, the party that submitted such notification may not submit during the 90-day period following such determination a subsequent notification under such paragraph involving the same other party to such notification with respect to such an item or service that was the subject of such initial notification.
(iii) Subsequent submission of requests permitted In the case of a notification that pursuant to clause (ii) is not permitted to be submitted under paragraph (1)(B) during a 90-day period specified in such clause, if the end of the open negotiation period specified in paragraph (1)(A), that but for this clause would otherwise apply with respect to such notification, occurs during such 90-day period, such paragraph (1)(B) shall be applied as if the reference in such paragraph to the 4-day period beginning on the day after such open negotiation period were instead a reference to the 30-day period beginning on the day after the last day of such 90-day period.
(iv) Reports The Secretary, jointly with the Secretary of Health and Human Services and the Secretary of the Treasury, shall examine the impact of the application of clause (ii) and whether the application of such clause delays payment determinations or impacts early, alternative resolution of claims (such as through open negotiations), and shall submit to Congress, not later than 2 years after the date of implementation of such clause an interim report (and not later than 4 years after such date of implementation, a final report) on whether any group health plans or health insurance issuers offering group or individual health insurance coverage or types of such plans or coverage have a pattern or practice of routine denial, low payment, or down-coding of claims, or otherwise abuse the 90-day period described in such clause, including recommendations on ways to discourage such a pattern or practice.
(F) Costs of independent dispute resolution process In the case of a notification under paragraph (1)(B) submitted by a nonparticipating provider, nonparticipating emergency facility, group health plan, or health insurance issuer offering group health insurance coverage and submitted to a certified IDR entity—
(i) if such entity makes a determination with respect to such notification under subparagraph (A), the party whose offer is not chosen under such subparagraph shall be responsible for paying all fees charged by such entity; and
(ii) if the parties reach a settlement with respect to such notification prior to such a determination, each party shall pay half of all fees charged by such entity, unless the parties otherwise agree.
(6) Timing of payment The total plan or coverage payment required pursuant to subsection (a)(1) or (b)(1), with respect to a qualified IDR item or service for which a determination is made under paragraph (5)(A) or with respect to an item or service for which a payment amount is determined under open negotiations under paragraph (1), shall be made directly to the nonparticipating provider or facility not later than 30 days after the date on which such determination is made.
(7) Publication of information relating to the IDR process (A) Publication of information For each calendar quarter in 2022 and each calendar quarter in a subsequent year, the Secretary shall make available on the public website of the Department of Labor—
(i) the number of notifications submitted under paragraph (1)(B) during such calendar quarter;
(ii) the size of the provider practices and the size of the facilities submitting notifications under paragraph (1)(B) during such calendar quarter;
(iii) the number of such notifications with respect to which a determination was made under paragraph (5)(A);
(iv) the information described in subparagraph (B) with respect to each notification with respect to which such a determination was so made;
(v) the number of times the payment amount determined (or agreed to) under this subsection exceeds the qualifying payment amount, specified by items and services;
(vi) the amount of expenditures made by the Secretary during such calendar quarter to carry out the IDR process;
(vii) the total amount of fees paid under paragraph (8) during such calendar quarter; and
(viii) the total amount of compensation paid to certified IDR entities under paragraph (5)(F) during such calendar quarter.
(B) Information For purposes of subparagraph (A), the information described in this subparagraph is, with respect to a notification under paragraph (1)(B) by a nonparticipating provider, nonparticipating emergency facility, group health plan, or health insurance issuer offering group health insurance coverage—
(i) a description of each item and service included with respect to such notification;
(ii) the geography in which the items and services with respect to such notification were provided;
(iii) the amount of the offer submitted under paragraph (5)(B) by the group health plan or health insurance issuer (as applicable) and by the nonparticipating provider or nonparticipating emergency facility (as applicable) expressed as a percentage of the qualifying payment amount;
(iv) whether the offer selected by the certified IDR entity under paragraph (5) to be the payment applied was the offer submitted by such plan or issuer (as applicable) or by such provider or facility (as applicable) and the amount of such offer so selected expressed as a percentage of the qualifying payment amount;
(v) the category and practice specialty of each such provider or facility involved in furnishing such items and services;
(vi) the identity of the health plan or health insurance issuer, provider, or facility, with respect to the notification;
(vii) the length of time in making each determination;
(viii) the compensation paid to the certified IDR entity with respect to the settlement or determination; and
(ix) any other information specified by the Secretary.
(C) IDR entity requirements For 2022 and each subsequent year, an IDR entity, as a condition of certification as an IDR entity, shall submit to the Secretary such information as the Secretary determines necessary to carry out the provisions of this subsection.
(D) Clarification The Secretary shall ensure the public reporting under this paragraph does not contain information that would disclose privileged or confidential information of a group health plan or health insurance issuer offering group or individual health insurance coverage or of a provider or facility.
(8) Administrative fee (A) In general Each party to a determination under paragraph (5) to which an entity is selected under paragraph (3) 55 So in original. Probably should be “paragraph (4)”. in a year shall pay to the Secretary, at such time and in such manner as specified by the Secretary, a fee for participating in the IDR process with respect to such determination in an amount described in subparagraph (B) for such year.
(B) Amount of fee The amount described in this subparagraph for a year is an amount established by the Secretary in a manner such that the total amount of fees paid under this paragraph for such year is estimated to be equal to the amount of expenditures estimated to be made by the Secretary for such year in carrying out the IDR process.
(9) Waiver authority The Secretary may modify any deadline or other timing requirement specified under this subsection (other than the establishment date for the IDR process under paragraph (2)(A) and other than under paragraph (6)) in cases of extenuating circumstances, as specified by the Secretary, or to ensure that all claims that occur during a 90-day period described in paragraph (5)(E)(ii), but with respect to which a notification is not permitted by reason of such paragraph to be submitted under paragraph (1)(B) during such period, are eligible for the IDR process.
(d) Certain access fees to certain databases In the case of a sponsor of a group health plan or health insurance issuer offering group health insurance coverage that, pursuant to subsection (a)(3)(E)(iii), uses a database described in such subsection to determine a rate to apply under such subsection for an item or service by reason of having insufficient information described in such subsection with respect to such item or service, such sponsor or issuer shall cover the cost for access to such database.
