Proposed regulations published on March 21, 2013 addressed not only the 90-day waiting period rule discussed below but also the eventual elimination of notices of creditable coverage under HIPAA’s preexisting condition exclusions rules.

The 2010 health care reform law prohibits group health plans from imposing preexisting condition exclusions, effective for plan years beginning on or after January 1, 2014, but the law did not eliminate the requirement (under the 1996 health insurance portability law “HIPAA”) that group health plans and health insurance issuers provide HIPAA certificates of creditable coverage to plan participants. Since non-calendar year plans may continue to impose pre-existing condition limitations after January 1, 2014 and until the first day of the 2014 plan year, the proposed regulations would not eliminate the requirement to provide certificates of creditable coverage until after 2014. This is so that individuals needing to offset a pre-existing condition exclusion applicable under a non-calendar year plan would still have access to certificates for proof of coverage through December 31, 2014.

After 2014, the health care reform law’s prohibition on preexisting condition exclusions will make HIPAA’s detailed rules on the application of preexisting condition exclusions obsolete, so final regulations are expected to eliminate the requirement to provide certificates of creditable coverage. Until then, group health plans and health insurance issuers must continue to provide HIPAA certificates of creditable coverage.

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Photo of Monique Warren Monique Warren

Monique Warren is a Principal in the White Plains, New York office of Jackson Lewis P.C. Ms. Warren is a member of the Employee Benefits Counseling, Executive Compensation, Benefits Litigation and Workplace Privacy Practice Group.

Ms. Warren counsels employers on employee benefits compliance…

Monique Warren is a Principal in the White Plains, New York office of Jackson Lewis P.C. Ms. Warren is a member of the Employee Benefits Counseling, Executive Compensation, Benefits Litigation and Workplace Privacy Practice Group.

Ms. Warren counsels employers on employee benefits compliance and administrative matters, drafts plan documents and employee communication materials, and represents employers to government agencies and in employee benefit litigation. Her expertise includes health and welfare plans as well as retirement plans.

Ms. Warren has spoken at numerous client and professional association events including SHRM and WEB meetings. She also has presented numerous seminars on employee benefits compliance topics including benefits basics for human resource professionals, HIPAA privacy and security, 409A requirements, and annual legal updates.

Prior to joining the firm in 2006, Ms. Warren was a member of the employee benefits group of a large Chicago law firm and later maintained her own practice in Illinois, representing employers in employee benefits, employment and employment-related immigration matters. While attending law school, she was an intern in the tax clinic at Loyola University Chicago School of Law and was a judicial extern for the Honorable Blanche Manning, Federal District Court, Northern District of Illinois. As a law student, she received academic honors and was a member of the moot court employment law team.

During the ten years prior to attending law school, Ms. Warren directed human resource functions in manufacturing and research enterprises. She was certified as a Senior Human Resource Professional by SHRM in 1996.