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[Billing Codes: 4120-01-P; 4830-01-P; 4510-29-P] - page 15 / 83





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treated as a material modification to the plan, except that the summary description of the

modification must be provided by not later than 60 days after the first day of the first plan year in

which the requirements apply. NMHPA also amended both the group and individual market

provisions of title XXVII of the PHS Act to apply the ERISA notice requirement to certain

entities not otherwise subject to ERISA.

The Department of Labor published interim regulations implementing section 711(d) of

ERISA on April 8, 1997 (62 FR 16979), issued separately from the HIPAA regulations published

on the same date.

Section 2704(d) of the PHS Act requires nonfederal governmental plans to comply with

the notice requirement contained in section 711(d) of ERISA as if that section applied to the plan.

Similarly, section 2751(b) of the PHS Act requires a health insurance issuer in the individual

market to comply with the notice requirement in section 711(d) of ERISA as if that section

applied to the issuer and as if the issuer were a group health plan.

The NMHPA interim rules published today include the notice provisions applicable under

the PHS Act. They are based on the requirements contained in the Department of Labor’s

original notice regulations, but have been adapted for two reasons. First, changes were made to

accommodate the Departments’ interpretations of NMHPA’s substantive requirements as

contained in these interim rules. A revision of the notice provisions applicable to plans subject to

ERISA recently was published in the Federal Register in order to accommodate these

interpretations. 63 FR 48372 (September 9, 1998). Second, the statute provides that covered

individuals in both the individual and group markets (in group health plans subject to either

ERISA or the PHS Act) be notified of their rights under NMHPA. While there are fundamental


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