Medical Plans — COBRA, HIPAA, HRAs, HSAs and Disability (Portfolio 389)


Greta Cowart


Jackson Walker LLP

At a glance

I. Introduction
II. Statutory and Nonemployer Financed Benefits
III. Employer-Financed Sickness and Personal Injury Benefits
IV. Employer-Provided Accident and Health Coverage
V. Employer Deductions
VI. Treatment of Long-Term Care Insurance as Provided Under an Accident and Health Plan
VII. Elective Continuation of Medical Coverage (COBRA)
VIII. HIPAA: Group Health Plan Portability, Access and Renewability Requirements
IX. Federal Regulation of Medical Benefits
X. Medicare Secondary Payer Rules
XI. Health Savings Accounts
XII. Medical Savings Accounts (Archer MSAs)
XIII. Compliance with ERISA
XIV. Compliance with Other Laws


Bloomberg Tax Portfolio, Medical Plans — COBRA, HIPAA, HRAs, HSAs and Disability, No. 389, analyzes the requirements of §§104, 105, 106, 220, 223, 401(h), 420, 4980B, 4980D, 7702B, 9801 through 9803, and 9831 through 9834. It examines the exclusions from gross income provided by §104 for workers’ compensation and other statutory benefits, accident and health insurance benefits not financed by an employer, and damages for personal injuries; the exclusion provided under §105 for employer-financed sickness and personal injury benefits; the exclusion provided by §106 for employer-financed coverage; and the health care continuation rules under §4980B (i.e., “COBRA”).

Included are analyses of the use of pension plan assets to provide retiree medical benefits under §§401(h) and 420. The Portfolio also describes the provisions of the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191), including the privacy standards for protected health information; the rules governing Health Savings Accounts (HSAs) and Health Reimbursement Accounts (HRAs); the treatment of long-term care insurance as amounts provided under an accident or health plan; and the application and enforcement of the group health plan portability, access, and renewability requirements. The federal legislation mandating certain benefits and mental health coverage parity also is covered.

In addition, this Portfolio discusses the requirements of ERISA applicable to welfare benefit plans, including qualified medical child support orders, and the impact of federal employment discrimination and medical and family leave legislation.

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