(e) Transparency regarding in-network and out-of-network deductibles and out-of-pocket limitations A group health plan or a health insurance issuer offering group health insurance coverage and providing or covering any benefit with respect to items or services shall include, in clear writing, on any physical or electronic plan or insurance identification card issued to the participants or beneficiaries in the plan or coverage the following:
(1) Any deductible applicable to such plan or coverage.
(2) Any out-of-pocket maximum limitation applicable to such plan or coverage.
(3) A telephone number and Internet website address through which such individual may seek consumer assistance information, such as information related to hospitals and urgent care facilities that have in effect a contractual relationship with such plan or coverage for furnishing items and services under such plan or coverage 66 So in original. Probably should be followed by a period.
(f) Advanced explanation of benefits (1) In general For plan years beginning on or after January 1, 2022, each group health plan, or a health insurance issuer offering group health insurance coverage shall, with respect to a notification submitted under section 300gg136 of title 42 by a health care provider or health care facility to the plan or issuer for a participant or beneficiary under plan or coverage scheduled to receive an item or service from the provider or facility (or authorized representative of such participant or beneficiary), not later than 1 business day (or, in the case such item or service was so scheduled at least 10 business days before such item or service is to be furnished (or in the case of a request made to such plan or coverage by such participant or beneficiary), 3 business days) after the date on which the plan or coverage receives such notification (or such request), provide to the participant or beneficiary (through mail or electronic means, as requested by the participant or beneficiary) a notification (in clear and understandable language) including the following:
(A) Whether or not the provider or facility is a participating provider or a participating facility with respect to the plan or coverage with respect to the furnishing of such item or service and—
(i) in the case the provider or facility is a participating provider or facility with respect to the plan or coverage with respect to the furnishing of such item or service, the contracted rate under such plan for such item or service (based on the billing and diagnostic codes provided by such provider or facility); and
(ii) in the case the provider or facility is a nonparticipating provider or facility with respect to such plan or coverage, a description of how such individual may obtain information on providers and facilities that, with respect to such plan or coverage, are participating providers and facilities, if any.
(B) The good faith estimate included in the notification received from the provider or facility (if applicable) based on such codes.
(C) A good faith estimate of the amount the health plan is responsible for paying for items and services included in the estimate described in subparagraph (B).
(D) A good faith estimate of the amount of any cost-sharing for which the participant or beneficiary would be responsible for such item or service (as of the date of such notification).
(E) A good faith estimate of the amount that the participant or beneficiary has incurred toward meeting the limit of the financial responsibility (including with respect to deductibles and out-of-pocket maximums) under the plan or coverage (as of the date of such notification).
(F) In the case such item or service is subject to a medical management technique (including concurrent review, prior authorization, and step-therapy or fail-first protocols) for coverage under the plan or coverage, a disclaimer that coverage for such item or service is subject to such medical management technique.
(G) A disclaimer that the information provided in the notification is only an estimate based on the items and services reasonably expected, at the time of scheduling (or requesting) the item or service, to be furnished and is subject to change.
(H) Any other information or disclaimer the plan or coverage determines appropriate that is consistent with information and disclaimers required under this section.
(2) Authority to modify timing requirements in the case of specified items and services (A) In general In the case of a participant or beneficiary scheduled to receive an item or service that is a specified item or service (as defined in subparagraph (B)), the Secretary may modify any timing requirements relating to the provision of the notification described in paragraph (1) to such participant or beneficiary with respect to such item or service. Any modification made by the Secretary pursuant to the previous sentence may not result in the provision of such notification after such participant or beneficiary has been furnished such item or service.
(B) Specified item or service defined For purposes of subparagraph (A), the term “specified item or service” means an item or service that has low utilization or significant variation in costs (such as when furnished as part of a complex treatment), as specified by the Secretary.
(Pub. L. 93406, title I, § 716, as added and amended Pub. L. 116260, div. BB, title I, §§ 102(b)(1), 103(b), 107(b), 111(c), Dec. 27, 2020, 134 Stat. 2772, 2806, 2858, 2865.)
## Notes
Editorial Notes
References in TextSection 109(a) of the No Surprises Act, referred to in subsec. (a)(2), is section 109(a) of Pub. L. 116260, div. BB, title I, Dec. 27, 2020, 134 Stat. 2859, which is not classified to the Code. Section 300gg132 of title 42, referred to in subsec. (a)(3)(C)(ii)(II)(bb), (cc), was in the original “section 2799B2”, which was translated as reading section 2799B2 of the Public Health Service Act, to reflect the probable intent of Congress. The phrase “in 2019”, referred to in subsec. (a)(3)(E)(iii)(III), does not appear in cl. (i)(I) of subsec. (a)(3)(E). However, subsec. (a)(3)(E)(iii)(III) of section 9816 of Title 26, Internal Revenue Code, which contains text similar to that in this subclause, refers to the phrase “on January 31, 2019”, which does appear in cl. (i)(I). The Social Security Act, referred to in subsec. (c)(5)(D), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Titles XVIII, XIX, and XXI of the Act are classified generally to subchapters XVIII (§ 1395 et seq.), XIX (§ 1396 et seq.), and XXI (§ 1397aa et seq.), respectively, of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.
Amendments2020—Subsecs. (c), (d). Pub. L. 116260, § 103(b), added subsec. (c) and redesignated former subsec. (c) as (d). Subsec. (e). Pub. L. 116260, § 107(b), added subsec. (e). Subsec. (f). Pub. L. 116260, § 111(c), added subsec. (f).
Statutory Notes and Related Subsidiaries
Effective Date of 2020 AmendmentAmendment by section 107(b) of Pub. L. 116260 applicable with respect to plan years beginning on or after Jan. 1, 2022, see section 107(d) of div. BB of Pub. L. 116260, set out as a note under section 9816 of Title 26, Internal Revenue Code.
Effective DateSection applicable with respect to plan years beginning on or after Jan. 1, 2022, see section 102(e) of div. BB of Pub. L. 116260, set out as an Effective Date of 2020 Amendment note under section 8902 of Title 5, Government Organization and Employees.
