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December 7, 2007

ShareU.S. Department of Labor Field Assistance Bulletin No. 2007-04: Supplemental Health Insurance Coverage as Excepted Benefits Under HIPAA & Related Legislation

The U.S. Department of Labor (DOL) Employee Benefits Security Administration closed a loophole and clarified that supplemental wellness plans that set biometric targets as a basis for employee member rewards or penalties must meet four additional requirements to be exempt from Health Insurance Portability and Accountability Act (HIPAA) regulations. Such plans must not be linked to the primary health plan; they must cover only gaps in coverage; the cost of coverage must not exceed 15% of the cost of the primary coverage; and must not differentiate among plan members in eligibility, benefits, or premiums.

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