1

Is my understanding correct that HIPAA in the US defines the concept of Qualifying Life Events as a means to ensure employer sponsored health programs provide a Special Enrollment Period upon being provided proof of the Qualifying Life Event?

Is it also true then that the law ensures medical coverage occurs AT the date of the Qualifying Life Event? For instance, would an employer be in violation of HIPAA if they declared that medical coverage changes would not take effect from a special enrollment period until the first of the next month as opposed to the date of the Qualifying Life Event?

If the above two are true then would HR at a company be incorrect to say that the Qualifying Life Event of losing your health insurance coverage where you are a dependent on a spouses employer sponsored health program is NOT a Qualified Life Event because the spouse still has the COBRA option?

1 Answer 1

1

Is my understanding correct that HIPAA in the US defines the concept of Qualifying Life Events as a means to ensure employer sponsored health programs provide a Special Enrollment Period upon being provided proof of the Qualifying Life Event?

Yes. If the employer is notified within 30 days of the event. ("The employee or dependent must request enrollment within 30 days after losing eligibility for coverage or after a marriage, birth, adoption, or placement for adoption.")

Is it also true then that the law ensures medical coverage occurs AT the date of the Qualifying Life Event?

Yes: "Those taking advantage of special enrollment as a result of a birth, adoption, or placement for adoption begin coverage no later than the day of the event."

For instance, would an employer be in violation of HIPAA if they declared that medical coverage changes would not take effect from a special enrollment period until the first of the next month as opposed to the date of the Qualifying Life Event?

Yes.

If the above two are true then would HR at a company be incorrect to say that the Qualifying Life Event of losing your health insurance coverage where you are a dependent on a spouses employer sponsored health program is NOT a Qualified Life Event because the spouse still has the COBRA option?

Yes.

You must log in to answer this question.

Not the answer you're looking for? Browse other questions tagged .