What Was the Main Point of the Health Insurance Portability Act of 1996?


Quick Answer

The main point of the Health Insurance Portability and Accountability Act of 1996, also known as HIPAA, is to guarantee health coverage protection for workers and their families when they experience loss of eligibility through life circumstances or face discrimination due to health factors, reports the U.S. Department of Labor. Additionally, insurers cannot refuse coverage because of disabilities, previous medical conditions or the results of a physical examination.

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Full Answer

Under HIPAA, employees can enroll in health plans that they previously declined outside of the plans' usual open enrollment periods in special situations, explains the U.S. Department of Labor. For instance, workers have special enrollment rights if they lose employer contributions or eligibility for coverage in a spouse's plan. They are also entitled to special enrollment consideration if they lose coverage due to divorce, legal separation, the death of a spouse, job loss or reduced hours of work.

HIPAA stipulates that health plans cannot deny coverage to employees or their families due to health status, medical history, genetic information or claims experience, according to the U.S. Department of Labor. Although health plans can require workers to fill out medical questionnaires, they cannot predicate coverage on the results. Plans are allowed to offer lower premiums to those who stop smoking or participate in wellness programs as long as the opportunities are available to all employees.

The Affordable Care Act and state laws complement HIPAA by providing additional employee health care protection.

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