Peter Barry's original message uses the terms plan, group plan, etc., -
appropriately, I believe. Lindsay's response uses the term employer -
inappropriately, in my opinion. HIPAA does not apply to employers, only to
health plans, clearinghouses, etc.. HIPAA also defines health plans. Thus, I
think care needs to be exercised when using terms such as plan, group health
plan, employer group health plan, and employer.

Rachel Foerster
Principal
Rachel Foerster & Associates, Ltd.
39432 North Avenue
Beach Park, IL 60099
Voice: 847-872-8070
Fax: 847-872-6860
eMail: [EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]>
http://www.rfa-edi.com


-----Original Message-----
From: Askew, Lindsay W [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, September 18, 2002 9:39 AM
To: '[EMAIL PROTECTED]'
Subject: RE: Does an insured group plan have to file extension?


If the employer in in question 4 is purchasing a fully insured plan, then it
is not a group health plan as defined by ERISA and it is not a covered
entity therefore the employer would not have to file for an extension.

If the employer has created a plan and passed some financial risk to a
vendor (ASO or TPA), the employer is still a group health plan thus a
covered entity and as such is eligible for the extension.

If the employer creates a dental plan and obtains a vendor (ASO or TPA) but
purchases a fully insured med/surg product. The employer is a group health
plan, a covered entity and is eligible for the extension.

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
Sent: Tuesday, September 17, 2002 5:35 PM
To: [EMAIL PROTECTED]
Subject: Does an insured group plan have to file extension?


Dear Transactions Group:

I was recently asked which employer sponsored group health plans should file

for the transaction extension.  The following is my analysis and a question.

I would be very interested if the analysis is wrong and if you have an
answer
to the question.

1.  An ERISA group health plan is a covered entity.

2.  A plan meeting the small health plan definition should not file for an
extension because there is no change in deadline and conceivably if they
filed they might incur the April 2003 deadline to begin testing.  They have
nothing to gain by filing.

3.  A plan that is not a small plan and that self-funds or self-insures all
or part of the plan should file for the extension.  It is dependent on its
ASO or TPA processor; so it should take steps to ensure the processor will
be
compliant by the extended deadline.

4.  But a plan that is not a small plan and that purchases all of its
coverage from a health insurance company, is it really required to file in
order to get the extension?  My reading of the rules suggests that it is so
required; however, since the insurance company is a covered entity and will
be required either to meet the 2002 deadline or file an extension for
itself,
and because the group plan is wholly dependent upon the insurance company,
it
seems unnecessary to require the group plan to file.

I would be interested in your thinking about "4" above.  Thanks.

Peter

Peter Barry
Peter T Barry Company
Independent Consulting Health Care and Information Systems
Ozaukee Bank Building
1425 West Mequon Road
Mequon Wisconsin 53092
(414) 732 5000 (national cell)
[EMAIL PROTECTED]

---------------------------
3.  The health plan definition excludes plans that are both self-funded and
self-administered.  There are some but not many.  Except, I have wondered if

a TPA self-funds and administers the plan for its employees, is its plan
excluded?  I don't know and so far the issue is not become important to me.

4.  So the plans you advise, and their need to file the extension by October

15, would appear to be:

4a.  Small group health plans under $5 million definition do not gain
anything by filing for the extension since they are not required to comply
until October 2002 anyway.  If they filed, there might be the downside to
their filing in that they might now be expected to start testing in April
2003 whereas they are currently not so required.  I think the filing would
not trigger the testing deadline, but that would be a legal question of
whether the filing or their small plan status determines.  I see no
advantage
to their filing; so I would think it best that if a plan, as of this
October,
meets the small plan definition, it is better for it not file for an
extension.

4b.  Group health plans that do not meet the small plan definition:

4b(1).  That only buys insurance and have no component that is self-funded
or
self-insured.  These plans are dependent upon their health insurance company

to comply.  The law requires the health insurance company to comply.  The
only alternative for the group plan if the insurance company did not comply
would be to change insurance companies.  So it seems absurd to require these

group plans to file for an extension.  Yet I have so far found nothing
except
the absurdity that lets them off the hook.  I will look into this more and
hopefully come back to you next week.

4b(2).  That self-funds or self-insures all or some part of the plan.  These

group plans must file for the extension.  In the application they must say
how to intend to comply and most will say they are depending upon an ASO or
TPA administrator to do the work.  So it would be prudent for them to get
assurance from the ASO or TPA that they will comply and a good explanation
of
how.  I think your company is in position to assist the plans in doing this,

and it would be reasonable for the plans to assume you are planning to do
so.

Therefore, the priorities are:

1.  Explain HIPAA, the deadlines, the need to extend, and Jabas's plans to
assist to all clients.

2.  Assist the group plans that are not small plans and that self-fund or
self-insure some part of the plan to file the extension.

3.  Meanwhile, I'll find out if the insured plans that are not self-funded
still have to file the extension.

Note that the extension applies only to moving the October 16, 2002,
deadline
for compliance with the Transactions and Code Sets rule one year to October
16, 2003.  The filing adds a new deadline of April, 2003, to begin testing.

The Privacy rule deadline is next April 2003 regardless of any of this.

Peter

Peter Barry
Peter T Barry Company
Independent Consulting Health Care and Information Systems
Ozaukee Bank Building
1425 West Mequon Road
Mequon Wisconsin 53092
(414) 732 5000 (national cell)
[EMAIL PROTECTED]


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