Utah 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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FAQ

In general, a health plan offered by an employer or employee organization that provides health coverage to employees and their families.

This certificate provides evidence of your prior health coverage. You may need to furnish this certificate if you become eligible under a group health plan that excludes coverage for certain medical conditions that you have before you enroll.

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.

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.

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. If you are unable to provide a Certificate of Creditable Coverage, you can talk to the health plan about other ways you can prove that you had a least 18 months of coverage.

You should receive a notice from your employer or plan around September of each year, informing you if your drug coverage is creditable. If you have not received this notice, contact your human resources department, drug plan, or benefits manager.

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.

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.

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 creditable coverage? Creditable coverage is a health insurance or health benefit plan that meets a minimum set of qualifications. Some examples include group and individual health plans, student health plans, and government-provided plans.

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