EBIA Weekly Archives - HIPAA - Questions

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  1. May our plan terminate the COBRA coverage of an individual who is eligible for coverage under another group health plan?
    From the May 17, 2007 EBIA Weekly
    QUESTION: A former employee of our company is receiving COBRA coverage under our company’s major medical plan and has been making timely COBRA premium payments. Her maximum COBRA coverage period will expire in another 12 months. She has ...
  2. If different employees have different balances in their HRAs, would the HRA violate HIPAA's nondiscrimination rules?
    From the May 10, 2007 EBIA Weekly
    QUESTION: For several years our company has had an HRA with an annual maximum reimbursement amount of $1,500 for each eligible employee and a carryover feature. Different employees have had different amounts of reimbursable expenses and now have different ...
  3. Are group health plans required to allow mid-year enrollment and option changes?
    From the April 12, 2007 EBIA Weekly
    QUESTION: Our company has a major medical plan with HMO and PPO options. Employees pay their share of premiums through our cafeteria plan. An employee who has been covered under the HMO option recently got married. She wants to drop ...
  4. Can we fire an employee who defrauded our health plan?
    From the March 15, 2007 EBIA Weekly
    QUESTION: We have a self-funded group health plan, and those of us here in the HR department handle plan functions as well as employment-related functions. We discovered that one of our employees submitted fraudulent claims to the plan. ...
  5. Can our group health plan's HIPAA notice of availability be provided electronically?
    From the February 08, 2007 EBIA Weekly
    QUESTION: We’re preparing our group health plan’s notice of availability (the notification that the HIPAA notice of privacy practices is available and how to obtain a copy). It would save us time and money if we ...
  6. Can we destroy the paper records for our ERISA plans and retain our records in electronic form?
    From the October 12, 2006 EBIA Weekly
    Please see this related Question of the Week: http://www.ebia.com/WeeklyArchives/401k/Questions/19741. QUESTION: Our company is the designated plan administrator of our employee benefit plans. We have run out of storage space for paper records in ...
  7. To reduce costs, can our self-funded group health plan exclude coverage for injuries resulting from misuse of alcohol or illegal drugs?
    From the September 14, 2006 EBIA Weekly
    QUESTION: Last year one of our employees was in a bad automobile accident and incurred huge hospital bills. He was driving, and his blood alcohol level was over the legal limit. We’re reviewing our plan for cost-saving ...
  8. What's a "hidden" preexisting condition exclusion?
    From the August 31, 2006 EBIA Weekly
    QUESTION: Our group health plan has a preexisting condition exclusion (PCE) provision that complies with the HIPAA portability regulations. However, we’ve been warned that we should examine the plan for “hidden” PCEs. What’s a ...
  9. Is an employee allowed to change from one health plan option to a different option when exercising special enrollment rights upon the birth of a baby?
    From the July 20, 2006 EBIA Weekly
    QUESTION: Our health plan offers two options—an HMO and a PPO. An employee who was enrolled in the HMO just had a new baby, and now wants to enroll the new baby and switch from the HMO to ...
  10. Are health FSAs subject to the HIPAA privacy and security rules?
    From the April 27, 2006 EBIA Weekly
    QUESTION: Our company has a fully insured major medical plan and a health FSA that we administer in-house (without a TPA). We know that the fully insured plan is subject to the HIPAA privacy and security rules, and we'...

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