The Health Insurance Portability and Accountability Act of 1996 (HIPAA) includes provisions of Federal law governing health coverage portability, health information privacy, administrative simplification, medical savings accounts, and long-term care insurance. The responsibility of the Department of Labor and the subject of these FAQs are the law’s portability and nondiscrimination requirements. HIPAA’s provisions affect group health plan coverage in the following ways: 

• Provide certain individuals special enrollment rights in group health coverage when specific events occur, e.g., birth of a child (regardless of any open season); 
• Prohibit discrimination in group health plan eligibility, benefits, and premiums based on specific health factors; and

While HIPAA previously provided for limits with respect to preexisting condition exclusions, new protections under the Affordable Care Act now prohibit preexisting condition exclusions for plan years beginning on or after January 1, 2014. For plan years beginning on or after January 1, 2014, plans are no longer required to issue the general notice of preexisting condition exclusion and individual notice of period of preexisting condition exclusion. Plans are also no longer required to issue certificates of creditable coverage after December 31, 2014. These amendments were made because plans are prohibited from imposing preexisting condition exclusions for plan years beginning on or after January 1, 2014.                                                                                                                                                                                                                                                                                                                                                                                                                     *The information published by Catholic Benefit Plans & Catholic Benefits Law is available for informational purposes only and is not considered legal advice on any subject matter. By viewing blog and social media posts, the reader understands there is no attorney-client relationship between the reader and the blog publisher. This information should not be used as a substitute for legal advice from a licensed professional attorney, and readers are urged to consult their own legal counsel on any specific legal questions concerning a specific situation. The completeness or accuracy of a particular post may be affected by changes in the law (statutes, regulations, rulings, court decisions, etc.) that occur after the date on which a particular post is written.

Consult an employee benefits / church plan / ERISA lawyer that has experience serving the unique needs of Catholic dioceses and religious communities.