U.S. Code » Title 29 » Chapter CHAPTER 18— EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM › Subchapter SUBCHAPTER I— PROTECTION OF EMPLOYEE BENEFIT RIGHTS › Subtitle Subtitle B— Regulatory Provisions › Part part 7— group health plan requirements › Subpart Subpart B— Other Requirements

29 U.S.C. § 1185d

Additional market reforms

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(a) General ruleExcept as provided in subsection (b)—(1) the provisions of part A of title XXVII of the Public Health Service Act [42 U.S.C. 300gg et seq.] (as amended by the Patient Protection and Affordable Care Act) shall apply to group health plans, and health insurance issuers providing health insurance coverage in connection with group health plans, as if included in this subpart; and(2) to the extent that any provision of this part conflicts with a provision of such part A with respect to group health plans, or health insurance issuers providing health insurance coverage in connection with group health plans, the provisions of such part A shall apply.(b) Exception

Notwithstanding subsection (a), the provisions of sections 2716 and 2718 of title XXVII of the Public Health Service Act [42 U.S.C. 300gg–16, 300gg–18] (as amended by the Patient Protection and Affordable Care Act) shall not apply with respect to self-insured group health plans, and the provisions of this part shall continue to apply to such plans as if such sections of the Public Health Service Act (as so amended) had not been enacted.

(Pub. L. 93–406, title I, § 715, as added Pub. L. 111–148, title I, § 1563(e), formerly § 1562(e), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 270, 911.)Editorial NotesReferences in Text

The Public Health Service Act, referred to in text, is act July 1, 1944, ch. 373, 58 Stat. 682. Part A of title XXVII of the Act is classified generally to part A (§ 300gg et seq.) of subchapter XXV of chapter 6A of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 201 of Title 42 and Tables.

The Patient Protection and Affordable Care Act, referred to in text, is Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 119. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of Title 42, The Public Health and Welfare, and Tables.

Codification

Pub. L. 111–148, which directed amendment of subpart B of part 7 of “subtitle A” of title I of the Employee Retirement Income Security Act of 1974 by adding this section at the end, was executed by adding this section at the end of this subpart, which is subpart B of part 7 of subtitle B of title I of the Act, to reflect the probable intent of Congress.

