---
kind: "section"
citation: "42 U.S.C. § 300gg–42"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300gg–42"
heading: "Guaranteed renewability of individual health insurance coverage"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/300gg-42"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter XXV — Requirements Relating to Health Insurance Coverage"
  - "Part B — Individual Market Rules"
  - "Subpart 1 — portability, access, and renewability requirements"
---

# §300gg–42. Guaranteed renewability of individual health insurance coverage

- (a) **In general—** Except as provided in this section, a [health insurance issuer](/usc/42/300gg–91.md?p=b-2) that provides [individual health insurance coverage](/usc/42/300gg–91.md?p=b-5) to an individual shall renew or continue in force such coverage at the option of the individual.
- (b) **General exceptions—** A [health insurance issuer](/usc/42/300gg–91.md?p=b-2) may nonrenew or discontinue [health insurance coverage](/usc/42/300gg–91.md?p=b-1) of an individual in the [individual market](/usc/42/300gg–91.md?p=e-1-A) based only on one or more of the following:
  - (1) **Nonpayment of premiums—** The individual has failed to pay premiums or contributions in accordance with the terms of the [health insurance coverage](/usc/42/300gg–91.md?p=b-1) or the issuer has not received timely premium payments.
  - (2) **Fraud—** The individual has performed an act or practice that constitutes fraud or made an intentional misrepresentation of material fact under the terms of the coverage.
  - (3) **Termination of plan—** The issuer is ceasing to offer coverage in the [individual market](/usc/42/300gg–91.md?p=e-1-A) in accordance with [subsection (c)](#c) and applicable [State](/usc/42/201.md?p=f) law.
  - (4) **Movement outside service area—** In the case of a [health insurance issuer](/usc/42/300gg–91.md?p=b-2) that offers [health insurance coverage](/usc/42/300gg–91.md?p=b-1) in the market through a [network plan](/usc/42/300gg–91.md?p=d-10), the individual no longer resides, lives, or works in the [service](/usc/42/201.md?p=a) area (or in an area for which the issuer is authorized to do business) but only if such coverage is terminated under this paragraph uniformly without regard to any [health status-related factor](/usc/42/300gg–91.md?p=d-9) of covered individuals.
  - (5) **Association membership ceases—** In the case of [health insurance coverage](/usc/42/300gg–91.md?p=b-1) that is made available in the [individual market](/usc/42/300gg–91.md?p=e-1-A) only through one or more [bona fide associations](/usc/42/300gg–91.md?p=d-3), the membership of the individual in the association (on the basis of which the coverage is provided) ceases but only if such coverage is terminated under this paragraph uniformly without regard to any [health status-related factor](/usc/42/300gg–91.md?p=d-9) of covered individuals.
- (c) **Requirements for uniform termination of coverage—**
  - (1) **Particular type of coverage not offered—** In any case in which an issuer decides to discontinue offering a particular type of [health insurance coverage](/usc/42/300gg–91.md?p=b-1) offered in the [individual market](/usc/42/300gg–91.md?p=e-1-A), coverage of such type may be discontinued by the issuer only if—
    - (A) the issuer provides notice to each covered individual provided coverage of this type in such market of such discontinuation at least 90 days prior to the date of the discontinuation of such coverage;
    - (B) the issuer offers to each individual in the [individual market](/usc/42/300gg–91.md?p=e-1-A) provided coverage of this type, the option to purchase any other [individual health insurance coverage](/usc/42/300gg–91.md?p=b-5) currently being offered by the issuer for individuals in such market; and
    - (C) in exercising the option to discontinue coverage of this type and in offering the option of coverage under [subparagraph (B)](#c-1-B), the issuer acts uniformly without regard to any [health status-related factor](/usc/42/300gg–91.md?p=d-9) of enrolled individuals or individuals who may become eligible for such coverage.
  - (2) **Discontinuance of all coverage—**
    - (A) **In general—** Subject to subparagraph (C), in any case in which a [health insurance issuer](/usc/42/300gg–91.md?p=b-2) elects to discontinue offering all [health insurance coverage](/usc/42/300gg–91.md?p=b-1) in the [individual market](/usc/42/300gg–91.md?p=e-1-A) in a [State](/usc/42/201.md?p=f), [health insurance coverage](/usc/42/300gg–91.md?p=b-1) may be discontinued by the issuer only if—
      - (i) the issuer provides notice to the [applicable State authority](/usc/42/300gg–91.md?p=d-1) and to each individual of such discontinuation at least 180 days prior to the date of the expiration of such coverage, and
      - (ii) all health insurance issued or delivered for issuance in the [State](/usc/42/201.md?p=f) in such market are discontinued and coverage under such [health insurance coverage](/usc/42/300gg–91.md?p=b-1) in such market is not renewed.
    - (B) **Prohibition on market reentry—** In the case of a discontinuation under [subparagraph (A)](#c-2-A) in the [individual market](/usc/42/300gg–91.md?p=e-1-A), the issuer may not provide for the issuance of any [health insurance coverage](/usc/42/300gg–91.md?p=b-1) in the market and [State](/usc/42/201.md?p=f) involved during the 5-year period beginning on the date of the discontinuation of the last [health insurance coverage](/usc/42/300gg–91.md?p=b-1) not so renewed.
- (d) **Exception for uniform modification of coverage—** At the time of coverage renewal, a [health insurance issuer](/usc/42/300gg–91.md?p=b-2) may modify the [health insurance coverage](/usc/42/300gg–91.md?p=b-1) for a policy form offered to individuals in the [individual market](/usc/42/300gg–91.md?p=e-1-A) so long as such modification is consistent with [State](/usc/42/201.md?p=f) law and effective on a uniform basis among all individuals with that policy form.
- (e) **Application to coverage offered only through associations—** In applying this section in the case of [health insurance coverage](/usc/42/300gg–91.md?p=b-1) that is made available by a [health insurance issuer](/usc/42/300gg–91.md?p=b-2) in the [individual market](/usc/42/300gg–91.md?p=e-1-A) to individuals only through one or more associations, a reference to an “individual” is deemed to include a reference to such an association (of which the individual is a member).

## Source credit

(July 1, 1944, ch. 373, title XXVII, § 2742, as added Pub. L. 104–191, title I, § 111(a), Aug. 21, 1996, 110 Stat. 1982.)

## Notes

### Statutory Notes and Related Subsidiaries

### Effective Date

Section applicable with respect to health insurance coverage offered, sold, issued, renewed, in effect, or operated in the individual market after June 30, 1997, regardless of when a period of creditable coverage occurs, see section 111(b) of Pub. L. 104–191, set out as a note under section 300gg–41 of this title.