@@ -0,0 +1,169 @@
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title: "29 U.S.C. § 1185f"
description: "Ending surprise air ambulance bills"
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title_name: "LABOR"
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chapter_name: "EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM"
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citation: "29 U.S.C. § 1185f"
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# 29 U.S.C. § 1185f - Ending surprise air ambulance bills
## Text
(a) In general In the case of a participant or beneficiary who is in a group health plan or group health insurance coverage offered by a health insurance issuer and who receives air ambulance services from a nonparticipating provider (as defined in section 1185e(a)(3)(G) of this title) with respect to such plan or coverage, if such services would be covered if provided by a participating provider (as defined in such section) with respect to such plan or coverage—
(1) the cost-sharing requirement with respect to such services shall be the same requirement that would apply if such services were provided by such a participating provider, and any coinsurance or deductible shall be based on rates that would apply for such services if they were furnished by such a participating provider;
(2) such cost-sharing amounts shall be counted towards the in-network deductible and in-network out-of-pocket maximum amount under the plan or coverage for the plan year (and such in-network deductible shall be applied) with respect to such items and services so furnished in the same manner as if such cost-sharing payments were with respect to items and services furnished by a participating provider; and
(3) the group health plan or health insurance issuer, respectively, shall—
(A) not later than 30 calendar days after the bill for such services is transmitted by such provider, send to the provider, an initial payment or notice of denial of payment; and
(B) pay a total plan or coverage payment, in accordance with, if applicable, subsection (b)(6), directly to such provider furnishing such services to such participant, beneficiary, or enrollee that is, with application of any initial payment under subparagraph (A), equal to the amount by which the out-of-network rate (as defined in section 1185e(a)(3)(K) of this title) for such services and year involved exceeds the cost-sharing amount imposed under the plan or coverage, respectively, for such services (as determined in accordance with paragraphs (1) and (2)).
(b) Determination of out-of-network rates to be paid by health plans; independent dispute resolution process (1) Determination through open negotiation (A) In general With respect to air ambulance services furnished in a year by a nonparticipating provider, with respect to a group health plan or health insurance issuer offering group health insurance coverage, and for which a payment is required to be made by the plan or coverage pursuant to subsection (a)(3), the provider or plan or coverage may, during the 30-day period beginning on the day the provider receives a payment or a statement of denial of payment from the plan or coverage regarding a claim for payment for such service, initiate open negotiations under this paragraph between such provider and plan or coverage for purposes of determining, during the open negotiation period, an amount agreed on by such provider, and such plan or coverage for payment (including any cost-sharing) for such service. For purposes of this subsection, the open negotiation period, with respect to air ambulance services, is the 30-day period beginning on the date of initiation of the negotiations with respect to such services.
(B) Accessing independent dispute resolution process in case of failed negotiations In the case of open negotiations pursuant to subparagraph (A), with respect to air ambulance services, that do not result in a determination of an amount of payment for such services by the last day of the open negotiation period described in such subparagraph with respect to such services, the provider or group health plan or health insurance issuer offering group health insurance coverage that was party to such negotiations may, during the 4-day period beginning on the day after such open negotiation period, initiate the independent dispute resolution process under paragraph (2) with respect to such item or service. The independent dispute resolution process shall be initiated by a party pursuant to the previous sentence by submission to the other party and to the Secretary of a notification (containing such information as specified by the Secretary) and for purposes of this subsection, the date of initiation of such process shall be the date of such submission or such other date specified by the Secretary pursuant to regulations that is not later than the date of receipt of such notification by both the other party and the Secretary.
(2) Independent dispute resolution process available in case of failed open negotiations (A) Establishment Not later than 1 year after December 27, 2020, the Secretary, jointly with the Secretary of Health and Human Services and the Secretary of the Treasury, shall establish by regulation one independent dispute resolution process (referred to in this subsection as the “IDR process”) under which, in the case of air ambulance services with respect to which a provider or group health plan or health insurance issuer offering group health insurance coverage submits a notification under paragraph (1)(B) (in this subsection referred to as a “qualified IDR air ambulance services”), a certified IDR entity under paragraph (4) determines, subject to subparagraph (B) and in accordance with the succeeding provisions of this subsection, the amount of payment under the plan or coverage for such services furnished by such provider.
(B) Authority to continue negotiations Under the independent dispute resolution process, in the case that the parties to a determination for qualified IDR air ambulance services agree on a payment amount for such services during such process but before the date on which the entity selected with respect to such determination under paragraph (4) makes such determination under paragraph (5), such amount shall be treated for purposes of section 1185e(a)(3)(K)(ii) of this title as the amount agreed to by such parties for such services. In the case of an agreement described in the previous sentence, the independent dispute resolution process shall provide for a method to determine how to allocate between the parties to such determination the payment of the compensation of the entity selected with respect to such determination.
(C) Clarification A nonparticipating provider may not, with respect to an item or service furnished by such provider, submit a notification under paragraph (1)(B) if such provider is exempt from the requirement under subsection (a) of section 300gg132 of title 42 with respect to such item or service pursuant to subsection (b) of such section.
(3) Treatment of batching of services The provisions of section 1185e(c)(3) of this title shall apply with respect to a notification submitted under this subsection with respect to air ambulance services in the same manner and to the same extent such provisions apply with respect to a notification submitted under section 1185e(c) of this title with respect to items and services described in such section.
(4) IDR entities (A) Eligibility An IDR entity certified under this subsection is an IDR entity certified under section 1185e(c)(4) of this title.
(B) Selection of certified IDR entity The provisions of subparagraph (F) of section 1185e(c)(4) of this title shall apply with respect to selecting an IDR entity certified pursuant to subparagraph (A) with respect to the determination of the amount of payment under this subsection of air ambulance services in the same manner as such provisions apply with respect to selecting an IDR entity certified under such section with respect to the determination of the amount of payment under section 1185e(c) of this title of an item or service. An entity selected pursuant to the previous sentence to make a determination described in such sentence shall be referred to in this subsection as the “certified IDR entity” with respect to such determination.