Notes of Decisions
Cited in 20 cases (7 in the last 5 years), 2012–2026 · leading case: Cyril Korte v. HHS, 735 F.3d 654 (7th Cir. 2013).
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Cyril Korte v. HHS, 735 F.3d 654 (7th Cir. 2013). · cites it 3× “§ 300gg-13(a); see also 29 U.S.C. § 1185d. Before promulgating regulations pursuant to this statutory directive, the HRSA sought advice from the Institute of Medicine at the National Academy of Science about what services to include in the preventive-care mandate.”
Gobeille v. Liberty Mut. Ins. Co., 136 S. Ct. 936 (2016). · cites it 2× “See 29 U. S. C. §1185d; 42 U. S. C. §§300gg–15a, 17; §18031(e)(3).”
Hobby Lobby Stores, Inc. v. Sebelius, 723 F.3d 1114 (10th Cir. 2013). · cites it 2× “§ 300gg-13; 29 U.S.C. § 1185d. One provision mandates coverage, without cost-sharing by plan participants or beneficiaries, of “preventive care and screenings” for women “as provided for in comprehensive guidelines supported by the Health Resources and Services Administration…”
New York State Psychiatric Ass'n v. Unitedhealth Grp., 980 F. Supp. 2d 527 (S.D.N.Y. 2013). · cites it 6× “See 29 U.S.C. § 1185d; 75 Fed.Reg. 43330 (July 23, 2010).”
A.Z. ex rel. Juno Therapeutics, Inc. v. Blueshield, 333 F. Supp. 3d 1069 (W.D. Wash. 2018). “§ 300gg-5(a) ; 29 U.S.C. § 1185d. See Amended Complaint at ¶¶ 2-4, 63-73, 98-103.”
King v. Blue Cross & Blue Shield of Illinois, 871 F.3d 730 (9th Cir. 2017). “” 29 U.S.C. § 1185d(a)(1) (emphasis supplied).”
Diocese of Fort Wayne-South Bend, Inc. v. Sebelius, 988 F. Supp. 2d 958 (N.D. Ind. 2013). “§ 300gg-13; 29 U.S.C. § 1185d. One provision mandates coverage, without cost-sharing by plan participants or beneficiaries, of “preventive care and screenings” for women “as provided for in comprehensive guidelines supported by the Health *961 Resources and Services…”
Schs. v. Sebelius, 988 F. Supp. 2d 935 (N.D. Ind. 2013). “§ 300gg-13; 29 U.S.C. § 1185d. One provision mandates coverage, without cost-sharing by plan participants or beneficia *940 ríes, of “preventive care and screenings” for women “as provided for in comprehensive guidelines supported by the Health Resources and Services…”
Diocese of Cheyenne v. Sebelius, 21 F. Supp. 3d 1215 (D. Wyo. 2014). “§ 300gg-13; 29 U.S.C. § 1185d). The provision of the ACA at issue here “mandates coverage, without cost-sharing by plan participants or beneficiaries, of ‘preventive care and screenings’ for women ‘as provided for in comprehensive guidelines supported by the Health Resources and…”
King v. Blue Cross & Blue Shield of Illinois, 104 F. Supp. 3d 1062 (S.D. Cal. 2015). · cites it 4× “Internal Revenue Code § 9815 is substantively identical to ERISA § 715 (29 U.S.C. § 1185d). . See 999 F.Supp.2d at 1184 ("The parties here agree that the Plan gives Aetna discretionary authority to interpret the plan’s provisions and determine factual matters of eligibility.”
Murphy Med. Assocs., LLC v. EmblemHealth, Inc. (D. Conn. 2024). · cites it 2× “§ 300gg-19a and 29 U.S.C. § 1185d(a); (3) an ERISA benefits claim, 29 U.”
Hudson Hosp. Opco, LLC v. Cigna Health & Life Ins. Co. (D.N.J. 2023). “8 Plaintiffs allege that the ACA’s cost-sharing requirements “are expressly incorporated into group health plans covered by ERISA,” citing 29 U.S.C. § 1185d(a). (Am. Compl. ¶ 52). Defendants do not contest this allegation.”
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— 29 U.S.C. § 1185d(a) — 3 cases
Murphy Med. Assocs., LLC v. EmblemHealth, Inc. (D. Conn. 2024). “§ 300gg-19a and 29 U.S.C. § 1185d(a); (3) an ERISA benefits claim, 29 U.”
Hudson Hosp. Opco, LLC v. Cigna Health & Life Ins. Co. (D.N.J. 2023). “8 Plaintiffs allege that the ACA’s cost-sharing requirements “are expressly incorporated into group health plans covered by ERISA,” citing 29 U.S.C. § 1185d(a). (Am. Compl. ¶ 52). Defendants do not contest this allegation.”
Advanced Gynecology & Laparascopy of North Jersey, P.C. v. Cigna Health & Life Ins. Co. (D.N.J. 2024).
— 29 U.S.C. § 1185d(a)(1) — 6 cases
King v. Blue Cross & Blue Shield of Illinois, 871 F.3d 730 (9th Cir. 2017). “” 29 U.S.C. § 1185d(a)(1) (emphasis supplied).”
Chirinian v. Travelers Companies, Inc., The (D. Minnesota 2025).
Artis v. GardaWorld Cash Serv. Inc. (W.D.N.C. 2025).
Bailey v. Sedgwick Claims Mgmt. Servs. Inc. (W.D. Tenn. 2025).
Plesha (E.D. Mo. 2026).
— 29 U.S.C. § 1185d(a)(2) — 1 case
King v. Blue Cross & Blue Shield of Illinois, 104 F. Supp. 3d 1062 (S.D. Cal. 2015). “Internal Revenue Code § 9815 is substantively identical to ERISA § 715 (29 U.S.C. § 1185d). . See 999 F.Supp.2d at 1184 ("The parties here agree that the Plan gives Aetna discretionary authority to interpret the plan’s provisions and determine factual matters of eligibility.”
— 29 U.S.C. § 1185d(a)(l) — 1 case
King v. Blue Cross & Blue Shield of Illinois, 104 F. Supp. 3d 1062 (S.D. Cal. 2015). “Internal Revenue Code § 9815 is substantively identical to ERISA § 715 (29 U.S.C. § 1185d). . See 999 F.Supp.2d at 1184 ("The parties here agree that the Plan gives Aetna discretionary authority to interpret the plan’s provisions and determine factual matters of eligibility.”
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