Does HIPAA apply to retiree health plan?

[Guest friedbrain]

We self-fund our general health and retiree health plans. The regs. under Sec. 9801 define "group health plan" to include plans that cover former employees. Is the small employer exemption (has "fewer than 2 participants who are current employees")under the temp. regs. for Sec. 9831 which defines "group health plans" applicable to retiree plans that have no participants who are current employees or am I reading this too literally? Would the 2 plans have to be considered as one plan thereby making the exemption inapplicable?

[Guest nb]

Good question. Our current practice is to keep them seperate. We do not give HIPAA certs to our retirees that waive coverage.

[Christine Roberts]

So, if a retiree medical plan is terminated under a scenario in which COBRA is inapplicable (i.e., employer terminates ALL group health plans), it is possible that a retiree who has a preexisting condition will be subject to an exclusion period under a new policy (i.e., will not be able to reduce the exclusion period by demonstrating prior coverage via HIPAA certificate)??

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[Guest nb]

Christine, that sounds possible. In our case, we're a governmental body and those retirees that waive coverage have always been individuals that have dual coverage and want to eliminate one of them. I don't see any possible way that we would discontinue offering medical plans. Could you imagine the "headlines" if we did?