HIPAA Compliance

As a very brief summary, of a complex law, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 provided for the "portability" of personal insurability from one employer to another, regardless of one's health condition. Prior to HIPAA, an employee with a serious health condition moving from a previous employer could have been required to go though health screening and underwriting. Individuals moving to a new job, especially with a smaller organization, were often turned down for health coverage under the new employer's group insurance plan. Resulting in the employee being forced to stay in a job they wish to leave, or to accept restrictions and exclusions to their individual coverage under the group plan. With HIPAA, as long as there is no more than a 62-day gap in coverage (after the end of the coverage period of the old plan as either an active employee or a COBRA enrollee), any new employer's plan would have to accept the employee as if they were in perfect health. Therefore the term "portability" is utilized.

So how does an employee exercise this "portability"? The prior plan, upon coverage termination, provides the affected employee and any covered dependents with a Certificate of Coverage, which the employee submits, at the time of his/her enrollment in the new employer's plan. Providing the Certificate, or combination of Certificates, meets the minimum legal requirements, the employee will be covered at the normal group rate regardless of any pre-existing medical condition.

Under our Continuation Services menu of options, Benesyst can generate HIPAA Certificates of Coverage for any period of Continuation, if, and as needed, very inexpensively. Alternately, health plans will often generate Certificates of Coverage directly. Just be sure to specify that you wish for Benesyst to provide this service when services are discussed. For more information on HIPAA itself, go to: http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html