[Federal Register Volume 62, Number 127 (Wednesday, July 2, 1997)]
[Rules and Regulations]
[Pages 35904-35906]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-17379]
[[Page 35903]]
_______________________________________________________________________
Part IV
Department of the Treasury
Internal Revenue Service
26 CFR Parts 54 and 602
Department of Labor
Pension and Welfare Benefits Administration
29 CFR Part 2590
Department of Health and Human Services
Health Care Financing Administration
45 CFR Parts 146 and 148
_______________________________________________________________________
Approval of Information Collection Requirements for the Joint Interim
Rules for Health Insurance Portability for Group Health Plans, and the
Individual Market Health Insurance Reform: Portability From Group to
Individual Coverage; Federal Rules for Access in the Individual Market;
State Alternative Mechanisms to Federal Rules; Interim Rules
Federal Register / Vol. 62, No. 127 / Wednesday, July 2, 1997 / Rules
and Regulations
[[Page 35904]]
DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Parts 54 and 602
[T.D. 8716]
RIN 1545-AV05
DEPARTMENT OF LABOR
Pension and Welfare Benefits Administration
29 CFR Part 2590
RIN 1210-AA54
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
45 CFR Parts 146 and 148
RIN 0938-AI08; RIN 0938-AH75
Approval of Information Collection Requirements for the Joint
Interim Rules for Health Insurance Portability for Group Health Plans,
and the Individual Market Health Insurance Reform: Portability From
Group to Individual Coverage; Federal Rules for Access in the
Individual Market; State Alternative Mechanisms to Federal Rules
AGENCIES: Internal Revenue Service, Department of the Treasury; Pension
and Welfare Benefits Administration, Department of Labor; Health Care
Financing Administration, Department of Health and Human Services.
ACTION: Interim rules with request for comments; approval of
information collection requirements.
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SUMMARY: On April 8, 1997, the Department of the Treasury, the
Department of Labor, and the Department of Health and Human Services
(Departments) published joint interim rules governing the access,
portability and renewability requirements for group health plans and
issuers offering group health insurance coverage in connection with a
group health plan. The rules implemented changes made to certain
provisions of the Internal Revenue Code of 1986 (Code), the Employee
Retirement Income Security Act of 1974 (ERISA), and the Public Health
Service Act (PHS Act) enacted as part of the Health Insurance
Portability and Accountability Act of 1996 (HIPAA). In the April 8
publication, the Departments submitted the group market information
collection requirements, for, among other things, establishing
creditable coverage, notice of special enrollment rights, and notice of
pre-existing condition exclusion periods, to the Office of Management
and Budget (OMB) for emergency review under the Paperwork Reduction Act
of 1995 (PRA 95). In addition, on April 8, 1997 the Department of
Health and Human Services submitted the HIPAA individual market
information collection requirements to OMB for emergency review under
PRA 1995. This document amends the April 8 Federal Register documents
to properly display the OMB control numbers.
DATES: These amendments are effective June 1, 1997.
FOR FURTHER INFORMATION CONTACT: Russ Weinheimer, Internal Revenue
Service, at 202-622-4695; Gerald Lindrew, Office of Policy and
Research, U.S. Department of Labor, Pension and Welfare Benefits
Administration, 200 Constitution Avenue, Room N-5647, Washington, DC
20210, at 202-219-4782; John Burke, Department of Health and Human
Services, Health Care Financing Administration, at 410-786-1325. (These
are not toll-free numbers.)
SUPPLEMENTARY INFORMATION: The interim regulations published on April
8, 1997 (62 FR 16894 and 16985), contained distinct information
collection requests (ICRs) for the group and individual insurance
markets. The ICRs issued by the Department of the Treasury and the
Department of Labor apply to employers and group health plans. The ICRs
issued by the Department of Health and Human Services apply to health
insurance issuers.
Department of the Treasury and Department of Labor ICRs
The ICRs on group health plans' obligations regarding Establishing
Prior Creditable Coverage and Notice of Enrollment Rights are
prescribed by the statute. The ICRs regarding the certification and
special enrollment notice obligations of health insurance issuers are
addressed separately in the Department of Health and Human Services'
ICR.
The first ICR implements statutorily prescribed requirements
necessary to establish Prior Creditable Coverage. This is accomplished
primarily through the issuance of certificates of prior coverage by
group health plans or by service providers with which the group health
plans contract in order to provide these documents. In addition this
ICR permits the use of a notice that may be used by the plans to meet
their obligations in connection with periods of coverage ending during
the transition period, October 1, 1996 through May 31, 1997, saving the
respondents both hours and cost during that period. This ICR also
covers the requests that certain plans will make regarding additional
information they require because they are using the Alternative Method
of Crediting Coverage. Finally, this ICR also includes the occasional
circumstances where a participant is unable to secure a certificate and
needs to provide some supplemental form of documentation in order to
establish prior creditable coverage.
The second ICR, Notice of Enrollment Rights, imposes disclosure
obligations on plans to inform a participant, at the time of
enrollment, of the plan's special enrollment rules.
The third ICR, Notice of Pre-existing Condition Exclusion, concerns
the disclosure requirements on those plans that contain pre-existing
condition exclusion provisions. This ICR has two components: a notice
to all participants at the time of the enrollment stating the terms of
the plan's pre-existing condition provisions, the participant's rights
to demonstrate creditable coverage, and that the plan or issuer will
assist in securing a certificate as necessary; and notice by the plan
of its determination that an exclusion period applies to an individual.
