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Chris Johnson, Manager Consulting Services - J.W. Terrill

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Healthcare Reform: HIPAA Opt-Out• Effective first renewal following September 23, 2010 non-CBA• Formerly Self-Insured Non-federal Governmental Plans were allowed to opt out ofcompliance with certain federal benefit mandates1. HIPPA limitation on pre-existing condition exclusion periods2. HIPAA requirements for special enrollment periods3. HIPAA prohibition against discrimination based on health status (does not include GINA)4. NMHPA newborn and mother hospital-stay benefits5. MHPAEA requirements of parity in application of certain mental health and substance abuse benefits6. WHCRA required coverage for reconstructive surgery following mastectomies7. Michelle’s Law requirement to provide coverage of dependent students on medically necessary leave• Under PPACA yellow coded provisions can still be opted out of• CBA ratified pre March 23, 2010• If exempted from any of first three requirements, will not have to come intocompliance with those requirements until first day of the first plan year followingexpiration of the last plan year governed by the CBA.• HHS will not be taking enforcement actions prior to April 1, 2011

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