(5) Payment determination (A) In general Not later than 30 days after the date of selection of the certified IDR entity with respect to a determination for qualified IDR ambulance services, the certified IDR entity shall—
(i) taking into account the considerations specified in subparagraph (C), select one of the offers submitted under subparagraph (B) to be the amount of payment for such services determined under this subsection for purposes of subsection (a)(3); and
(ii) notify the provider or facility and the group health plan or health insurance issuer offering group health insurance coverage party to such determination of the offer selected under clause (i).
(B) Submission of offers Not later than 10 days after the date of selection of the certified IDR entity with respect to a determination for qualified IDR air ambulance services, the provider and the group health plan or health insurance issuer offering group health insurance coverage party to such determination—
(i) shall each submit to the certified IDR entity with respect to such determination—
(I) an offer for a payment amount for such services furnished by such provider; and
(II) such information as requested by the certified IDR entity relating to such offer; and
(ii) may each submit to the certified IDR entity with respect to such determination any information relating to such offer submitted by either party, including information relating to any circumstance described in subparagraph (C)(ii).
(C) Considerations in determination (i) In general In determining which offer is the payment to be applied pursuant to this paragraph, the certified IDR entity, with respect to the determination for a qualified IDR air ambulance service shall consider—
(I) the qualifying payment amounts (as defined in section 1185e(a)(3)(E) of this title) for the applicable year for items and services that are comparable to the qualified IDR air ambulance service and that are furnished in the same geographic region (as defined by the Secretary for purposes of such subsection) as such qualified IDR air ambulance service; and
(II) subject to clause (iii), information on any circumstance described in clause (ii), such information as requested in subparagraph (B)(i)(II), and any additional information provided in subparagraph (B)(ii).
(ii) Additional circumstances For purposes of clause (i)(II), the circumstances described in this clause are, with respect to air ambulance services included in the notification submitted under paragraph (1)(B) of a nonparticipating provider, group health plan, or health insurance issuer the following:
(I) The quality and outcomes measurements of the provider that furnished such services.
(II) The acuity of the individual receiving such services or the complexity of furnishing such services to such individual.
(III) The training, experience, and quality of the medical personnel that furnished such services.
(IV) Ambulance vehicle type, including the clinical capability level of such vehicle.
(V) Population density of the pick up location (such as urban, suburban, rural, or frontier).
(VI) Demonstrations of good faith efforts (or lack of good faith efforts) made by the nonparticipating provider or nonparticipating facility or the plan or issuer to enter into network agreements and, if applicable, contracted rates between the provider and the plan or issuer, as applicable, during the previous 4 plan years.
(iii) Prohibition on consideration of certain factors In determining which offer is the payment amount to be applied with respect to qualified IDR air ambulance services furnished by a provider, the certified IDR entity with respect to such determination shall not consider usual and customary charges, the amount that would have been billed by such provider with respect to such services had the provisions of section 300gg135 of title 42 not applied, or the payment or reimbursement rate for such services furnished by such provider payable by a public payor, including under the Medicare program under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.], under the Medicaid program under title XIX of such Act [42 U.S.C. 1396 et seq.], under the Childrens Health Insurance Program under title XXI of such Act [42 U.S.C. 1397aa et seq.], under the TRICARE program under chapter 55 of title 10, or under chapter 17 of title 38.
(D) Effects of determination The provisions of section 1185e(c)(5)(E) of this title shall apply with respect to a determination of a certified IDR entity under subparagraph (A), the notification submitted with respect to such determination, the services with respect to such notification, and the parties to such notification in the same manner as such provisions apply with respect to a determination of a certified IDR entity under section 1185e(c)(5)(E) of this title, the notification submitted with respect to such determination, the items and services with respect to such notification, and the parties to such notification.
(E) Costs of independent dispute resolution process The provisions of section 1185e(c)(5)(F) of this title shall apply to a notification made under this subsection, the parties to such notification, and a determination under subparagraph (A) in the same manner and to the same extent such provisions apply to a notification under section 1185e(c) of this title, the parties to such notification and a determination made under section 1185e(c)(5)(A) of this title.
(6) Timing of payment The total plan or coverage payment required pursuant to subsection (a)(3), with respect to qualified IDR air ambulance services for which a determination is made under paragraph (5)(A) or with respect to air ambulance services for which a payment amount is determined under open negotiations under paragraph (1), shall be made directly to the nonparticipating provider not later than 30 days after the date on which such determination is made.
(7) Publication of information relating to the IDR process (A) In general For each calendar quarter in 2022 and each calendar quarter in a subsequent year, the Secretary shall publish on the public website of the Department of Labor—
(i) the number of notifications submitted under the IDR process during such calendar quarter;
(ii) the number of such notifications with respect to which a final determination was made under paragraph (5)(A);
(iii) the information described in subparagraph (B) with respect to each notification with respect to which such a determination was so made.11 So in original. The period probably should be a semicolon.
(iv) the number of times the payment amount determined (or agreed to) under this subsection exceeds the qualifying payment amount;
(v) the amount of expenditures made by the Secretary during such calendar quarter to carry out the IDR process;
(vi) the total amount of fees paid under paragraph (8) during such calendar quarter; and
(vii) the total amount of compensation paid to certified IDR entities under paragraph (5)(E) during such calendar quarter.
(B) Information with respect to requests For purposes of subparagraph (A), the information described in this subparagraph is, with respect to a notification under the IDR process of a nonparticipating provider, group health plan, or health insurance issuer offering group health insurance coverage—
(i) a description of each air ambulance service included in such notification;
(ii) the geography in which the services included in such notification were provided;
(iii) the amount of the offer submitted under paragraph (2) by the group health plan or health insurance issuer (as applicable) and by the nonparticipating provider expressed as a percentage of the qualifying payment amount;
(iv) whether the offer selected by the certified IDR entity under paragraph (5) to be the payment applied was the offer submitted by such plan or issuer (as applicable) or by such provider and the amount of such offer so selected expressed as a percentage of the qualifying payment amount;
(v) ambulance vehicle type, including the clinical capability level of such vehicle;
(vi) the identity of the group health plan or health insurance issuer or air ambulance provider with respect to such notification;
(vii) the length of time in making each determination;
(viii) the compensation paid to the certified IDR entity with respect to the settlement or determination; and
(ix) any other information specified by the Secretary.
