HIPAA Letter

January 1, 2012

TO: All Employees Eligible for Health Insurance Benefits
FROM: Maureen M. Dennis, Director of Finance

Under a Federal law known as the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, as amended, group health plans must generally comply with the requirements listed below. However, the law also permits State and local governmental employers that sponsor health plans to elect to exempt a plan from these requirements for any part of the plan that is "self-funded" by the employer, rather than provided through a health insurance policy. The Parkway School District has elected to exempt its self funded insurance plan from the following requirements:

  1. Special enrollment periods for individuals losing other group coverage.
  2. Prohibitions against discriminating against individual participants and beneficiaries based on health status.
  3. Benefits for mother and newborns, under the Newborns' and Mothers' Protection Act of 1996.
  4. Mental health parity under the Mental Health Parity Act of 1996.
  5. Required coverage for reconstructive surgery following mastectomies.

HIPAA also requires the Plan to provide covered employees and dependents with a "certificate of creditable coverage" when they cease to be covered under the Plan. There is no exemption from this requirement. The certificate provides evidence that you were covered under this Plan, because if you can establish your prior coverage, you may be entitled to certain rights to reduce or eliminate a preexisting condition exclusion if you join another employer's health plan, or if you wish to purchase an individual health insurance policy.