HRAs and HIPAA

[Ron Snyder]

It appears to me that health reimbursement arrangements (or employer-funded flex plans) are subject to HIPAA. This is inconvenient, especially to those flex plan administrators who are used to not having to provide a certificate of creditable coverage to terminating employees relative to their participation in the employer's flex plan.

The relief granted under DOL's Technical Release No. 97-01 clearly does not apply.

1. Is there another way out of this requirement?

2. Is one certificate of creditable coverage (from the primary health plan) sufficient to meet HIPAA's requirement, or must each plan provide such a certificate?

3. Can the certificate be provided on request only, since the HRA (or flex arrangement) is secondary coverage?

4. Can such a certificate of coverage be used to trick a subsequent employer or insurance company into waiving pre-existing conditions even though the employee wasn't really covered under a group-health plan but merely given an allowance to cover OOP medical expenses up to a certain level?

[Note: I am also posting this under flex plans as it seems to have a wider audience.]

[Guest JTK]

I was wondering about the same thing. Are HRAs definitely subject to the requirement to provide certificates of creditable coverage?

[leevena]

I do not know the definitive answer, but have a comments that might help.

I am in California and the state does not recognize the HRA side-fund as eligible for state COBRA, which means that the employee can continue their underlying health plan, but not the side-fund. In fact, the fed govt does not even want the ex-employee to have the side fund. The side-fund is an employer owned, self-funded pool of money.

That being said I would assume that the cert from the underlying plan should be sufficient, however, I cannot find anything definitive about it.