Health Insurance Portability and Accountability Act (HIPAA)

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law developed to:

• improve the portability of health coverage for people who lose or change employment,
• promote administrative simplification through the use of electronic transaction, and
• ensure the security and privacy Protected Health Information (PHI).

HIPAA imposes certain requirements on group health plans as follows:

1. Limitations on pre-existing condition exclusion periods;
2. Special enrollment periods for individuals (and dependents) losing other coverage;
3. Prohibitions against discriminating against individual participants and beneficiaries based on health status;
4. Standards relating to benefits for mothers and newborns;
5. Parity in the application of certain limits to mental health benefits; and
6. Required coverage for reconstructive surgery following mastectomies.

Related links

• HIPAA Short Form – ERS Summary Notice of Privacy Practices
• HIPAA Long Form – ERS Notice of Privacy Practices
• HIPAA Policies and Procedures