HIPAA

The longest pre-existing period for conditions that occurred prior to employment under HIPAA is:

 6 months
 12 months
 18 months
 24 months
Correct
Under HIPAA, a group plan may not exclude conditions that have been diagnosed or treated prior to employment, unless it is within 12 months before hire. That can be modified if the employee has been covered by another group plan during that time. Service under another group plan is referred to as creditable coverage.

HIPAA recognizes time served under group plans to determine pre-existing condition restrictions. If a person is not covered, what is the maximum period they are allowed to go without coverage before the HIPAA requirements become void?

 6 months
 5 months
 90 days
 63 days
Correct
If a person is without creditable group coverage, including COBRA options, for 63 days the clock for creditable coverage starts again. With a 63 day lapse, the insurance company may apply pre-existing condition clauses without recognizing prior coverage.