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December 10, 2007 at 03:13 PM
The Employee Benefits Security Administration has issued a batch of guidance that could affect companies that sell supplemental health insurance benefits.
Daniel Maguire, director of health plan standards and compliance assistance at EBSA, an arm of the U.S. Department of Labor, has presented EBSA’s views on supplemental health in Field Assistance Bulletin Number 2007-04.
The bulletin covers the relationship between supplemental health insurance products and consumer-protection requirements in benefits laws such as the Health Insurance Portability and Accountability Act of 1996.
Federal laws and regulations exclude supplemental health insurance from provisions in HIPAA and later laws that do things such as restricting use of preexisting condition exclusions, mandating mental health parity, prohibiting discrimination based on health factors, and providing special enrollment rights for individuals who have maintained continuous “creditable coverage,” Maguire writes.
Existing regulations indicate the supplemental coverage, referred to as “similar supplemental coverage,” “must be specifically designed to fill gaps in primary coverage, such as coinsurance or deductibles,” Maguire writes.
The Labor Department has come across situations that raise concerns about whether some products marketed as supplemental coverage really qualify as such, Maguire writes.
