For purposes of this part—
(1) **Group health plan** — The term “group health plan” means an employee welfare benefit plan providing medical care (as defined in [section 213(d) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section213/d&num=0&edition=prelim)) 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 [section 7702B(c) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section7702B/c&num=0&edition=prelim)). Such term shall not include any qualified small employer health reimbursement arrangement (as defined in [section 9831(d)(2) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section9831/d/2&num=0&edition=prelim)).
(2) **Covered employee** — The 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 [section 401(c)(1) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section401/c/1&num=0&edition=prelim)).
(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 em
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Stable record: federal_law:legal_authorities:record_usc_5c5cc9f3dcd0c0c69bc1ca2e Source file: Laws/federal/codes/united-states-code/title-29/section-1167-definitions-and-special-rules--90f25818ac.md Pages: Not recorded – Not recorded Passage SHA-256: 903cbd9bc3eb8420d7e4712cc23ea3e6d9d75e93bf3e71f4decfb2dba5ceaf21 Retained source evidence SHA-256: 733f603a25e822beb956309eed7eb9c5eb0ba23b03d320a920cc561d36454e1b
Source location: Title 29, Chapter 18, § 1167; chapter-018-employee-retirement-income-security-program.md
Stored source content
For purposes of this part—
(1) **Group health plan** — The term “group health plan” means an employee welfare benefit plan providing medical care (as defined in [section 213(d) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section213/d&num=0&edition=prelim)) 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 [section 7702B(c) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section7702B/c&num=0&edition=prelim)). Such term shall not include any qualified small employer health reimbursement arrangement (as defined in [section 9831(d)(2) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section9831/d/2&num=0&edition=prelim)).
(2) **Covered employee** — The 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 [section 401(c)(1) of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section401/c/1&num=0&edition=prelim)).
(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* — In the case of a qualifying event described in [section 1163(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1163/2&num=0&edition=prelim), the term “qualified beneficiary” includes the covered employee.
(C) *Special rule for retirees and widows* — In the case of a qualifying event described in [section 1163(6) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1163/6&num=0&edition=prelim), 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** — Subsection (n) (relating to leased employees) and subsection (t) (relating to application of controlled group rules to certain employee benefits) of [section 414 of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section414&num=0&edition=prelim) shall apply for purposes of this part in the same manner and to the same extent as such subsections apply for purposes of [section 106 of title 26](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title26-section106&num=0&edition=prelim). 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) that the period of extended coverage referred to in [section 1162(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1162/2&num=0&edition=prelim) commences with the date of the loss of coverage, and
(B) that the applicable notice period provided under [section 1166(a)(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title29-section1166/a/2&num=0&edition=prelim) commences with the date of the loss of coverage.
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Federal law — U.S. Code and appendices · legal_authorities
§ 1167. Definitions and special rules
For purposes of this part—
(1) Group health plan
The term ‘‘group health plan’’ means an em-
ployee welfare benefit plan providing medical
care (as defined in section 213(d) of title 26) to
participants
or
beneficiaries
directly
or
through insurance, reimbursement, or other-
wise. Such term shall not include any plan
substantially all of the coverage under which
is for qualified long-term care services (as de-
fined in section 7702B(c) of title 26). Such term
shall not include any qualified small employer
health reimbursement arrangement (as de-
fined in section 9831(d)(2) of title 26).
(2) Covered employee
The term ‘‘covered employee’’ means an in-
dividual who is (or was) provided coverage
under a group health plan by virtue of the per-
formance of services by the individual for 1 or
more persons maintaining the plan (including
as an employee defined in section 401(c)(1) of
title 26).
Page 565
TITLE 29—LABOR
§ 1167
(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 em-
ployee, or
(ii) as the dependent child of the em-
ployee.
Such term shall also include a child who is
born to or placed for adoption with the cov-
ered employee during the period of continu-
ation coverage under this part.
(B) Special rule for terminations and re-
duced employment
In the case of a qualifying event described
in section 1163(2) of this title, the term
‘‘qualified beneficiary’’ includes the covered
employee.
(C) Special rule for retirees and widows
In the case of a qualifying