Welcome to Your Compliance Roadmap

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is
a broad federal law regarding health coverage. It contains provisions
related to the portability of health coverage and provisions prohibiting
discrimination by a health plan based upon an individual's health status.
HIPAA also includes provisions relating to the privacy and security of
personal health information.

What is the privacy rule?

What is the security rule?

Who is subject to HIPAA rules?

The HIPAA Privacy and Security Rules directly apply to covered entities. Covered entities include health plans, health care clearinghouses, and health care providers that conduct certain transactions electronically. The HIPAA Privacy and Security Rules indirectly regulate health plan sponsors. The extent of an employer’s obligations under the HIPAA Privacy and Security Rules generally depends on whether the employer has access to PHI for plan administration purposes. Other third parties that use PHI to provide services to covered entities (known as business associates) must also comply with certain provisions of the Privacy and Security Rules.

What is protected health information (PHI)?

PHI is oral, written or electronic individually identifiable health information that is created or received by a covered entity and relates to past, present or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present or future payment for the provision of health care to an individual. The Privacy Rule applies to all types of PHI (written, oral and electronic). The Security Rule’s requirements, however, only apply to electronic PHI (ePHI).

Documents and Notices

HIPAA Employer Education

HIPAA Privacy and Security Employer Education

Employee Education

Notices and Forms

Click Here for More Common Questions

Children's Health Insurance Program Reauthorization Act (CHIPRA)

Watch This Video on CHIP Updates

Employees and dependents who are eligible for health care coverage under an employer-sponsored health plan, but are not enrolled, must be permitted to enroll in the plan if they lose eligibility for Medicaid or CHIP (Children’s Health Insurance Program) coverage or become eligible for a premium assistance subsidy under Medicaid or CHIP.

CHIPRA Overview

Notices

Americans with Disabilities Act

Employers covered by the ADA Practices covered by the employment nondiscrimination requirements Qualified applicant with a disability vs. other applicants Reasonable Accommodations Modifying Existing Facilities

Employers covered by the ADA

The employment provisions of title I of the ADA apply to private employers, state and local governments, employment agencies and labor unions. Employers with 15 or more employees are covered.

Practices covered by the employment nondiscrimination requirements

Qualified applicant with a disability vs. other applicants

No. An employer is free to select the most qualified applicant available and to make decisions based on reasons unrelated to the existence or consequence of a disability. For example, if two persons apply for a job opening as a typist, one a person with a disability who accurately types 50 words per minute, the other a person without a disability who accurately types 75 words per minute, the employer may hire the applicant with the higher typing speed, if typing speed is needed for successful performance of the job.

Reasonable Accommodations

Reasonable accommodation is a modification or an adjustment to a job or the work environment that will enable a qualified applicant or employee with a disability to participate in the application process or to perform essential job functions. Reasonable accommodation also includes adjustments to ensure that a qualified individual with a disability has rights and privileges in employment equal to those of nondisabled employees.

Modifying Existing Facilities

An employer may be required to modify facilities to enable an individual to perform essential job functions and to have equal opportunity to participate in other employment-related activities. For example, if an employee lounge is located in a place inaccessible to a person using a wheelchair, the lounge might be modified or relocated, or comparable facilities might be provided in a location that would enable the individual to take a break with coworkers.

Click Here for More Common Questions

Documents and Notices

ADA Employer Education

ADA Employee Education

Genetic Information Nondiscrimination Act

The Genetic Information Nondiscrimination Act of 2008 (GINA) provides broad protections in employment and health coverage against the improper collection, use or disclosure of individuals’ genetic information.

Title I prohibits group health plans and health insurance issuers from discriminating based on genetic information and from collecting genetic information.

Title II, which applies to employers with 15 or more employees, protects job applicants and employees from employment discrimination based on their genetic information.

Documents and Notices

GINA Information

For Health Plans

For Employers

Compliance Over 15 Employees

Welcome to Your Compliance Roadmap

Clarke and Company is focused on ensuring that your business is in compliance with all federal and state insurance laws. Use this page to learn more about recent regulations and more. Click below for more information on our upcoming compliance webinars.

Employers with 15 or More Employees

In addition to the requirements on the previous page, employers with 15 or more employees must comply with the Americans with Disabilities Act and Genetic Information Nondiscrimination Act.

Affordable Care Act

CHIPRA

HIPAA

Americans with Disabilities Act

GINA

Affordable Care Act

Small Employer Toolkit

Large Employer Toolkit

ACA Documents and Notices

Health Insurance Portability and Accountability Act (HIPAA)

Documents and Notices

Children's Health Insurance Program Reauthorization Act (CHIPRA)

Americans with Disabilities Act

Documents and Notices

Genetic Information Nondiscrimination Act

Documents and Notices

connect with us

columbia office

other offices

come see us