Tennessee Certificate of Group Health Plan Coverage with Statement of HIPAA Portability Rights

State:
Multi-State
Control #:
US-AHI-010
Format:
Word; 
Rich Text
Instant download

Description

This AHI form is a certificate of group health plan coverage. This form is evidence that the employee is covered under the group health care plan.
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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

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.

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.

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.

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.

As a recap, all plans that self-insure, have fewer than 50 participants and are internally administered, are exempt from the privacy rule.

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.

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.

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Tennessee Certificate of Group Health Plan Coverage with Statement of HIPAA Portability Rights