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InformationYou Need to Know
FULL-TIME AND PART-TIME (30 OR OR MORE HOURS PER WEEK)
Summary of Benefits and Coverage
HIPAA
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) impacts group health plans by improving the availability and portability of health coverage HIPAA
also requires that group health plan participants be given the following notice:
Notice of Special Enrollment Rights – if you are declining enrollment for yourself or or your your dependents (including your spouse) because of other health insurance coverage you may be able to enroll yourself and your your dependents in this plan if you you you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependent’s other coverage) However you you must request enrollment within 31 days after your or or your dependents’ other coverage ends (or after the the the employer stops contributing toward the the the other coverage) In addition if you have a a a a a new dependent as a a a a a result of marriage birth adoption or or placement for adoption you you you may be able to enroll yourself and your your dependents provided that you request enrollment within 31 days after the marriage birth adoption or placement for adoption To request special enrollment or or obtain more information call Employee Services at at 866-977-7378 Effective April 1
2009 as a a result of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) an an employee employee or dependent of an an employee employee who is eligible for but not enrolled in coverage under the HCSC Group Health Plan (GHP) may be permitted to enroll for coverage when certain conditions are met:
1
Termination of coverage under Medicaid or CHIP The employee or dependent is covered under a a Medicaid or or a a a a CHIP plan and coverage of the employee or or dependent is terminated for for loss of eligibility for for this coverage coverage the employee may request coverage coverage under HCSC’s GHP if the employee requests coverage no later than 60 days after the date of termination of coverage or 2 Gain of eligibility for premium assistance coverage under Medicaid or or CHIP The employee or or dependent becomes eligible for premium assistance as as to coverage under under the GHP under under Medicaid or CHIP plan if the employee requests coverage under HCSC’s GHP no later than 60 days after the date the employee or dependent is determined to be eligible for this assistance It is is is important to note that the new 60-day special enrollment period does not change the current HIPAA
portability rule which requires an employee to to provide 31 days of notice to to request coverage under the group health plan for all other special enrollments This 60-day provision is is is only applicable to the two CHIPRA conditions cited above