experimental or not medically necessary, but only if the benefit limitation or exclusion applies uniformly to all similarly situated individuals and is not directed at individual participants based on any health factor of the participants. 45 CFR Issuer may require the satisfaction of a deductible, or other §146.121 requirement if the limit or cost-sharing requirement (b)(2)(i)(C) applies uniformly to all similarly situated individuals and is not directed at individual participants based on a health factor. In Premiums 42 U.S.C. Issuer may not require a person, as a condition of enrollment or Contributions §300gg-4 (b); continued enrollment in the plan, to pay a premium or contribution 45 CFR greater than that for a similarly situated enrollee in the plan on §146.121(c)(1) any health factor of the individual or a dependent of the individual. This includes discounts, rebates, payments in kind, and any other premium differential mechanisms. 45 CFR Plan may not adjust premium amount on genetic information of In Premiums 148.180(c)(1) the enrollee or a family member. and 45 CFR 148.180 Manifestation of a disease or disorder in one individual also Contributions (c)(2)(ii) cannot be used as genetic information about other, covered, (Cont’d) individuals.
experimental or not medically necessary, but only if the benefit limitation or exclusion applies uniformly to all similarly situated individuals and is not directed at individual participants based on any health factor of the participants. 45 CFR §146.121 (b)(2)(i)(C) Issuer may require the satisfaction of a deductible, or other requirement if the limit or cost-sharing requirement applies uniformly to all similarly situated individuals and is not directed at individual participants based on a health factor. In Premiums Contributions In Premiums and Contributions (Cont’d) 42 U.S.C. §300gg-4 (b); 45 CFR §146.121(c)(1) Issuer may not require a person, as a condition of enrollment or continued enrollment in the plan, to pay a premium or contribution greater than that for a similarly situated enrollee in the plan on any health factor of the individual or a dependent of the individual. This includes discounts, rebates, payments in kind, and any other premium differential mechanisms. 45 CFR 148.180(c)(1) Plan may not adjust premium amount on genetic information of the enrollee or a family member. 45 CFR 148.180 (c)(2)(ii) Manifestation of a disease or disorder in one individual also cannot be used as genetic information about other, covered, individuals.
cl-forms-19-hcsc-sg-analyst-checklist.docx