Health Insurance Portability and Accountability Act (HIPAA)

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law passed in 1996 that establishes national standards for the protection of certain health information. HIPAA includes provisions that impact employee benefits, particularly with respect to health insurance.

Key features of HIPAA that impact employee benefits include:

• Portability: HIPAA requires that group health plans and health insurance issuers provide portability of health coverage. This means that employees who lose coverage under one plan must be allowed to enroll in another plan without being subject to pre-existing condition exclusions, as long as they meet certain conditions.

• Privacy: HIPAA includes rules regarding the privacy and security of personal health information. These rules apply to all covered entities, including health plans, health care providers, and health care clearinghouses. The privacy rule limits the use and disclosure of protected health information, while the security rule establishes standards for protecting electronic health information.

• Pre-existing conditions: HIPAA limits the ability of health plans to impose pre-existing condition exclusions. Health plans may only exclude coverage for a pre-existing condition for a limited period of time (generally 12 months).

• Nondiscrimination: HIPAA prohibits discrimination based on health status by health plans and issuers of health insurance. This means that individuals cannot be denied coverage or charged more for coverage based on their health status.

• Breach notification: HIPAA requires covered entities to notify individuals and the Department of Health and Human Services in the event of a breach of unsecured protected health information.

Overall, HIPAA provides important protections for individuals' health information and ensures that individuals have access to health coverage regardless of their health status. It also establishes rules that health plans and insurers must follow to protect individuals' privacy and security.

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