Loss of public health plan no longer special enrollment event?

[Guest kmbing]

I understand that the HIPAA Portability Regulations, issued Dec. 30, 2004, changed the special enrollment rules so that loss of coverage under Medicare, Medicaid, CHAMPUS/Tricare or other publicly sponsored or subsidized health plan is no longer a loss of coverage that would trigger a special enrollment right. Does anyone know WHY that change was made? I advise an employer who is not satisfied just to know what the rule is; the employer wants to know why the rule was changed. Any thoughts?

[Guest taylorjeff]

What you're saying doesn't make sense to me. The regs actually expanded the number of "public" programs considered to be creditable coverage (S-Chip, foreign plans, etc). The only language I've seen still says loss of coverage qualifies the individual for special enrollment priviliges. Most of the modifications expanded opportunities for qualifying for coverage, not the other way around.

Who is telling you they would not be eligible? A carrier, TPA?