U.S. Code > Title 42 The Public Health and Welfare > CHAPTER 6A—PUBLIC HEALTH SERVICE > SUBCHAPTER XXV—REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE > Part A—Group Market Reforms > subpart 4—exclusion of plans; enforcement; preemption > § 300gg-23. Preemption; State flexibility; construction

§ 300gg-23. Preemption; State flexibility; construction

(a) Continued applicability of State law with respect to health insurance issuers
(1) In general
Subject to paragraph (2) and except as provided in subsection (b) of this section, this part and part C of this subchapter insofar as it relates to this part shall not be construed to supersede any provision of State law which establishes, implements, or continues in effect any standard or requirement solely relating to health insurance issuers in connection with group health insurance coverage except to the extent that such standard or requirement prevents the application of a requirement of this part.
(2) Continued preemption with respect to group health plans
Nothing in this part shall be construed to affect or modify the provisions of section 1144 of title 29 with respect to group health plans.
(b) Special rules in case of portability requirements
(1) In general
Subject to paragraph (2), the provisions of this part relating to health insurance coverage offered by a health insurance issuer supersede any provision of State law which establishes, implements, or continues in effect a standard or requirement applicable to imposition of a preexisting condition exclusion specifically governed by section 300gg of this title [1] which differs from the standards or requirements specified in such section.
(2) Exceptions
Only in relation to health insurance coverage offered by a health insurance issuer, the provisions of this part do not supersede any provision of State law to the extent that such provision—
(i) substitutes for the reference to “6-month period” in section 300gg (a)(1) of this title a reference to any shorter period of time;
(ii) substitutes for the reference to “12 months” and “18 months” in section 300gg (a)(2) of this title a reference to any shorter period of time;
(iii) substitutes for the references to “63” days in sections 300gg (c)(2)(A) and 300gg (d)(4)(A) [2] of this title a reference to any greater number of days;
(iv) substitutes for the reference to “30-day period” in sections 300gg (b)(2) and 300gg (d)(1) of this title a reference to any greater period;
(v) prohibits the imposition of any preexisting condition exclusion in cases not described in section 300gg (d) of this title or expands the exceptions described in such section;
(vi) requires special enrollment periods in addition to those required under section 300gg (f) of this title; or
(vii) reduces the maximum period permitted in an affiliation period under section 300gg (g)(1)(B) of this title.
(c) Rules of construction
Nothing in this part (other than section 300gg–4 of this title) shall be construed as requiring a group health plan or health insurance coverage to provide specific benefits under the terms of such plan or coverage.
(d) Definitions
For purposes of this section—
(1) State law
The term “State law” includes all laws, decisions, rules, regulations, or other State action having the effect of law, of any State. A law of the United States applicable only to the District of Columbia shall be treated as a State law rather than a law of the United States.
(2) State
The term “State” includes a State (including the Northern Mariana Islands), any political subdivisions of a State or such Islands, or any agency or instrumentality of either.

[1] See References in Text note below.

[2] So in original. Probably should be “300gg(d)(4)”.