[20191113]IF11359_联邦要求对选定医疗保险安排的适用性：概述.pdf

https:/crsreports.congress.gov November 13, 2019Applicability of Federal Requirements to Selected Health Coverage Arrangements: An OverviewIntroduction A majority of individuals in the United States have private health insurance coverage. In general, health plans sold in the private health insurance market (i.e., individual coverage, small- and large-group coverage, and self-insured plans) must comply with applicable federal and state health insurance requirements. The federal requirements are codified in Title XXVII of the Public Health Service Act (PHSA), Part 7 of the Employee Retirement Income Security Act of 1974 (ERISA), and Chapter 100 of the Internal Revenue Code (IRC). They relate to how coverage is offered and issued, the benefits it must cover, and how it is priced, among other issues. Such requirements include the prohibition of preexisting condition exclusions and requirements to cover certain benefits, such as maternity care. However, not all private health coverage arrangements comply with federal health insurance requirements. This includes exempted health coverage arrangements and noncompliant health coverage arrangements, as discussed below. This document provide