(C) IDR entity requirements For 2022 and each subsequent year, an IDR entity, as a condition of certification as an IDR entity, shall submit to the Secretary such information as the Secretary determines necessary for the Secretary to carry out the provisions of this paragraph.
(D) Clarification The Secretary shall ensure the public reporting under this paragraph does not contain information that would disclose privileged or confidential information of a group health plan or health insurance issuer offering group or individual health insurance coverage or of a provider or facility.
(8) Administrative fee (A) In general Each party to a determination under paragraph (5) to which an entity is selected under paragraph (4) in a year shall pay to the Secretary, at such time and in such manner as specified by the Secretary, a fee for participating in the IDR process with respect to such determination in an amount described in subparagraph (B) for such year.
(B) Amount of fee The amount described in this subparagraph for a year is an amount established by the Secretary in a manner such that the total amount of fees paid under this paragraph for such year is estimated to be equal to the amount of expenditures estimated to be made by the Secretary for such year in carrying out the IDR process.
(9) Waiver authority The Secretary may modify any deadline or other timing requirement specified under this subsection (other than the establishment date for the IDR process under paragraph (2)(A) and other than under paragraph (6)) in cases of extenuating circumstances, as specified by the Secretary, or to ensure that all claims that occur during a 90-day period applied through paragraph (5)(D), but with respect to which a notification is not permitted by reason of such paragraph to be submitted under paragraph (1)(B) during such period, are eligible for the IDR process.
(c) Definition For purposes of this section:
(1) Air ambulance services The term “air ambulance service” means medical transport by helicopter or airplane for patients.
(2) Qualifying payment amount The term “qualifying payment amount” has the meaning given such term in section 1185e(a)(3) of this title.
(3) Nonparticipating provider The term “nonparticipating provider” has the meaning given such term in section 1185e(a)(3) of this title.
(Pub. L. 93406, title I, § 717, as added Pub. L. 116260, div. BB, title I, § 105(a)(2)(A), Dec. 27, 2020, 134 Stat. 2838.)
## Notes
Editorial Notes
References in TextThe Social Security Act, referred to in subsec. (b)(5)(C)(iii), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Titles XVIII, XIX, and XXI of the Act are classified generally to subchapters XVIII (§ 1395 et seq.), XIX (§ 1396 et seq.), and XXI (§ 1397aa et seq.), respectively, of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.
Statutory Notes and Related Subsidiaries
Effective DateSection applicable with respect to plan years beginning on or after Jan. 1, 2022, see section 105(a)(4) of div. BB of Pub. L. 116260, set out as a note under section 9817 of Title 26, Internal Revenue Code.
@@ -0,0 +1,87 @@
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# 29 U.S.C. § 1185g - Continuity of care
## Text
(a) Ensuring continuity of care with respect to terminations of certain contractual relationships resulting in changes in provider network status (1) In general In the case of an individual with benefits under a group health plan or group health insurance coverage offered by a health insurance issuer and with respect to a health care provider or facility that has a contractual relationship with such plan or such issuer (as applicable) for furnishing items and services under such plan or such coverage, if, while such individual is a continuing care patient (as defined in subsection (b)) with respect to such provider or facility—
(A) such contractual relationship is terminated (as defined in paragraph (b));
(B) benefits provided under such plan or such health insurance coverage with respect to such provider or facility are terminated because of a change in the terms of the participation of the provider or facility in such plan or coverage; or
(C) a contract between such group health plan and a health insurance issuer offering health insurance coverage in connection with such plan is terminated, resulting in a loss of benefits provided under such plan with respect to such provider or facility;
the plan or issuer, respectively, shall meet the requirements of paragraph (2) with respect to such individual.
(2) Requirements The requirements of this paragraph are that the plan or issuer—
(A) notify each individual enrolled under such plan or coverage who is a continuing care patient with respect to a provider or facility at the time of a termination described in paragraph (1) affecting such provider or facility on a timely basis of such termination and such individuals right to elect continued transitional care from such provider or facility under this section;
(B) provide such individual with an opportunity to notify the plan or issuer of the individuals need for transitional care; and
(C) permit the patient to elect to continue to have benefits provided under such plan or such coverage, under the same terms and conditions as would have applied and with respect to such items and services as would have been covered under such plan or coverage had such termination not occurred, with respect to the course of treatment furnished by such provider or facility relating to such individuals status as a continuing care patient during the period beginning on the date on which the notice under subparagraph (A) is provided and ending on the earlier of—
(i) the 90-day period beginning on such date; or
(ii) the date on which such individual is no longer a continuing care patient with respect to such provider or facility.
(b) Definitions In this section:
(1) Continuing care patient The term “continuing care patient” means an individual who, with respect to a provider or facility—
(A) is undergoing a course of treatment for a serious and complex condition from the provider or facility;
(B) is undergoing a course of institutional or inpatient care from the provider or facility;
(C) is scheduled to undergo nonelective surgery from the provide or facility, including receipt of postoperative care from such provider or facility with respect to such a surgery;
(D) is pregnant and undergoing a course of treatment for the pregnancy from the provider or facility; or
(E) is or was determined to be terminally ill (as determined under section 1395x(dd)(3)(A) of title 42) and is receiving treatment for such illness from such provider or facility.
(2) Serious and complex condition The term “serious and complex condition” means, with respect to a participant or beneficiary under a group health plan or group health insurance coverage—
(A) in the case of an acute illness, a condition that is serious enough to require specialized medical treatment to avoid the reasonable possibility of death or permanent harm; or
(B) in the case of a chronic illness or condition, a condition that—
(i) is life-threatening, degenerative, potentially disabling, or congenital; and
(ii) requires specialized medical care over a prolonged period of time.
(3) Terminated The term “terminated” includes, with respect to a contract, the expiration or nonrenewal of the contract, but does not include a termination of the contract for failure to meet applicable quality standards or for fraud.
(Pub. L. 93406, title I, § 718, as added Pub. L. 116260, div. BB, title I, § 113(c)(1), Dec. 27, 2020, 134 Stat. 2871.)
