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Thursday, June 20, 2013

Self–compliance Tools for Health Benefits Laws

Self–compliance Tools for Health Benefits Laws
 
There’s no denying it — numerous provisions of Health Insurance Portability and Accountability Act (HIPAA) and Affordable Care Act (ACA) are complicated and confusing. To help with this confusion, the Department of Labor (DOL) now provides two tools on its website that group health plans, plan sponsors, plan administrators, and health insurance issuers can use to test their compliance. These tools, or checklists, deal specifically with group health plan requirements (Part 7) of ERISA.
The first checklist focuses on HIPAA portability and other law provisions, such as pre–existing conditions exclusions, certificates of creditable coverage, special enrollment rights, wellness programs, and more. The questions and explanations of applicable statutes and other regulatory/administrative interpretation materials assist those involved in operating a group health plan in understanding the laws and their related responsibilities.
The second checklist focuses on ACA provisions, including a plan’s status as a "grandfathered" plan exempt from some ACA requirements, and such ACA requirements as limitations on rescission and annual and lifetime limits, and more. The various sets of questions and answers allow users to assess their plan's compliance with the ACA provisions that have already taken place, or will take place in the near future

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