In General 45 CFR The decision whether health coverage is elected for an individual §146.121(a) (including whether the individual enrolls during special enrollment or late (3) enrollment) is not, itself, within the of any health factor. However, a plan or issuer must treat special enrollees the same as similarly situated 45 CFR individuals who are enrolled when first eligible. §146.117 Discrimination on the of a health factor prohibited - In General (Cont’d) Discrimination 42 U.S.C. Prohibited discrimination in for eligibility: §300gg-4 In Eligibility (a) May not have any rule for eligibility (including continued eligibility) of 45 Rules CFR any individual to enroll that discriminates based on any health factor §146.121 Prohibited that relates to that individual or a dependent of that individual, subject Discrimination (b)(1)(i) to the provisions below regarding how this rule applies to benefits, on the Basis of allows establishment of groups of similarly situated individuals, a Health provides for wellness programs, and permits favorable treatment of Factor individuals with adverse health factors. – Prohibited 45 C.F.R. Rules for eligibility include, but are not limited to, rules relating to— §146.121 Enrollment;
In General Discrimination on the of a health factor prohibited - In General (Cont’d) 45 CFR §146.121(a) (3) 45 CFR §146.117 The decision whether health coverage is elected for an individual (including whether the individual enrolls during special enrollment or late enrollment) is not, itself, within the of any health factor. However, a plan or issuer must treat special enrollees the same as similarly situated individuals who are enrolled when first eligible. Discrimination In Eligibility Rules Prohibited Discrimination on the Basis of a Health Factor Prohibited – 42 U.S.C. §300gg-4 (a) 45 CFR §146.121 (b)(1)(i) Prohibited discrimination in for eligibility: May not have any rule for eligibility (including continued eligibility) of any individual to enroll that discriminates based on any health factor that relates to that individual or a dependent of that individual, subject to the provisions below regarding how this rule applies to benefits, allows establishment of groups of similarly situated individuals, provides for wellness programs, and permits favorable treatment of individuals with adverse health factors. 45 C.F.R. §146.121 Rules for eligibility include, but are not limited to, rules relating to— Enrollment;
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