SPD for self-funded plan

[waid10]

Does anyone know whether an SPD for a self-funded plan is required to have HIPAA language?

[papogi]

If the plan is subject to HIPAA, yes (meaning this is a group health plan with more than 50 participants).

[Guest benefitsmom]

What do you mean by "HIPAA language?" SPD content rules (See Reg. Sect. 2520.102-3) require certain additional information but these were effective January '03 for calendar year plans, so my guess is you're asking about privacy language.

The privacy rules require certain provisions in your plan document, so if your SPD serves as the plan document (many of the ones we look at serve this dual purpose), it would need the language.

If, however, you have a wrap around plan document, the privacy language doesn't necessarily have to be in the SPD.

[Steve72]

Benefitsmom is correct. Unless the SPD is also the plan document, HIPAA privacy language is not required to be in the SPD. In fact, there are legitimate reasons why it should NOT appear in the SPD.

HIPAA privacy mandates a "Privacy Notice", which has its own content and disclosure requirements. This document should serve in place of the SPD for privacy issues.

[Guest tintree73]

Here's a link to a DOL web page on the "other" HIPAA requirements (non-privacy) re the SPD:

http://www.dol.gov/ebsa/newsroom/fshipaa.html

Also, it was my understanding that HIPAA required SPDs to be updated to include specific language to identify health insurers who are responsible for financing or administering benefits under the plan, the new language regarding ERISA rights (which has been further modified from PWBA to EBSA) and language regarding newbors and mothers (although I don't think that was HIPAA - I think it was a separate law).

I'm pretty sure there were regs on this and I found:http://www.dol.gov/ebsa/regs/fedreg/final/2000029765.htm

Hope it helps.