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help!

NaeNae55NaeNae55 3,243 Posts
in Benefits & Leave Vote Up0Vote Down
We offer a stand alone vision plan which is fully paid for by the employees. It is an ERISA plan, but I cannot find what I am looking for on the web to tell me for sure if it is subject to COBRA and HIPAA. I assume so, but I am looking for documentation.

Does it matter if the company claims it is not insurance but a membership plan?

:help: :help: :help:
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  • 2 Comments sorted by Votes Date Added
  • Dutch2Dutch2 1,590 Posts
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    NaeNae: I too could not find your answer so I asked our TPA your question and they responded as follows:
    Yes, it would be an ERISA Plan subject to HIPAA and would need COBRA offered. By keeping it a stand alone, it is viewed as an “excepted benefit”. As long as it requires a separate premium and EE’s have the option to accept or deny coverage in the program, it will remain an excepted benefit. This is important as excepted benefits are not subject to the Health Reform rules.
    Hope this is of some help.
    Dutch2
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  • NaeNae55NaeNae55 3,243 Posts
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    Thank you Dutch! I did a lot of research and could not find anything definitive except that it would be an ERISA plan. From something on the DOL site I thought it would be subject to COBRA, but there is some internal dispute on this (it is a 100% employee funded 'membership' plan). I found one site that said it wouldn't be subject to HIPAA, but that made no sense to me. Thank you for your help. Your expert advice makes me feel better about my own conclusions.
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