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Benefit Comparison Summary: MEDICAL | DENTAL | VISION
Health Insurance Premiums: HEALTHCARE
| COBRA
COBRA | HIPAA | Care
Counsel | Employee Assistance
Program (EAP)
Eligibility | Open
Enrollment | Additional Info | Change
in Coverage
Waiver
of Coverage
Flexible Spending Accounts: Health | Dependent
Care | Transit
& Parking
Health Insurance Portability and Accountability Act (HIPAA)
The Health Insurance Portability and Accountability Act of 1996 (HIPAA
(P.L. 104-191), was enacted on August 21, 1996. HIPAA amended the Employee
Retirement Income Security Act (ERISA), the Internal Revenue Code (IRC),
and the Public Health Service Act (PHSA).
HIPAA was enacted, among other things, to “improve portability
and continuity of health care coverage in the group and individual
markets,” as stated in the Congressional Conference Report. The
law accomplishes these goals by instituting reforms in the group and
individual insurance markets, including provisions limiting the use
of preexisting condition exclusions, and requiring guaranteed access
to health care coverage and guaranteed renewability for certain groups
and individuals. There also are nondiscrimination provisions and special
enrollment rights in the statute.
The HIPAA amendments are designed to improve the availability and
portability of health coverage by:
- limiting exclusions for preexisting medical conditions; the Superior
Court does not have any pre-existing condition limitations on enrollment
in its health plans.
- providing credit for prior health coverage and
a process for transmitting certificates and other information
concerning prior
coverage to a new group
health plan
or issuer; You have the right to receive a certificate of prior
health coverage since July 1, 1996 to take to your new employer after
you
leave Santa Barbara County Superior Court employment. Your health plan will issue a
certificate after your separation. You may need to provide other
documentation
for
earlier periods
of health care
coverage. Check with your new plan administrator to see if your
new plan excludes coverage for preexisting conditions and if you
need to
provide
a certificate
or other documentation of your previous coverage.
- providing new rights
that allow individuals to enroll for health coverage when they
lose other health coverage or have a new dependent (special
enrollment
rights); Santa Barbara County Superior Court recognizes these special enrollment
rights which permit an employee (or a dependent of that employee)
who is eligible
for coverage,
but not enrolled, to enroll in the plan at a date later than
the initial enrollment period, if:
- the employee or dependent was
covered under a group health plan or had health insurance
coverage at the time coverage was previously
offered
to the employee
or individual; 9 the employee stated in writing that the other
coverage was the reason for declining enrollment (but only if the
plan
sponsor required
such a statement and provided the employee with notice of the
requirement and the consequences of the requirement at the time);
10 the
other coverage was
either COBRA coverage that was exhausted, or other health plan
coverage that was terminated as a result of loss of eligibility
for the
coverage (including
as a result of legal separation, divorce, death, termination
of employment, or reduction in the number of hours of employment)
or employer contributions
towards the coverage were terminated; 11 and the employee requests
enrollment not later than 30 days after the date of exhaustion
or termination of
the other coverage.
The special enrollment periods supplement any
regular open enrollment period otherwise available under the plan
or policy. Also, an individual
who enrolls
for coverage during a special enrollment period is not treated as a “late
enrollee,” even if the enrollment period corresponds with a regular
open enrollment period.
- prohibiting discrimination in enrollment and premiums
against employees and their dependents based on health status; Santa Barbara County Superior Court enrollment
requirements are only that an employee be in a regular County position
and
has no health
requirements.
- preserving, through narrow preemption provisions, the states' traditional
role in regulating health insurance, including state flexibility
to provide greater
protections.
Santa Barbara County Superior Court complies with all additional
State health insurance requirements.
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