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COBRA & HIPAA

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     The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers with 20 or more employees to continue to provide health insurance for employees (and covered spouses and dependents) who would otherwise lose their health insurance due to a qualifying event.

     Qualified beneficiaries can choose to continue employer-provided health coverage for up to 18 or 36 months, depending on the type of event that caused the employee to lose coverage. Events that are "qualifying events" for COBRA purposes include a termination of employment or reduction in hours, divorce or separation, death, entitlement to Medicare and losing dependent status under the plan.

     As of October 1, 1997, Connecticut law requires all group health insurance plans (regardless of the number of individuals covered) to include continuation coverage provisions virtually identical to COBRA. As a result, employers of fewer than 20 employees that have group health insurance have the same continuation obligations that larger employers have under the federal COBRA.

     Under the Health Insurance Portability and Accountability Act (HIPAA), group health plans and insurers are required to furnish a statement of prior health coverage, commonly referred to as a "certificate of coverage," to provide documentation of the individual’s prior creditable coverage.

For more information on COBRA and HIPAA, click on the following topics:

• Article: This COBRA can bite: Plan administrators need to be aware of COBRA's new notice requirements
• Article: New continuation-of-coverage law is broader than it appears (December 2003)
• Summary of COBRA Continuation Coverage*
• Article: IRS ruling: Spouse dropped from coverage gets COBRA after divorce
  
• Article: Are you covered under HIPAA?
• Article: The HIPAA Nightmare: A legal perspective for the health-care employer
• Article: HIPAA privacy rules and workers' compensation
• The U.S. departments of Treasury, Labor, and Health and Human Services have issued final regulations regarding health coverage portability requirements under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Click here for the final rules. (PDF document, Dec. 2004)
  
• Frequently asked questions about HIPAA (Source: United States Health Department Web site)
• HIPAA Forms
• Employer Information Concerning HIPAA (HCFA Web site)
• Frequently Asked Questions*
• U.S. Department of Labor COBRA & HIPAA Publications:
  These publications are is available to you in PDF format. PDF format allows you to view your form electronically on most computers. The freely available Adobe Acrobat reader is required to view and print PDF files. 
  • Health Plans & Benefits
  • Questions & Answers: Recent Changes in Health Care Law   This publication covers HIPAA, as well as the Mental Health Parity Act of 1996, the Newborns’ and Mothers’ Health Protection Act of 1996, and the Women’s Health and Cancer Rights Act of 1998. (This is a pdf document. It is 88 pages long.)

CBIA now offers COBRA Administration services to existing Health Connections and CBIA/Aetna U.S. Healthcare customers. CBIA’s COBRA Administration program is available only to CBIA Health Connections or CBIA Aetna/U.S. Healthcare customers. Because we already have and maintain the information required to administer your health insurance plans, we can offer you a cost-effective COBRA administration program that will take care of the many details required to stay in compliance with both federal and state laws. For more information click here.

© 2003 Connecticut Business & Industry Association (CBIA). All rights reserved.

The articles, forms and other materials available through this Web site are for informational purposes only. They are not intended as legal advice or as a solution to an individual problem. You are encouraged to consult with appropriate legal counsel prior to relying on the materials in whole or in part.