Insurance · Individual and Group Coverage

Under HIPAA, what is the primary protection for individuals changing jobs?

Correct answer

Portability rules limiting pre-existing condition exclusions and ensuring access to coverage; HIPAA also established privacy and security rules for health information

  1. A Guaranteed promotions
  2. B Portability rules limiting pre-existing condition exclusions and ensuring access to coverage; HIPAA also established privacy and security rules for health information
  3. C Wage protections
  4. D Vacation guarantees

Why this is the answer

HIPAA (Health Insurance Portability and Accountability Act of 1996) has two main pillars: (1) Portability — limited pre-existing condition exclusions, prohibited discrimination based on health factors in group coverage, and certificates of creditable coverage to reduce pre-ex exclusions when changing plans (mostly superseded by ACA's complete ban on pre-ex exclusions); (2) Privacy and Security — the Privacy Rule (which protects how health information can be used and shared) and the Security Rule (which protects electronic health information). Most consumer awareness of HIPAA today centers on privacy: medical records cannot be shared without authorization, with limited exceptions for treatment, payment, and healthcare operations. Producers must comply with HIPAA when handling applicant health information.
Source: NAIC Model Outline, HIPAA

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