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Telemedicine services - group health plan?

Guest Aust916

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Guest Aust916

I have a client who has been approached by a vendor that provides telemedicine/phone advice services (e.g., the employee calls/video chats with a licensed doctor who then would provide diagnostic advice about the employee's ailment). The vendor has a network of licensed doctors who participate in this program. The vendor has told the client that this program is not a group health plan - not subject to ERISA or COBRA. However, the vendor has provided a HIPAA business associate agreement to the client, which seems odd because HIPAA purportedly would not be implicated unless the program is a group health plan. The client also has a HDHP and contributes to the HSAs of HDHP participants. I think this group health plan should be considered a group health plan, which may provide disqualifying health plan coverage, so HDHP participants should be required to pay FMV for any non-preventive care advice. Does anyone have any thoughts or experience with these types of telemedicine services? Thanks for any help.

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My first thought is that there is confusion about and a misunderstanding of the terms "group Health plan" and also the term "health plan". As a result answering the post is not realy possible, since what you posted is not what you really mean.

A provider of services, such as this vendor, and any other provider of medical services, e.g a hospital, is neither a "group health plan" nor a "health plan". It is simply a provider of services. Whether those services are provided on behalf of a "group health plan" or a "health plan" is another matter.

An insurer such as Aetna or an HMO or a service such as BCBS is also not a "group health plan" nor a "health plan". These are either insurers or arrangements having the effect of insurance.

The insurance policy is also not the "group health plan" not a " health plan". It is simply the insurance policy.

It would seem that this telemedicine service is simply another provider of medical services, no different from any other network of doctors (such as BeechStreet), hospitals (such as HCA) or pharmacies (such as Walgreens) providing medical services.

George D. Burns

Cost Reduction Strategies

Burns and Associates, Inc

www.costreductionstrategies.com(under construction)

www.employeebenefitsstrategies.com(under construction)

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