Under the Affordable Care Act (ACA), group health plans and issuers are prohibited from imposing pre-existing condition exclusions on any enrollees.
As a result, the requirement to provide HIPAA Certificates has been eliminated beginning Dec. 31, 2014. Thus, group health plans and issuers are not required to provide HIPAA Certificates during 2015 and later years.
Here is the supporting text from the ruling released by HHS, DOL, and the Treasury:
“54.9801-5 Evidence of creditable coverage.
(a) In general. The rules for providing certificates of creditable coverage and demonstrating creditable coverage have been superseded by the prohibition on preexisting condition exclusions. See section 2704 of the Public Health Service Act, incorporated into section 9815 of the Code, and its implementing regulations for rules prohibiting the imposition of a preexisting condition exclusion.
(b) Applicability. The provisions of this section apply beginning December 31, 2014.“
I hope that you find this compliance summary helpful. If you have any questions, please contact the CBG Benefits team at 781-759-1222.