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CFR › Title 45 › Subtitle A › Subchapter B › Part 146 › Subpart E › Section 146.160

45 CFR 146.160 - Disclosure of information.

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§ 146.160
Disclosure of information.
(a) General rule. In connection with the offering of any health insurance coverage to a small employer, a health insurance issuer is required to—
(1) Make a reasonable disclosure to the employer, as part of its solicitation and sales materials, of the availability of information described in paragraph (b) of this section; and
(2) Upon request of the employer, provide that information to the employer.
(b) Information described. Subject to paragraph (d) of this section, information that must be provided under paragraph (a)(2) of this section is information concerning the following:
(1) Provisions of coverage relating to the following:
(i) The issuer's right to change premium rates and the factors that may affect changes in premium rates.
(ii) Renewability of coverage.
(iii) Any preexisting condition exclusion, including use of the alternative method of counting creditable coverage.
(iv) Any affiliation periods applied by HMOs.
(v) The geographic areas served by HMOs.
(2) The benefits and premiums available under all health insurance coverage for which the employer is qualified, under applicable State law. See § 146.150(b) through (f) for allowable limitations on product availability.
(c) Form of information. The information must be described in language that is understandable by the average small employer, with a level of detail that is sufficient to reasonably inform small employers of their rights and obligations under the health insurance coverage. This requirement is satisfied if the issuer provides each of the following with respect to each product offered:
(1) An outline of coverage. For purposes of this section, outline of coverage means a description of benefits in summary form.
(2) The rate or rating schedule that applies to the product (with and without the preexisting condition exclusion or affiliation period).
(3) The minimum employer contribution and group participation rules that apply to any particular type of coverage.
(4) In the case of a network plan, a map or listing of counties served.
(5) Any other information required by the State.
(d) Exception. An issuer is not required to disclose any information that is proprietary and trade secret information under applicable law.
(Approved by the Office of Management and Budget under control number 0938-0702)
[62 FR 16958, Apr. 8, 1997, as amended at 62 FR 35906, July 2, 1997]

Title 45 published on 2012-10-01

no entries appear in the Federal Register after this date.

This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.

This list is taken from the Parallel Table of Authorities and Rules provided by GPO [Government Printing Office].

It is not guaranteed to be accurate or up-to-date, though we do refresh the database weekly. More limitations on accuracy are described at the GPO site.

United States Code
U.S.C. : Title 42 - THE PUBLIC HEALTH AND WELFARE

42 USC § 300gg–1 - Guaranteed availability of coverage

42 USC § 300gg–2 - Guaranteed renewability of coverage

42 USC § 300gg–3 - Prohibition of preexisting condition exclusions or other discrimination based on health status

42 USC § 300gg–4 - Prohibiting discrimination against individual participants and beneficiaries based on health status

42 USC § 300gg–5 - Non-discrimination in health care

42 USC § 300gg–11 - No lifetime or annual limits

42 USC § 300gg–12 - Prohibition on rescissions

42 USC § 300gg–13 - Coverage of preventive health services

42 USC § 300gg–14 - Extension of dependent coverage

42 USC § 300gg–15 - Development and utilization of uniform explanation of coverage documents and standardized definitions

42 USC § 300gg–15a - Provision of additional information

42 USC § 300gg–16 - Prohibition on discrimination in favor of highly compensated individuals

42 USC § 300gg–17 - Ensuring the quality of care

42 USC § 300gg–18 - Bringing down the cost of health care coverage

42 USC § 300gg–19 - Appeals process

42 USC § 300gg–19a - Patient protections

42 USC § 300gg–21 - Exclusion of certain plans

42 USC § 300gg–22 - Enforcement

42 USC § 300gg–23 - Preemption; State flexibility; construction

42 USC § 300gg–91 - Definitions

42 USC § 300gg–92 - Regulations

Public Laws

105-277

Title 45 published on 2012-10-01

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 45 CFR 146 after this date.

  • 2013-03-21; vol. 78 # 55 - Thursday, March 21, 2013
    1. 78 FR 17313 - Ninety-Day Waiting Period Limitation and Technical Amendments to Certain Health Coverage Requirements Under the Affordable Care Act
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, DEPARTMENT OF LABOR, DEPARTMENT OF THE TREASURY, Internal Revenue Service, Employee Benefits Security Administration
      Proposed rules.
      Comments are due on or before May 20, 2013.
      26 CFR Part 54