The HIPAA health insurance reform requirements that apply to group health plans, as well as the Newborns and Mothers Health Protection Act, and the Women's Health and Cancer Rights Act, apply to group health plans. The Mental Health Parity Act also applies to group health plans, but does not apply to group health plans of small employers. A small employer is a company (or a nonfederal governmental employer) that has at least two but not more than 50 employees. Some states, however, may consider a business with only one employee a small employer. Generally, HIPAA provides more protections for employees who work for small employers.

A large employer is an organization (or a nonfederal governmental employer) that has at least 51 employees. Certain HIPAA requirements only apply to large employers

In general, nonfederal governmental group health plans are subject to the requirements mentioned above to the same extent as other employer group health plans. However, a nonfederal governmental employer that provides self-funded group health coverage to its employees may elect to exempt its plan from certain requirements of title XXVII of the Public Health Service (PHS) Act.

In addition to having to comply with certain requirements under HIPAA, employers sponsoring group health plans also enjoy certain protections under HIPAA. For example, a group health insurance issuer generally is required to sell coverage to all small employers. Also, a group health insurance issuer generally is required to renew coverage to all employers.

For more information on these requirements, you may call 877-267-2323, ext. 61565.

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