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[Billing Codes: 4120-01-P; 4830-01-P; 4510-29-P] - page 16 / 83





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differences in the types of entities regulated under ERISA as compared to the PHS Act, and in the

structure of the two Acts, the Departments are coordinating their work on these two regulations

to ensure that affected individuals will receive the same disclosure of rights, adapted as

appropriate to take into account the different contexts.

Substance of the PHS Act notice requirements — In the group market. Section 2704 of

the PHS Act applies the NMHPA requirements to group health plans that are subject to the group

market provisions of Part A of Title XXVII of the PHS Act. The only group health plans that

are subject to the PHS Act are nonfederal governmental plans, which are not directly subject to

any ERISA requirements. In addition, these plans may elect to be exempt from most of the

requirements of Title XXVII, including the NMHPA requirements, with respect to self-insured

benefits. Section 2704(d) states that a group health plan subject to the PHS Act “shall comply

with the notice requirement under section 711(d) of [ERISA] with respect to the requirements of

this section as if such section applied to such plan.”

These interim rules interpret section 2704(d) of the PHS Act to require that nonfederal

governmental plans that provide benefits for hospital lengths of stay in connection with childbirth,

and that are subject to the NMHPA requirements, provide participants and beneficiaries with a

statement describing those requirements. The statement must be included in the plan document

that provides a description of plan benefits to participants and beneficiaries and must be furnished

to participants and beneficiaries not later than 60 days after the first day of the first plan year

beginning on or after the effective date of these interim rules.9 The interim rules set forth the

9 Although the specific requirements of these interim rules therefore apply for plan years beginning on or after January 1, 1999, the underlying statutory requirement went into effect for plan years beginning on or after January 1, 1998, the effective date of NMHPA.


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