Applicability

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  1. A health benefit plan is subject to this part if it provides health benefits for small employers and if either of the following conditions is met:
    1. Any part of the premiums or benefits is paid by a small employer, or any covered individual is reimbursed, whether through wage adjustments or otherwise, by a small employer for any portion of the premium, or for which the small employer has permitted payroll deduction for the covered individual, whether or not the coverage is issued through a group or individual policy of insurance, and whether or not the small employer pays any part of the premium; or
    2. The health benefit plan is treated by the employer or any of the covered individuals as part of a plan or program for the purpose of § 106 or § 162 of the Internal Revenue Code (26 U.S.C. §§ 106 and 162).
  2. Chapter 5, part 3 of this title does not apply to individual accident and health insurance policies or contracts to the extent they are subject to this part.


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