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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.
When you apply for a HIPAA plan, you should provide a Certificate of Creditable Coverage from your last health plan. This is a letter that says how long you have been covered and provides proof that you have had at least 18 months of coverage.
The prescription drug coverage in a group health plan is considered creditable if its actuarial value equals or exceeds the actuarial value of standard Medicare Part D prescription drug coverage. If not, the coverage is deemed ?non-creditable.? Is Your Prescription Drug Coverage Creditable? | Consolidated consolidatedinsurance.com ? news ? 2018/10 consolidatedinsurance.com ? news ? 2018/10
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.
Health plans: Medicare, Medicaid, Medicare+Choice, and Medicare supplement insurers. Long-term care insurers (excluding nursing home fixed-indemnity policies) Employer-sponsored group health plans. Government- and church-sponsored health plans.