## Notes
Statutory Notes and Related Subsidiaries
Effective DateSection applicable with respect to plan years beginning on or after Jan. 1, 2022, see section 113(e) of div. BB of Pub. L. 116260, set out as a note under section 9818 of Title 26, Internal Revenue Code.
@@ -0,0 +1,41 @@
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# 29 U.S.C. § 1185h - Maintenance of price comparison tool
## Text
A group health plan or a health insurance issuer offering group health insurance coverage shall offer price comparison guidance by telephone and make available on the Internet website of the plan or issuer a price comparison tool that (to the extent practicable) allows an individual enrolled under such plan or coverage, with respect to such plan year, such geographic region, and participating providers with respect to such plan or coverage, to compare the amount of cost-sharing that the individual would be responsible for paying under such plan or coverage with respect to the furnishing of a specific item or service by any such provider.
(Pub. L. 93406, title I, § 719, as added Pub. L. 116260, div. BB, title I, § 114(c)(1), Dec. 27, 2020, 134 Stat. 2874.)
## Notes
Statutory Notes and Related Subsidiaries
Effective DateSection applicable with respect to plan years beginning on or after Jan. 1, 2022, see section 114(d) of div. BB of Pub. L. 116260, set out as a note under section 9819 of Title 26, Internal Revenue Code.
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# 29 U.S.C. § 1185i - Protecting patients and improving the accuracy of provider directory information
## Text
(a) Provider directory information requirements (1) In general For plan years beginning on or after January 1, 2022, each group health plan and health insurance issuer offering group health insurance coverage shall—
(A) establish the verification process described in paragraph (2);
(B) establish the response protocol described in paragraph (3);
(C) establish the database described in paragraph (4); and
(D) include in any directory (other than the database described in subparagraph (C)) containing provider directory information with respect to such plan or such coverage the information described in paragraph (5).
(2) Verification process The verification process described in this paragraph is, with respect to a group health plan or a health insurance issuer offering group health insurance coverage, a process—
(A) under which, not less frequently than once every 90 days, such plan or such issuer (as applicable) verifies and updates the provider directory information included on the database described in paragraph (4) of such plan or issuer of each health care provider and health care facility included in such database;
(B) that establishes a procedure for the removal of such a provider or facility with respect to which such plan or issuer has been unable to verify such information during a period specified by the plan or issuer; and
(C) that provides for the update of such database within 2 business days of such plan or issuer receiving from such a provider or facility information pursuant to section 300gg139 of title 42.
(3) Response protocol The response protocol described in this paragraph is, in the case of an individual enrolled under a group health plan or group health insurance coverage offered by a health insurance issuer who requests information through a telephone call or electronic, web-based, or Internet-based means on whether a health care provider or health care facility has a contractual relationship to furnish items and services under such plan or such coverage, a protocol under which such plan or such issuer (as applicable), in the case such request is made through a telephone call—
(A) responds to such individual as soon as practicable and in no case later than 1 business day after such call is received, through a written electronic or print (as requested by such individual) communication; and
(B) retains such communication in such individuals file for at least 2 years following such response.
(4) Database The database described in this paragraph is, with respect to a group health plan or health insurance issuer offering group health insurance coverage, a database on the public website of such plan or issuer that contains—
(A) a list of each health care provider and health care facility with which such plan or such issuer has a direct or indirect contractual relationship for furnishing items and services under such plan or such coverage; and
(B) provider directory information with respect to each such provider and facility.
(5) Information The information described in this paragraph is, with respect to a print directory containing provider directory information with respect to a group health plan or group health insurance coverage offered by a health insurance issuer, a notification that such information contained in such directory was accurate as of the date of publication of such directory and that an individual enrolled under such plan or such coverage should consult the database described in paragraph (4) with respect to such plan or such coverage or contact such plan or the issuer of such coverage to obtain the most current provider directory information with respect to such plan or such coverage.
(6) Definition For purposes of this subsection, the term “provider directory information” includes, with respect to a group health plan and a health insurance issuer offering group health insurance coverage, the name, address, specialty, telephone number, and digital contact information of each health care provider or health care facility with which such plan or such issuer has a contractual relationship for furnishing items and services under such plan or such coverage.
(7) Rule of construction Nothing in this section shall be construed to preempt any provision of State law relating to health care provider directories, to the extent such State law applies to such plan, coverage, or issuer, subject to section 1144 of this title.
(b) Cost-sharing for services provided based on reliance on incorrect provider network information (1) In general For plan years beginning on or after January 1, 2022, in the case of an item or service furnished to a participant or beneficiary of a group health plan or group health insurance coverage offered by a health insurance issuer by a nonparticipating provider or a nonparticipating facility, if such item or service would otherwise be covered under such plan or coverage if furnished by a participating provider or participating facility and if either of the criteria described in paragraph (2) applies with respect to such participant or beneficiary and item or service, the plan or coverage—
(A) shall not impose on such participant or beneficiary a cost-sharing amount for such item or service so furnished that is greater than the cost-sharing amount that would apply under such plan or coverage had such item or service been furnished by a participating provider; and
(B) shall apply the deductible or out-of-pocket maximum, if any, that would apply if such services were furnished by a participating provider or a participating facility.
(2) Criteria described For purposes of paragraph (1), the criteria described in this paragraph, with respect to an item or service furnished to a participant or beneficiary of a group health plan or group health insurance coverage offered by a health insurance issuer by a nonparticipating provider or a nonparticipating facility, are the following:
(A) The participant or beneficiary received through a database, provider directory, or response protocol described in subsection (a) information with respect to such item and service to be furnished and such information provided that the provider was a participating provider or facility was a participating facility, with respect to the plan for furnishing such item or service.
(B) The information was not provided, in accordance with subsection (a), to the participant or beneficiary and the participant or beneficiary requested through the response protocol described in subsection (a)(3) of the plan or coverage information on whether the provider was a participating provider or facility was a participating facility with respect to the plan for furnishing such item or service and was informed through such protocol that the provider was such a participating provider or facility was such a participating facility.
