US Code

Public Law 119-73 (01/23/2026)

29 U.S.C. § 1167

Definitions and special rules

For purposes of this part—
(1)

Group health plan

section 213(d) of title 26section 7702B(c) of title 26section 9831(d)(2) of title 26The term “group health plan” means an employee welfare benefit plan providing medical care (as defined in ) 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 ). Such term shall not include any qualified small employer health reimbursement arrangement (as defined in ).

(2)

Covered employee

section 401(c)(1) of title 26The 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 ).

(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

section 1163(2) of this titleIn the case of a qualifying event described in , the term “qualified beneficiary” includes the covered employee.

(C)

Special rule for retirees and widows

section 1163(6) of this titleIn the case of a qualifying event described in , 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

section 414 of title 26section 106 of title 26Subsection (n) (relating to leased employees) and subsection (t) (relating to application of controlled group rules to certain employee benefits) of shall apply for purposes of this part in the same manner and to the same extent as such subsections apply for purposes of . 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 Secretary’s 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)
section 1162(2) of this title that the period of extended coverage referred to in commences with the date of the loss of coverage, and
(B)
section 1166(a)(2) of this title that the applicable notice period provided under commences with the date of the loss of coverage.

Pub. L. 93–406, title I, § 607Pub. L. 99–272, title X, § 10002(a)100 Stat. 231Pub. L. 99–509, title IX, § 9501(c)(2)100 Stat. 2077Pub. L. 99–514, title XVIII, § 1895(d)(8)100 Stat. 2940Pub. L. 100–647, title III, § 3011(b)(6)102 Stat. 3625Pub. L. 101–239, title VII103 Stat. 2432Pub. L. 104–191, title III, § 321(d)(2)110 Stat. 2058Pub. L. 114–255, div. C, title XVIII, § 18001(b)(2)130 Stat. 1344(, as added , , ; amended , , ; , (9)(A), , ; , , ; , §§ 7862(c)(2)(A), (6)(A), 7891(a)(1), (d)(2)(B)(i), , , 2433, 2445, 2446; , title IV, § 421(b)(3), , , 2088; , , .)

Editorial Notes

Amendments

Pub. L. 114–255section 9831(d)(2) of title 262016—Par. (1). inserted at end “Such term shall not include any qualified small employer health reimbursement arrangement (as defined in ).”

Pub. L. 104–191, § 321(d)(2)section 7702B(c) of title 261996—Par. (1). , 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 ).”

Pub. L. 104–191, § 421(b)(3)Par. (3)(A). , 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.”

Pub. L. 101–239, § 7891(d)(2)(B)(i)(I)1989—, inserted “and special rules” after “Definitions” in section catchline.

Pub. L. 101–239, § 7862(c)(6)(A)Pub. L. 100–647, § 3011(b)(6)Par. (1). , repealed , see 1988 Amendment note below.

Pub. L. 101–239, § 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.

Pub. L. 101–239, § 7862(c)(2)(A)section 401(c)(1) of title 26Par. (2). , substituted “the performance of services by the individual for 1 or more persons maintaining the plan (including as an employee defined in )” for “the individual’s employment or previous employment with an employer”.

Pub. L. 101–239, § 7891(d)(2)(B)(i)(II)Par. (5). , added par. (5).

Pub. L. 100–647, § 3011(b)(6)section 162(i)(2) of title 26section 162(i)(3) of title 26Pub. L. 101–239, § 7862(c)(6)(A)1988—Par. (1). , which directed amendment of par. (1) by substituting “” for “”, was repealed by .

Pub. L. 99–514, § 1895(d)(8)section 162(i)(3) of title 26, 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 ).”

Pub. L. 99–509Par. (3)(C). added subpar. (C).

Pub. L. 99–514, § 1895(d)(9)(A)Par. (4). , added par. (4).

Statutory Notes and Related Subsidiaries

Effective Date of 2016 Amendment

Pub. L. 114–255, div. C, title XVIII, § 18001(b)(3)130 Stat. 1344

section 1191b of this title“The amendments made by this subsection [amending this section and ] shall apply to plan years beginning after .”
, , , provided that:

Effective Date of 1996 Amendment

section 321(d)(2) of Pub. L. 104–191section 321(f) of Pub. L. 104–191section 7702B of Title 26Amendment by applicable to contracts issued after , see , set out as an Effective Date note under , Internal Revenue Code.

section 421(b)(3) of Pub. L. 104–191section 421(d) of Pub. L. 104–191section 4980B of Title 26Amendment by effective , regardless of whether qualifying event occurred before, on, or after such date, see set out as a note under .

Effective Date of 1989 Amendment

section 7862(c)(2)(A) of Pub. L. 101–239section 7862(c)(2)(C) of Pub. L. 101–239section 4980B of Title 26Amendment by applicable to plan years beginning after , see , set out as a note under , Internal Revenue Code.

Pub. L. 101–239, title VII, § 7862(c)(6)(B)103 Stat. 2433

section 3011(b)(6) of Pub. L. 100–647Pub. L. 100–647“Subparagraph (A) [repealing , 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 [].”
, , , provided that:

section 7891(a)(1) of Pub. L. 101–239Pub. L. 99–514section 7891(f) of Pub. L. 101–239section 1002 of this titleAmendment by effective, except as otherwise provided, as if included in the provision of the Tax Reform Act of 1986, , to which such amendment relates, see , set out as a note under .

section 7891(d)(2)(B)(i) of Pub. L. 101–239section 7891(d)(2)(C) of Pub. L. 101–239section 4980B of Title 26Amendment by applicable with respect to plan years beginning on or after , see , set out as a note under , Internal Revenue Code.

Effective Date of 1988 Amendment

Pub. L. 100–647section 162(k) of Title 26section 10001(e)(2) of Pub. L. 99–272section 3011(d) of Pub. L. 100–647section 162 of Title 26Amendment by applicable to taxable years beginning after , but not applicable to any plan for any plan year to which , Internal Revenue Code (as in effect on the day before ) did not apply by reason of , see , set out as a note under .

Effective Date of 1986 Amendments

Pub. L. 99–514, title XVIII, § 1895(d)(9)(B)100 Stat. 2940

section 1151(k) of Pub. L. 99–514section 89 of Title 26“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 , set out as an Effective Date note under ].”
, , , provided that:

section 1895(d)(8) of Pub. L. 99–514Pub. L. 99–272section 1895(e) of Pub. L. 99–514section 162 of Title 26Amendment by effective, except as otherwise provided, as if included in enactment of the Consolidated Omnibus Budget Reconciliation Act of 1985, , see , set out as a note under .

Pub. L. 99–509Pub. L. 99–272section 9501(e) of Pub. L. 99–509section 162 of Title 26Amendment by effective, except as otherwise provided, as if included in title X of the Consolidated Omnibus Budget Reconciliation Act of 1985, , see , set out as a note under .

Plan Amendments Not Required Until January 1, 1989

Pub. L. 99–514section 1140 of Pub. L. 99–514section 401 of Title 26For provisions directing that if any amendments made by subtitle A or subtitle C of title XI [§§ 1101–1147 and 1171–1177] or title XVIII [§§ 1800–1899A] of 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 , see , as amended, set out as a note under , Internal Revenue Code.