Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Provisions of the act
Improves the availability and portability of heath insurance coverage
in both the group and individual insurance markets.
Specific requirements
Pre-existing conditions exclusions are limited and health plans
must give credit for prior periods of coverage to reduce the length
of preexisting condition exclusions. The Act prohibits the exclusion
of individuals based on their health status or medical history.
It guarantees availability and renewability of insurance coverage
for employers in the group health market, guarantees availability
of individual policies for certain previously insured individuals
under group health plans and guarantees renewability of individual
health insurance coverage.
Implications of non-conformance
Individual enforcement is available under ERISA Section 502. The
Internal Revenue Code was amended to provide for penalties of non-compliance
(starting at $100 per day, with certain penalties based on a percentage
of the cost of medical coverage capped at $500,000 for each instance
of non-compliance.)
One Or More Employees