(c) Disclosure on patient protections against balance billing For plan years beginning on or after January 1, 2022, each group health plan and health insurance issuer offering group health insurance coverage shall make publicly available, post on a public website of such plan or issuer, and include on each explanation of benefits for an item or service with respect to which the requirements under section 1185e of this title applies—
(1) information in plain language on—
(A) the requirements and prohibitions applied under sections 300gg131 and 300gg132 of title 42 (relating to prohibitions on balance billing in certain circumstances);
(B) if provided for under applicable State law, any other requirements on providers and facilities regarding the amounts such providers and facilities may, with respect to an item or service, charge a participant or beneficiary of such plan or coverage with respect to which such a provider or facility does not have a contractual relationship for furnishing such item or service under the plan or coverage after receiving payment from the plan or coverage for such item or service and any applicable cost sharing payment from such participant or beneficiary; and
(C) the requirements applied under section 1185e of this title; and
(2) information on contacting appropriate State and Federal agencies in the case that an individual believes that such a provider or facility has violated any requirement described in paragraph (1) with respect to such individual.
(Pub. L. 93406, title I, § 720, as added Pub. L. 116260, div. BB, title I, § 116(b), Dec. 27, 2020, 134 Stat. 2881.)
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# 29 U.S.C. § 1185k - Other patient protections
## Text
(a) Choice of health care professional If a group health plan, or a health insurance issuer offering group health insurance coverage, requires or provides for designation by a participant or beneficiary of a participating primary care provider, then the plan or issuer shall permit each participant and beneficiary to designate any participating primary care provider who is available to accept such individual.
(b) Access to pediatric care (1) Pediatric care In the case of a person who has a child who is a participant or beneficiary under a group health plan, or group health insurance coverage offered by a health insurance issuer, if the plan or issuer requires or provides for the designation of a participating primary care provider for the child, the plan or issuer shall permit such person to designate a physician (allopathic or osteopathic) who specializes in pediatrics as the childs primary care provider if such provider participates in the network of the plan or issuer.
(2) Construction Nothing in paragraph (1) shall be construed to waive any exclusions of coverage under the terms and conditions of the plan or health insurance coverage with respect to coverage of pediatric care.
(c) Patient access to obstetrical and gynecological care (1) General rights (A) Direct access A group health plan, or health insurance issuer offering group health insurance coverage, described in paragraph (2) may not require authorization or referral by the plan, issuer, or any person (including a primary care provider described in paragraph (2)(B)) in the case of a female participant or beneficiary who seeks coverage for obstetrical or gynecological care provided by a participating health care professional who specializes in obstetrics or gynecology. Such professional shall agree to otherwise adhere to such plans or issuers policies and procedures, including procedures regarding referrals and obtaining prior authorization and providing services pursuant to a treatment plan (if any) approved by the plan or issuer.
(B) Obstetrical and gynecological care A group health plan or health insurance issuer described in paragraph (2) shall treat the provision of obstetrical and gynecological care, and the ordering of related obstetrical and gynecological items and services, pursuant to the direct access described under subparagraph (A), by a participating health care professional who specializes in obstetrics or gynecology as the authorization of the primary care provider.
(2) Application of paragraph A group health plan, or health insurance issuer offering group health insurance coverage, described in this paragraph is a group health plan or coverage that—
(A) provides coverage for obstetric or gynecologic care; and
(B) requires the designation by a participant or beneficiary of a participating primary care provider.
(3) Construction Nothing in paragraph (1) shall be construed to—
(A) waive any exclusions of coverage under the terms and conditions of the plan or health insurance coverage with respect to coverage of obstetrical or gynecological care; or
(B) preclude the group health plan or health insurance issuer involved from requiring that the obstetrical or gynecological provider notify the primary care health care professional or the plan or issuer of treatment decisions.
(Pub. L. 93406, title I, § 722, as added Pub. L. 116260, div. BB, title I, § 102(b)(2), Dec. 27, 2020, 134 Stat. 2783.)
## Notes
Statutory Notes and Related Subsidiaries
Effective DateSection applicable with respect to plan years beginning on or after Jan. 1, 2022, see section 102(e) of div. BB of Pub. L. 116260, set out as an Effective Date of 2020 Amendment note under section 8902 of Title 5, Government Organization and Employees.
@@ -0,0 +1,61 @@
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# 29 U.S.C. § 1185l - Air ambulance report requirements
## Text
(a) In general Each group health plan and health insurance issuer offering group health insurance coverage shall submit to the Secretary, jointly with the Secretary of Health and Human Services and the Secretary of the Treasury—
(1) not later than the date that is 90 days after the last day of the first calendar year beginning on or after the date on which a final rule is promulgated pursuant to the rulemaking described in section 106(d) of the No Surprises Act, the information described in subsection (b) with respect to such plan year; and
(2) not later than the date that is 90 days after the last day of the plan year immediately succeeding the calendar year described in paragraph (1), such information with respect to such immediately succeeding plan year.
(b) Information described For purposes of subsection (a), information described in this subsection, with respect to a group health plan or a health insurance issuer offering group health insurance coverage, is each of the following:
(1) Claims data for air ambulance services furnished by providers of such services, disaggregated by each of the following factors:
(A) Whether such services were furnished on an emergent or nonemergent basis.
(B) Whether the provider of such services is part of a hospital-owned or sponsored program, municipality-sponsored program, hospital independent partnership (hybrid) program, independent program, or tribally operated program in Alaska.
(C) Whether the transport in which the services were furnished originated in a rural or urban area.
(D) The type of aircraft (such as rotor transport or fixed wing transport) used to furnish such services.
(E) Whether the provider of such services has a contract with the plan or issuer, as applicable, to furnish such services under the plan or coverage, respectively.
(2) Such other information regarding providers of air ambulance services as the Secretary may specify.
(Pub. L. 93406, title I, § 723, as added Pub. L. 116260, div. BB, title I, § 106(b)(2)(A), Dec. 27, 2020, 134 Stat. 2853.)
## Notes
Editorial Notes
References in TextSection 106(d) of the No Surprises Act, referred to in subsec. (a)(1), is section 106(d) of div. BB of Pub. L. 116260, which is set out as a note under section 300gg118 of Title 42, The Public Health and Welfare.
