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October 29, 2004    DOL > EBSA > Consumer Health Plan Information   

Consumer Health Plan Information

HIPAA Nondiscrimination Guidance

EBSA, together with the Internal Revenue Service and the Department of Health and Human Services issued two separate regulations providing guidance on the nondiscrimination provisions under the Health Insurance Portability and Accountability Act (HIPAA).

National Medical Support Notice

DOL issues final rule which will help children gain access to coverage under their noncustodial parents' employer-based group health plan.

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elaws Health Benefits Advisor

An interactive Web site that will serve as a resource to help employees and their families make informed decisions about their health benefits when facing life and work changes. In addition to learning the specific requirements and rights under laws like the Consolidated Omnibus Budget Reconciliation Act (COBRA) and the Health Insurance Portability and Accountability Act (HIPAA), the Web site provides information about the rights and responsibilities of employees and their families under a group health plan upon the occurrence of specific life and work changes -- including marriage, childbirth, death, divorce, job loss, new job, or retirement.

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Health Benefit Claims and Appeals

The U.S. Department of Labor announces final rule for handling health benefit claims and appeals.

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Women's Health and Cancer Rights Act of 1998

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Health Benefits Education Campaign

The U.S. Department of Labor's Health Benefits Education Campaign focuses on life and work events and how they affect employees' benefit choices. Partnering with the Department in this campaign are over 70 public and private organizations.

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Recent Changes in Health Care Law

Educational material on the following Health Care Law topics:

  • The Health Insurance Portability & Accountability Act of 1996

  • The Mental Health Parity Act of 1996

  • The Newborns' and Mothers' Health Protection Act of 1996

  • The Women's Health and Cancer Rights Act of 1998

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Health Plan Fact Sheets

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Health Benefits Under COBRA

This brochure provides information about provisions of the law that allows certain former employees, retirees, spouses, and dependent children the right to continuation health coverage.

IRS Notice 98-12

This notice contains questions and answers for individuals deciding whether to elect COBRA continuation coverage in light of changes in the law made by HIPAA (February 2, 1998).

Copies are available by calling EBSA's toll free number at 1.866.444.EBSA (3272).

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Frequently Asked Questions for Dislocated Workers

This brochure provides health benefit information to workers dislocated by plant closings or layoffs.

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Retiree Health Benefits Fact Sheet

This information provides retirees and current employees some tips for checking the documents that determine health care coverage during retirement.

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How to File a Claim for Your Benefits

Advice to participants on how to file a claim for benefits and what to do if the claim is denied.

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ERISA Related Regulations, Interpretations, and Opinions

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Related Health Care Web Sites

  • Agency for Healthcare Research and Quality
    The lead agency charged with supporting research designed to improve the quality of health care, reduce its cost, and broaden access to essential services.

  • Department of Health and Human Services
    Web site has materials concerning recently enacted federal health care laws. These materials include information on the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Mental Health Parity Act of 1996 (MHPA).

  • Federal Employees Health Benefit Plan
    Gives current and valuable information to help you choose a health plan. This site offers extensive information on the health benefit plans offered to employees, beneficiaries and retirees of the Federal government. Participants are able to obtain information on the various plans offered as well as instructions for changing plans, filing claims, reporting fraud, and patients rights.

  • Healthfinder
    Sponsored by the Department of Health and Human Services’ Office of Disease Prevention and Health Promotion (ODPHP) is a gateway consumer health information web site that can lead consumers to selected online publications, databases and web sites.

  • Indian Health Service
    An agency of the U.S. Public Health Service, provides information about healthcare services available to the general public and offers answers to questions and concerns regarding illness and protection.

  • Medicare
    Provides information about Medicare and the expanded health plan options with the creation Medicare+Choice. Information is available in English and Spanish.

  • State Children's Health Insurance
    Helps states expand health insurance to children whose families earn too much to qualify for Medicaid, yet not enough to afford private insurance.

  • State Insurance Departments
    Continue to regulate heath insurance issuers (e.g., insurance companies or HMOs) who sell group insurance to ERISA-covered group health plans, even under the Health Insurance Portability and Accountability Act (HIPAA), the Mental Health Parity Act, and the Newborns’ and Mothers’ Health Protection Act. In addition, States continue to have responsibilities in individual insurance market (e.g., selling individual insurance policies). The National Association of Insurance Commissioners has created access to state web sites with information on particular state health insurance laws. You may also contact your state insurance commissioner for further information on particular state health insurance laws.

  • TRICARE Military Health System
    TRICARE (formerly known as Champus) provides health care coverage for active and retired members of the Armed Forces, military families, and others entrusted to the care of the Department of Defense. This site contains information on the TRICARE benefits, resources, administration, etc. including current events affecting the military health system.

  • National Women's Health Information Center
    This site includes a database and links to more than 1,000 federal agencies, publications and hundreds of government-screened private sector organizations related to women's health.

  • Veterans Administration
    Sponsors a telemedicine healthcare site dedicated towards improving access, coordination, continuity and outcomes for healthcare for veterans. Through the use of this electronic information and support, consumers are able to overcome distance and time.

  • AARP
    Formerly known as the American Association of Retired Persons, provides useful generic consumer information on managed care. Included in this site are a glossary of terms, checkpoints for comparing plans, descriptions of differences between traditional fee-for-service and managed care, and AARP principles on essential managed care plan features and services.

  • Commonwealth Fund
    Offers articles researched and written by experts in fields such as managed care quality, employer value-based purchasing, insurance and coverage, and women, children and minority health.

  • Employer Quality Partnership
    Provides help to consumers and employers about health care. This site offers advice on how to navigate the entire health care system whether its about questions for a doctor, determining a plan's value and/or choosing a plan.

  • Foundation for Accountability
    Provides a strong consumer focus on providing general information about health care quality and quality measurement. Their section "Educating Consumers About Health Care Quality" includes papers and articles on understanding health care quality and highlights national education efforts.

  • Georgetown University Institute for Health Care Research and Policy
    Produces high-quality research on a variety of health policy issues, including group health plan rights under ERISA and HIPAA. Their interactive section, entitled the "Home Page for Kassebaum-Kennedy Consumer Guides" provides geographical information about plan rights under ERISA/HIPAA for consumers.

  • Joint Commission on Accreditation of Healthcare Organizations
    Evaluates and accredits more than 18,000 health care organizations in the United States, including hospitals, health care networks, managed care organizations, and health care organizations that provide home care, long term care, behavioral health care, laboratory, and ambulatory care services. Their web site has useful information about quality, making health care choices, and performance measurement. Performance reports on health care facilities can be accessed and downloaded.

  • Leap Frog Group
    Comprised of more than 100 public and private organizations that provide health care benefits, The Leapfrog Group works with medical experts throughout the U.S. to identify problems and propose solutions that it believes will improve hospital systems that could break down and harm patients. Representing approximately 32 million health care consumers in all 50 states, Leapfrog provides important information and solutions for consumers and health care providers.

  • National Committee for Quality Assurance
    The National Committee for Quality Assurance is a private, 501(c)(3) not-for-profit organization dedicated to improving health care quality everywhere.  Frequently referred to as a watchdog for the managed care industry, NCQA is active in quality oversight and improvement initiatives at all levels of the health care system.

  • Pacific Business Group on Health
    Provides practical and cutting edge information about how to use report cards and other indicators to select health plans and providers. It also has good information on health services in general and health and wellness benefits.

  • Service Employees International Union
    The nation’s largest healthcare union. This site details many of their activities in the healthcare arena.

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