Health Benefits Advisor for Employers

Determining Compliance with the HIPAA Provisions in Part 7 of ERISA

Compliance with the MEWA or Multiemployer Plan Guaranteed Renewability Provisions

If the plan is a multiemployer plan, or a MEWA, does the plan provide guaranteed renewability?

• Yes
• No

Group health plans that are multiemployer plans or MEWAs may not deny an employer continued access to the same or different coverage, other than:

• For nonpayment of contributions;
• For fraud or other intentional misrepresentation by the employer;
• For noncompliance with material plan provisions;
• Because the plan is ceasing to offer coverage in a geographic area;
• In the case of a plan that offers benefits through a network plan, there is no longer any individual enrolled through the employer who lives, resides, or works in the service area of the network plan and the plan applies this paragraph uniformly without regard to the claims experience of employers or any health-related factor in relation to such individuals or dependents; or
• For failure to meet the terms of an applicable collective bargaining agreement, to renew a collective bargaining or other agreement requiring or authorizing contributions to the plan, or to employ employees covered by such agreement. See ERISA section 703.

**Note: The Public Health Service (PHS) Act contains different guaranteed renewability requirements for issuers.