The Health Insurance Portability and Accountability Act
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires Stanford to provide documentation of prior health coverage when you leave.
HIPAA protects you if you have a pre-existing medical condition that might make getting medical coverage more difficult. It also:
- Limits the exclusions for pre-existing conditions as long as you do not have a break in coverage
- Safeguards the privacy of your health information by notifying you of your rights and how your protected health information (PHI) can be used and disclosed
Federal law allows health care providers and employers to use and disclose PHI solely for the purposes of treatment, payment and heath care operations, but not for any employment-related decisions. By law, Stanford has safeguards in place to protect your PHI.
Under the Privacy Rule, you have the following rights:
- Request a copy of PHI records (copying fees may apply)
- Request an accounting of when PHI was disclosed for purposes other than payment, treatment and health care operations
- Request corrections or amendments to PHI records
- Review PHI records
The HIPAA certificate, also known as certificate of creditable coverage, documents the health coverage you had before you lost coverage. If you had less than 18 months of continuous coverage, the certificate includes the dates any waiting period began and when coverage began and ended.
You will automatically receive a HIPAA "certificate of creditable coverage" when you or your covered dependents lose or drop health coverage from Stanford, including COBRA coverage. You may also request a certificate from Stanford Benefits within 24 months after your coverage ends.
Keep a copy of the certificate since you may need it to prove you had prior coverage when you join a new health plan. For example, if you obtain new employment and your new employer’s plan has a pre-existing condition limit, that employer may be required to reduce the length of the limit based on your coverage under Educated Choices. Or, if you purchase individual coverage, your insurer may request a copy of the certificate.
- If you have questions or complaints about your rights or the privacy practices at Stanford, contact the University HR Service Team.
- Learn more at the U.S. Department Of Labor Employee Benefit Security Administration website.