Is there another way that a group health plan or issuer can credit coverage under HIPAA?
Yes. A plan or issuer may elect the alternative method for crediting coverage for all employees. Under the alternative method of counting creditable coverage, the plan or issuer determines the amount of an individual’s creditable coverage for any of the five specified categories of benefits. Those categories are mental health, substance abuse treatment, prescription drugs, dental care and vision care. The standard method is used to determine an individual’s creditable coverage for benefits that are not within any of the five categories that a plan or issuer may use. (The plan or issuer may use some or all of these categories.) When using the alternative method, the plan or issuer looks to see is an individual has coverage within a category of benefits (regardless of the specific level of benefits provided within that category). For example, if an individual who is a regular enrollee (not a late enrollee) has 12 months of creditable coverage, but coverage for only 6 of those months prov
Yes, a plan or issuer may elect the “alternative method” for crediting coverage for all employees. Under the alternative method of counting creditable coverage, the plan or issuer determines the amount of an individual’s creditable coverage for any of the five specified categories of benefits. Those categories are mental health, substance abuse treatment, prescription drugs, dental care and vision care. The standard method (described above) is used to determine an individual’s creditable coverage for benefits that are not within any of the five categories that a plan or issuer may use. (The plan or issuer may use some or all of these categories.) When using the alternative method, the plan or issuer looks to see if an individual has coverage within a category of benefits (regardless of the specific level of benefits provided within that category). For example, if an individual has 12 months of creditable coverage, but coverage for only 6 of those months provided benefits for dental car
Related Questions
- Is a health insurance issuer or HMO who provides health insurance or health coverage to a group health plan a business associate of the group health plan?
- Can an employer or group choose not to offer coverage to qualified dependents through their health plan?
- Is there another way that a group health plan or issuer can credit coverage under HIPAA?
