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LegalText 29 U.S.C. § 1164 Applicable premium us united_states_code code_section 29 LABOR 18 EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM 1164 29 U.S.C. § 1164 current 119-100 2026-06-26 official https://uscode.house.gov/download/releasepoints/us/pl/119/100/xml_usc29@119-100.zip /us/usc/t29/s1164 data/legal/raw/us/code/title-29/usc29.xml 001a7f3e43974631d01ea8ec81a4d7da6ca26229a59440a326db3c039be2e0e3 123f65eaf0f6719b01d66f4a47cd03d5134b66fbd92ae96d7387b67454b98476 29ce77d243e71ae2d105ab687aa2bd00a6d092da4328e22a28614e3f9347c39e 2026-07-04 official
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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.)