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Determining Compliance with the WHCRA Provisions in Part 7 of ERISA

Incentive Provisions

Does the plan comply with WHCRA by not providing impermissible incentives or penalties with respect to patients or attending providers?

A plan may not deny a patient eligibility to enroll or renew coverage solely to avoid WHCRA's requirements under ERISA section 713(c)(1).

In addition, under ERISA section 713(c)(2), a plan may not penalize or offer incentives to an attending provider to induce the provider to furnish care in a manner inconsistent with WHCRA.