HIPAA

[Guest ro32]

Does anyone know whether HIPAA's nondiscrimination provision, or any other law for that matter, prevents a health plan from requiring a participant to provide proof of good health before reinstating the participant's lifetime maximum benefit under the health plan?

[GBurns]

Is this self funded or fully insured?

If you are going to let this participant be reinstated under the plan, do you not think that it would be gross discrimination to change the terms of coverage just for this employee? The person is either going to get the plan that everyone similarly situated, or in the same class, gets.

If the coverage is guaranteed issue, how can you change it? What you are adding is essentially a pre-existing condition.

If the coverage is fully insured, how and why would you want to try and change the issued policy which was issued by the insurer not by the employer? What is your state law on pre-ex?

If the person suffers from something that falls under ADA, why open a big can of worms?