A federal law called the Health Insurance Portability and Accountability Act (HIPAA) made some important changes concerning health insurance in the United States. The Florida Legislature passed a law implementing these requirements. In some cases, state law alread met or excedded the new federal standards. However, HIPAA and the state law that implements it are subject to differing interpretations due to the complexity and variety of situations addressed. State laws will likely evolve to clarify and address HIPAA for many years.

In general terms, HIPAA and the state law that implements it apply to persons who have maintained continuous health care coverage but leave or move from one group to another.

In some cases, these laws apply to persons who lose individual coverage.

Portability

One of the most important changes involves ýportability,ý or allowing yout time under previous coverage to reduce any waiting period for a pre-existing condition under a new group plan you want to join. The law also limits these waiting periods to 12 months for a new employee joining the plan or 18 months if an employee decides to join the plan at a later date.

Credit for previous coverage

The law will also effect any person who changes health insurance policies.

Your insurance company or employer plan will now provicde a ýCertificate of Previous Coverageý when you leave a major medical or comprehensive health plan. This certificate will includde a statement of how long you and any dependents were insured. It will also explain to your new employer or company the range of benefits and coverage you had under that plan or policy.

You may have had health plan benefits for the most recent 12 months from either a group plan or an individual insurance policy. In either cae, your previous coverage will generally reduce an waiting period for a pre-existing condition if you apply for a new group plan within 63 days.

Pre-existing conditions

Florida law has already addressed many of the federal changes for pre-existing conditions. For example, it limits waiting periods for pre-existing conditinos to 12 to 18 months depending upon when you join a group plan.

Our state law includes one important change in that insurers may not consider pregnancy a pre-existing medical condition. This means a pregnant woman who changes jobs and jjoins a new group plan does not have to fulfill a waiting period for her condition.

Leaving a group health plan

Under current law, your employer (of 20 or more people) or insurer must offer you ýCOBRAý insurance when you leave group coverage. COBRA refers to a Consolidated Omnibus Budget Reconciliation Act passed by the federal government. In general, this nsurance will last for 18 months.

COBRA coverage allows the individual or family member to conitinue the benefits of the group plan at a higher premium cost.

Your choice to continue a COBRA policy has become important because of another change in state and federal insurance laws. This change creates new oppotunities to continue major medical health insurance when you leave a group plan. It affects persons who leave a gropu under an individual and/or family health insurance policy.