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# 29 U.S.C. § 1185m - Increasing transparency by removing gag clauses on price and quality information
## Text
(a) 11 So in original. There is no subsec. (b). Increasing price and quality transparency for plan sponsors and consumers (1) In general A group health plan (or an issuer of health insurance coverage offered in connection with such a plan) may not enter into an agreement with a health care provider, network or association of providers, third-party administrator, or other service provider offering access to a network of providers that would directly or indirectly restrict a group health plan or health insurance issuer offering such coverage from—
(A) providing provider-specific cost or quality of care information or data, through a consumer engagement tool or any other means, to referring providers, the plan sponsor, participants or beneficiaries, or individuals eligible to become participants or beneficiaries of the plan or coverage;
(B) electronically accessing de-identified claims and encounter information or data for each participant or beneficiary in the plan or coverage, upon request and consistent with the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990 [42 U.S.C. 12101 et seq.], including, on a per claim basis—
(i) financial information, such as the allowed amount, or any other claim-related financial obligations included in the provider contract;
(ii) provider information, including name and clinical designation;
(iii) service codes; or
(iv) any other data element included in claim or encounter transactions; or
(C) sharing information or data described in subparagraph (A) or (B), or directing that such data be shared, with a business associate as defined in section 160.103 of title 45, Code of Federal Regulations (or successor regulations), consistent with the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990 [42 U.S.C. 12101 et seq.].
(2) Clarification regarding public disclosure of information Nothing in paragraph (1)(A) prevents a health care provider, network or association of providers, or other service provider from placing reasonable restrictions on the public disclosure of the information described in such paragraph (1).
(3) Attestation A group health plan (or health insurance coverage offered in connection with such a plan) shall annually submit to the Secretary an attestation that such plan or issuer of such coverage is in compliance with the requirements of this subsection.
(4) Rules of construction Nothing in this section shall be construed to modify or eliminate existing privacy protections and standards under State and Federal law. Nothing in this subsection shall be construed to otherwise limit access by a group health plan, plan sponsor, or health insurance issuer to data as permitted under the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990 [42 U.S.C. 12101 et seq.].
(Pub. L. 93406, title I, § 724, as added Pub. L. 116260, div. BB, title II, § 201(b), Dec. 27, 2020, 134 Stat. 2892.)
## Notes
Editorial Notes
References in TextSection 264(c) of the Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (a)(1)(B), (C), (4), is section 264 of Pub. L. 104191, which is set out as a note under section 1320d2 of Title 42, The Public Health and Welfare. The Genetic Information Nondiscrimination Act of 2008, referred to in subsec. (a)(1)(B), (C), (4), is Pub. L. 110233, May 21, 2008, 122 Stat. 881. For complete classification of this Act to the Code, see Short Title note set out under section 2000ff of Title 42, The Public Health and Welfare, and Tables. The Americans with Disabilities Act of 1990, referred to in subsec. (a)(1)(B), (C), (4), is Pub. L. 101336, July 26, 1990, 104 Stat. 327, which is classified principally to chapter 126 (§ 12101 et seq.) of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 12101 of Title 42 and Tables.
@@ -0,0 +1,83 @@
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# 29 U.S.C. § 1185n - Reporting on pharmacy benefits and drug costs
## Text
(a) In general Not later than 1 year after December 27, 2020, and not later than June 1 of each year thereafter, a group health plan (or health insurance coverage offered in connection with such a plan) shall submit to the Secretary, the Secretary of Health and Human Services, and the Secretary of the Treasury the following information with respect to the health plan or coverage in the previous plan year:
(1) The beginning and end dates of the plan year.
(2) The number of participants and beneficiaries.
(3) Each State in which the plan or coverage is offered.
(4) The 50 brand prescription drugs most frequently dispensed by pharmacies for claims paid by the plan or coverage, and the total number of paid claims for each such drug.
(5) The 50 most costly prescription drugs with respect to the plan or coverage by total annual spending, and the annual amount spent by the plan or coverage for each such drug.
(6) The 50 prescription drugs with the greatest increase in plan expenditures over the plan year preceding the plan year that is the subject of the report, and, for each such drug, the change in amounts expended by the plan or coverage in each such plan year.
(7) Total spending on health care services by such group health plan or health insurance coverage, broken down by—
(A) the type of costs, including—
(i) hospital costs;
(ii) health care provider and clinical service costs, for primary care and specialty care separately;
(iii) costs for prescription drugs; and
(iv) other medical costs, including wellness services; and
(B) spending on prescription drugs by—
(i) the health plan or coverage; and
(ii) the participants and beneficiaries.
(8) The average monthly premium—
(A) paid by employers on behalf of participants and beneficiaries, as applicable; and
(B) paid by participants and beneficiaries.
(9) Any impact on premiums by rebates, fees, and any other remuneration paid by drug manufacturers to the plan or coverage or its administrators or service providers, with respect to prescription drugs prescribed to participants or beneficiaries in the plan or coverage, including—
(A) the amounts so paid for each therapeutic class of drugs; and
(B) the amounts so paid for each of the 25 drugs that yielded the highest amount of rebates and other remuneration under the plan or coverage from drug manufacturers during the plan year.
(10) Any reduction in premiums and out-of-pocket costs associated with rebates, fees, or other remuneration described in paragraph (9).
(b) Report Not later than 18 months after the date on which the first report is required under subsection (a) and biannually thereafter, the Secretary, acting in coordination with the Inspector General of the Department of Labor, shall make available on the internet website of the Department of Labor a report on prescription drug reimbursements under group health plans (or health insurance coverage offered in connection with such a plan), prescription drug pricing trends, and the role of prescription drug costs in contributing to premium increases or decreases under such plans or coverage, aggregated in such a way as no drug or plan specific information will be made public.
(c) Privacy protections No confidential or trade secret information submitted to the Secretary under subsection (a) shall be included in the report under subsection (b).
(Pub. L. 93406, title I, § 725, as added Pub. L. 116260, div. BB, title II, § 204(b), Dec. 27, 2020, 134 Stat. 2919.)

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