THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996
(The "Kennedy Kassebaum Act")
INTRODUCTION
The Health Insurance Portability and Accountability Act of 1996's (HIPAA) main purpose is to insure most people who change jobs or are temporarily out of work will have greater access to health insurance. Informally known as "The Kennedy - Kassebaum Act," this federal law regulates the vast majority of group planERISA covered, self-insured plans. In addition, it provides new requirements for those companies which market "individual" insurance. The following information will summarize the main features of this law:
PROVISIONS THAT APPLY TO INSURED AND SELF-INSURED GROUP HEALTH PLAN
- Eligibilty Rules
- Limitations on pre-existing conditions
- Credit for prior health insurance (known as Creditable Coverage)
- Special enrollment periods
- Privacy guidlines
PROVISIONS THAT ONLY APPLY TO INSURED GROUP HEALTH PLANS
- Guaranteed renewability of coverage
- Guarantee issue of group insurance (only applies to small group plans with 2 - 50 employees)
- Disclosure of information by insurers (only applies to small group plans with 2 - 50 employees)
OTHER PROVISIONS AFFECTING EMPLOYER SPONSERED GROUP HEALTH PLANS
- Change in COBRA continuation law
- Change to ERISA reporting requirments
- Increase of deduction for health care costs for self employeed persons
This is just a summary of the major points of the Act. Please contact us for a more complete summary of all the provisions of HIPAA.
For answers to commonly asked questions go to www.dol.gov/ebsa/FAQs/faq_compliance_hipaa.html
For more comprehensive information go to www.hhs.gov/ocr/hipaa
For a copy of the law go to http://aspe.hhs.gov/admnsimp/pl104191.htm
Unsure how to handle HIPAA go to www.hipaa.org