Human Resource Blog

HIPAA vs. Company-Offered Insurance

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If we have a few employees in our Indiana company that are covered under HIPAA instead of our company insurance plan, I know that they have some individual policy rights. Can you please tell me more about them though?

Sure. Any employee is eligible for HIPAA (Health Insurance Portability and Accountability.) In order to qualify for HIPAA coverage, your employees need to either change jobs or have a preexisting condition that precludes them from being covered under the company’s insurance policy. HIPAA is in place because it often happens that when an employee has had a serious medical illness or a series of illnesses, they are not eligible to renew their insurance with the current provider, or they move on to a new company or plan that will not take the employee on.

HIPAA states that employees have the right to pursue independent health insurance when they are denied benefits through the company’s current health coverage plan. Policy regulations for employees are set forth not only for employees, but also for the other beneficiaries under an employee’s plan, such as a spouse or a child. These individual rights include the following:

Patients and dependents are allowed to inspect and copy personal health information

Policy holders are allowed to restrict disclosure of personal health information from any party, including the employer

It is the individual’s right to amend any personal health information that the employee thinks is inaccurate, such as an inaccurate diagnosis

Obtain information about when a company has disclosed a policy holder’s personal information for any purpose other than treatment, payment, or health care operations. Exceptions to this right can be made when there is disclosure made to the individual at his or her request or when disclosure has been made as a result of individual authorization

Patients are entitled to receive written notice of a plan’s policies about privacy and access to personal health care information

Your employees can sign up with HIPAA as long as they have had qualifying health insurance through the job for at least 18 months. They must also have been on COBRA and has exhausted COBRA (which has a varying level of duration depending on the individual employee and the company.)