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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.
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.
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.
HIPAA applies to healthcare providers, health plans, and healthcare clearinghouses, as well as to their business associates, who handle or process protected health information (PHI) on their behalf.
For HIPAA purposes, health plans include: Health insurance companies. HMOs, or health maintenance organizations. Employer-sponsored health plans. Government programs that pay for health care, like Medicare, Medicaid, and military and veterans' health programs.
The HIPAA Privacy Rule regulates the use and disclosure of protected health information (PHI) by "covered entities." These entities include health care clearinghouses, health insurers, employer-sponsored health plans, and medical providers.
Who Must Follow These Laws. We call the entities that must follow the HIPAA regulations "covered entities." Covered entities include: Health Plans, including health insurance companies, HMOs, company health plans, and certain government programs that pay for health care, such as Medicare and Medicaid.