Hipaa Cobra
hipaa cobra
What are the essential differences between COBRA and HIPAA?
“JFAD” gave some good information about the two, but here’s more:
1) COBRA is a federal law (mirrored by some states) that enables a person to continue their group coverage although they’ve lost eligibility due to a “qualifying event.” HIPAA is a group of federal laws, one of which contains a “portability provision.” This provision enables a person with previous group-based health coverage that hasn’t been lapsed for more than 63 days to either a) replace the coverage with another group policy (for example, moving from one employer to another and picking up the second employer’s plan); or b) obtain an individual policy after COBRA has run out from either an insurer or a state high risk pool.
2) No evidence of insurability is required to elect COBRA. A pre-existing condition exclusionary period usually won’t apply to COBRA coverage because of the length of time the person’s coverage has been in force. Under HIPAA, if a person permits their previous group-based coverage to lapse more than 63 days, a person seeking an individual policy will be medically underwritten, and the insurer may exclude conditions from coverage, or decline to cover the person; if the person is applying for group coverage, a pre-existing condition exclusionary period may be applied.
3) COBRA guarantees that you will continue to pay the group rate, plus a “processing fee;” HIPAA does not guarantee that you be given a group rate if you’re applying for an individual policy. In fact, you may be charged up to 200% of the standard rate for a non-medically underwritten individual HIPAA policy (this may vary by state).
4) COBRA is not available to employees of all employers; HIPAA applies to all persons working for all employers.
I hope this helps.
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