Group Health Notification Rules To Change July 1

June 17, 2005 at 08:00 PM
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Group Health Notification Rules To Change July 1

Group health brokers should advise clients that many will have new coverage rights notification responsibilities starting July 1.[@@]

The government put the new notification rules in regulations that deal with the health coverage portability rules in the Health Insurance Portability and Accountability Act, according to Ashley Kaplan, a Sunrise, Fla., labor law specialist.

Starting July 1, employers using non-calendar year health plans must provide a revised "certificate of creditable coverage" for any employees who are changing jobs or losing coverage for other reasons, Kaplan says in a commentary on the new rules.

"The examples in the final regulations regarding an employee's or dependant's right to enroll in a health plan upon losing other coverage may surprise some plan sponsors," Kaplan says.

Here are some other rules that take effect July 1 for most employers using non-calendar year health plans:

- The certificate of creditable coverage must include an educational statement about the individual's coverage portability and other rights under HIPAA.

- Before July 1, employers and their benefits advisors must revise all group summary plan descriptions and employee communications that define "creditable coverage." Sponsors also must review plans' administrative practices to ensure compliance with the new regulations.

- Sponsors may have to update references in plan communications materials to specific benefit waiting periods for pre-existing medical conditions.

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