From: Health Care Reform
The Health Insurance Portability and Accountability Act (HIPAA) requires health plans to provide special enrollment opportunities for employees and their dependents outside the plans’ regular enrollment periods in certain situations. Employees and dependents may have special enrollment rights when an individual:
- Loses eligibility for other health coverage;
- Becomes a new dependent through marriage, birth, adoption or placement for adoption;
- Loses eligibility for coverage under a state Children’s Health Insurance Program (CHIP)
or Medicaid; or - Becomes eligible to receive premium assistance under CHIP or Medicaid for group
health coverage.
Special enrollees must be offered all the benefits packages available to similarly situated individuals who enroll when first eligible. Employees must receive a description of special enrollment rights on or before the date they are first offered the opportunity to enroll in the group health plan.
This checklist outlines steps for determining certain factors to assist employers in complying with HIPAA’s special enrollment rules.
Download: HIPAA Special Enrollment Checklist
