HIPAA and Change in Status Rules

[Guest Amanda Davis]

We have recently implemented our new HIPAA compliance procedures and have sent out the HIPAA compliance notice to employees. We now have an EE that doesn't believe that HIPAA is protecting his rights sufficiently and wants to opt out of our SEC125 medical and FSA plans. (There is no qualified change in status at this time)

I'm inclined to believe that without a change in status, he'll have to wait until Open Enrollment to make this change.

Am I correct to assume that there is nothing in HIPAA that gives EEs the right to decline coverage because they "don't agree" with the legislation?

Thanks for your input!

[SLuskin]

I would not let this employee change his elections without a valid change in status. If you have "rollover" elections, I would go the extra mile and make sure that he follows procedure not to participate for the next plan year.

[Steve72]

Sooo......He was fine when there was NO Federal law enforcing the protection of health information, but now that one is in effect, he's got a problem?

I am aware of nothing in HIPAA that would permit a midyear change without a change in status.

[GBurns]

If you eventually, this year or next, allow him out, please get him to sign a document outlining his reasons and your explanation.

I have seen a few cases where the employees have come back after a number of years claiming that because the tax benefits or the impact on SS was not sufficiently well explained to them, they were led to a bad decision and either lost money or lost SS benefits.

[Jbentz]

I agree that HIPAA does not allow for any employee to drop coverage due to the regulations. He can ask for a restriction on the notice (you do not have to grant it, but at least you would know what the real problem is). He can always ask for an accounting of disclosure in the future.

Even if he could withdraw from the plan, you cannot destroy his PHI that you have, so he woudl not be gaining anything.