HIPAA

Question 1

What does HIPAA stand for

Answer 1

Health Insurance Portability & Accountability Act

Question 2

HIPAA objectives

Answer 2

Enables American workers and their families to transfer and continue their health insurance coverage when they change or lose their jobs.

Question 3

HIPAA privacy rule

Answer 3

• Provides federal protection for an individual’s health information
• Gives patients rights regarding individually identifiable health information

Question 4

HIPAA Security Rule

Answer 4

Provides technical safeguards to assure the confidentiality, integrity, and availability of electronic protected health information

Question 5

HIPAA Requirements

Answer 5

• Employers with >=20 employees to allow former employees to continue benefits under the employer’s health insurance
• Healthcare providers must follow HIPAA requirements when disclosing protected health information
• A policyholder must be given notice of information practices at least every 3 years
• When an employee begins a new employment immediately after leaving the previous employer, he/she is eligible for group health insurance coverage upon hire.

Question 6

HIPAA Requirements (Continued)

Answer 6

• A group health policy renewable can be denied if an employer violated the participaton or contribution rules
• The 10% exercise tax for early withdrawal from an IRA will not apply if the withdrawal is used to cover medical expenses 10% above an individual’s adjusted gross income as of 2019.
• HIPAA limits the ability of a new employer plan to exclude coverage for pre-existing conditions

Question 7

HIPAA Application

Answer 7

• to all group health insurance plans, except
• disability income plans

Question 8

HIPAA Pre-existing Conditions - Definition

Answer 8

Health issues that existed, were treated, or diagnosed within 6 months prior to employment.

Question 9

HIPAA Pre-existing Conditions - Portability

Answer 9

• Transferring from one health plan to another.
• This usually happens due to job change or your employer switching to a new insurance company

Question 10

HIPAA Pre-existing Conditions - Portability Rules

Answer 10

Allow individuals who change from one group medical plan to another to reduce or eliminate any pre-existing conditions excluded under the new plan. So, this individual is eligible for coverage upon hire.

Question 11

Creditable coverage

Answer 11

Creditable coverage is health insurance, prescription drug, or other health benefit plan that meets a minimum set of qualifications.

Types of creditable coverage plans include group health plans, individual health plans, student health plans, as well as a variety of government-sponsored or government-provided plans.

Creditable coverage is used to determine coverage and costs associated with pre-existing conditions, and whether policyholders have to pay late enrollment penalties

The Medicare Modernization Act imposes a late enrollment penalty on individuals who do not maintain creditable coverage for a period of 63 days or longer following their initial enrollment period for the Medicare prescription drug benefit.

The 63-day period starts when one’s previous coverage ends, and ends when his/her plan/waiting period of the plan starts.