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...r Building Maintenance COBRA vendors Coffee service Co...s for individual clients. Phaze II Consulting can advise you on the compliance...

...r Building Maintenance COBRA vendors Coffee service Co...ewman is the president of Phaze II Consulting, Inc. (Ft. Myers, FL), a management consulting firm for the insurance industry. Phaze II Consulting is the owner of the Master Agenc...

... in the nongroup market will be required to offer individual coverage to all eligible individuals moving from group to individual coverage. To be eligible for this guarantee, the individual: must have been covered under one or more health plans for coverage; must not be eligible for group health coverage; must not have lost group coverage due to nonpayment of premiums or fraud; and if eligible for continuation coverage under COBRA* or similar state programs, must have elected and exhausted this coverage. [* NOTE: Title of the Consolidated Omnibus Budget Reconciliation Act of 1985 requires employers with 20 or more employees to offer continued group health insurance coverage to employees and their dependents after certain events, including job termination or death of the worker. The employer is not required to pay for this coverage, which may last ... Act. [1 ] Former enrollees who need to document creditable coverage prior to July 1, 1996 may follow procedures established by the Secretaries of Labor, Health and Human Services, and Treasury. [2 ] Former enrollees must make written requests for certification of creditable coverage which ended between July 1, and October 1, 1996 Beth Fuchs is a specialist in social legislation. Madeline Smith is a consultant with the Congressional Research Service Education and Public Welfare Division. Login or Register (for FREE) to gain access to thousands of other great articles. Need more reasons to join? Need insurance for you, your business or your family? Get quality appointments - Save yourself a whole lot of time & money when you use our directory of carriers, wholesalers and service providers. Negotiate lucrative contracts ...

...le for continuation coverage under COBRA* or similar state programs, must have... or otherwise becomes covered under a COBRA continuation provision; after termination of COBRA coverage, if applicable; and ...

... contracts, it's subject to all of HIPAA, just as if it were an insurance company. Since your group health plan is probably a covered entity, you must determine who your business associates might be and make sure that you have signed agreements with all of them. This list identifies many vendors or others that might come in contact with your agency, particularly on premises: Benefits administrator Building Maintenance COBRA vendors Coffee service Computer maintenance Consultants Contract labor New agent Office cleaning service Offsite storage Outside auditor Outside legal Outsourced payroll service Plan vendor insurance carrier Renewal review with current agent Shredding service Telephone service or repair TPAs &# 160 PROTECTED HEALTH INFORMATION Plan documents will need to be modified if any employee of the employer that sponsors the plan receives any protected health information (PHI) from the plan, other ... eligibility verification and summary health information. One of the requirements for a group health plan to disclose PHI to a plan sponsor is the plan document, which must provide an effective mechanism for resolving issues of noncompliance' by the plan sponsor. See 45 CFR A § 164.504 (f )( 2 )( iii)(C ) . The relationship defined by HIPAA among the group health plan, the plan sponsor, a third-party administrator (TPA), and other entities can be confusing. When employees of the plan sponsor perform plan administration duties, their access to the group health plan's PHI is considered a disclosure of PHI from the plan to the plan sponsor. When employees of a TPA under contract to the plan have access to the plan's PHI, this is considered a disclosure ...