Key Provisions of the Health Insurance Portability and Accountability Act of 1996

Medical Economics, September 23, 1996 | Go to article overview

Key Provisions of the Health Insurance Portability and Accountability Act of 1996


No group health insurer in the small-group market can exclude an employee or his dependent from coverage based on health status.

Once an insurer sells a policy, it must renew it regardless of the health status of the individual who buys it, or of any member of a group that buys it.

People who lose their group coverage when they're fired or change jobs will be able to buy new coverage as individuals. Insurers may not deny them policies because of health status.

People who've been insured for at least 12 months must be covered immediately when they join a new group health plan, regardless of pre-existing medical conditions. People qualifying for group coverage for the first time can be excluded no more than 12 months due to a pre-existing condition.

States are charged with enforcing these protections. If they don't fulfill this obligation, the Feds can step in with various fines and penalties on insurers.

For four years starting next January, firms with 50 or fewer employees and self-employed individuals can set up medical savings accounts. …

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