Massachusetts Certificate of Group Health Plan Coverage with Statement of HIPAA Portability Rights
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How to fill out Certificate Of Group Health Plan Coverage With Statement Of HIPAA Portability Rights?
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FAQ
What is a Non-Covered Entity Under HIPAA? As mentioned above, a non-covered entity is an entity that is not subject to the requirements of the HIPAA Privacy Rule. There are two types of non-covered entities under HIPAA: business associates and hybrid entities.
Group Health Plan ? The component of the employer that includes individuals who require access to other employees' PHI to perform their day-to-day job functions of administering health benefits for those employees. These individuals usually work within the human resources/employee benefits area of the employer.
HIPAA's "portability" protection means that once a person obtains creditable health plan coverage, he or she can use evidence of that coverage to reduce or eliminate any preexisting medical condition exclusion period that might otherwise be imposed when moving to another health plan.
ANSWER: A health plan with fewer than 50 participants that is administered by the sponsoring employer is excluded from the definition of a ?group health plan? under HIPAA's administrative simplification provisions, which include the privacy and security requirements.
The HIPAA certificate, also known as certificate of creditable coverage, documents the health coverage you had before you lost coverage. If you had less than 18 months of continuous coverage, the certificate includes the dates any waiting period began and when coverage began and ended.
Exceptions to the HIPAA Privacy Rule Limitations apply to uses and disclosures for the purpose of facilitating another party's activities. Exceptions are allowed for a covered entity to disclose PHI to: Any other provider (even a non-covered entity) to facilitate that provider's treatment activities.
The definition of ?group health plan? is adopted from the statutory definition at section 1171(5)(A), and excludes from the rule as ?health plans? only the few insured or self-insured ERISA plans that have less than 50 participants and are self administered.
As a recap, all plans that self-insure, have fewer than 50 participants and are internally administered, are exempt from the privacy rule.