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Federal Agencies Finalize Rules on Health Nondiscrimination


Tuesday, Dec. 12, 2006

The U. S. Department of Laborís Employee Benefits Security Administration (EBSA), Internal Revenue Service and Department of Health and Human Services today announced the publication of final rules that provide guidance in complying with the nondiscrimination provisions of the Health Insurance Portability and Accountability Act (HIPAA). The final rules also provide guidance on the implementation of wellness programs.

HIPAAís nondiscrimination provisions generally prohibit a group health plan or group health insurance issuer from denying an individual eligibility for benefits based on a health factor and from charging an individual a higher premium than a similarly situated individual based on a health factor. Health factors include: health status, medical condition (including both physical and mental illnesses), claims experience, receipt of health care, medical history, genetic information, evidence of insurability (including conditions arising out of acts of domestic violence) and disability.

EBSA also issued updated frequently asked questions at on HIPAAís nondiscrimination requirements to assist the employee benefit community in complying with the new rules.

The final rules are to be published Dec. 13, 2006 in the Federal Register. The rules will be effective on the first day of the plan year beginning on or after July 1, 2007. For calendar year plans, the new rules generally apply beginning Jan. 1, 2008.


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