Department of Health and Human Services ICRs
The Department of Health and Human Services separately issued two
Information Collection Requirements. The first one, titled Information
Collection Requirements referenced in HIPAA for the Individual
Insurance Market, will ensure that the issuers in the individual market
will provide individuals with documentation necessary to demonstrate
prior creditable coverage. These information collection requirements
will also give the States the flexibility to implement State
alternative mechanisms to protect HIPAA eligible individuals.
The second information collection requirements, titled Information
Collection Requirements referenced in HIPAA for the Group Health Plans,
will ensure that the issuers in the group market will provide
individuals with documentation necessary to demonstrate prior
creditable coverage, and that group health plans notify individuals of
their special enrollment rights in the group health insurance market.
Approval
OMB reviewed the Department of the Treasury's collection of
information collection in accordance with the
[[Page 35905]]
Paperwork Reduction Act of 1995 (PRA 95). On May 30, 1997, under OMB
control number 1545-1537, OMB approved the information collection
requests contained in (1) 26 CFR 54.9801-3T, 54.9801-4T and 54.9801-5T
on rules relating to the notices regarding preexisting condition
exclusion periods; (2) 26 CFR 54.9801-5T on rules relating to
establishing prior coverage; and (3) 26 CFR 54.9801-6T on rules
relating to special enrollment periods. These information collection
provisions are currently approved until November 30, 1997.
OMB also reviewed the Department of Labor's collection of
information requirements in accordance with the PRA 95, 44 U.S.C.
chapter 35, and 5 CFR 1320.11. On May 30, 1997, OMB approved the
information collection requirements contained in 29 CFR 2590.701-6 for
Notice of Special Enrollment Rights under OMB control number 1210-0101.
OMB also approved the information collection requirements contained in
29 CFR 2590.701-3, 2590.701-4, and 2590.701-5 for Notice of Preexisting
Condition Exclusion under OMB clearance number 1210-0102. In addition,
OMB approved the information collection requirements contained in 29
CFR 2590.701-5 for Establishing Prior Creditable Coverage under OMB
control number 1210-0103. These information collection provisions are
currently approved until December 31, 1997.
Finally, OMB reviewed the Department of Health and Human Services'
collection of information requests in accordance with the PRA 95. On
May 30, 1997, under OMB control number 0938-0702, OMB approved the
information collection requests contained in 45 CFR 146.111, 146.115,
146.117, 146.150, 146.152, 146.160 and 146.180 for issuers in the group
market on demonstrating prior creditable coverage and notice of special
enrollment rights. On the same day, under OMB control number 0938-0703,
OMB also approved the information collection requests contained in 45
CFR 148.120, 148.122, 148.124, and 148.128 for issuers in the
individual market on demonstrating prior creditable coverage and State
alternative mechanisms. These information collection requests are
currently approved until December 31, 1997.
Statutory Authorities
The Department of the Treasury temporary rule is adopted pursuant
to the authority contained in 26 U.S.C. 7805 and in 26 U.S.C. 9806, as
added by Section 401 (Pub. L. 104-191, 101 Stat. 1936).
The Department of Labor interim final rule is adopted pursuant to
the authority contained in 29 U.S.C. 1027, 1059, 1135, 1171, 1194;
Section 101, Public L. 104-191, 101 Stat. 1936 (29 U.S.C. 1181);
Secretary of Labor's Order No. 1-87, 52 FR 13139, April 21, 1987.
The Department of Health and Human Services interim final rule is
adopted pursuant to the authority contained in Sections 2701 through
2723 of the Public Health Service Act (PHS Act, 42 U.S.C. 300gg, et.
seq.), Sections 2741 through 2763 of the PHS Act, and 2791 through 2792
of the PHS Act as amended by HIPAA.
List of Subjects
26 CFR Part 54
Excise taxes, Health insurance, Pensions, Reporting and
recordkeeping requirements.
29 CFR Part 2590
Employee benefit plans, Employee Retirement Income Security Act,
Group health plans, Health care, Health insurance, Reporting and
recordkeeping requirements, Welfare benefit plans.
45 CFR Parts 146 and 148
Health care, Health insurance, Reporting and recordkeeping
requirements, State regulation of health insurance.
Internal Revenue Service
26 CFR Chapter I
Accordingly, 26 CFR Part 602 is amended as follows:
PART 602--[AMENDED]
1. The authority citation for Part 602 continues to read as
follows:
Authority: 26 U.S.C. 7805.
2. In Sec. 602.101, paragraph (c) is amended by adding entries in
numerical order to the table to read as follows:
Sec. 602.101 OMB Control numbers.
* * * * *
(c) * * *
------------------------------------------------------------------------
Current OMB
CFR part or section where identified and described control No.
------------------------------------------------------------------------
* * * * *
54.9801-3T.............................................. 1545-1537
54.9801-4T.............................................. 1545-1537
54.9801-5T.............................................. 1545-1537
54.9801-6T.............................................. 1545-1537
* * * * *
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Dale D. Goode,
Federal Register Liaision, Assistant Chief Counsel (Corporate).
Pension and Welfare Benefits Administration
29 CFR Chapter XXV
Accordingly, 29 CFR Part 2590 is amended as follows:
PART 2590--[AMENDED]
1. The authority citation for Part 2590 continues to read as
follows:
Authority: 29 U.S.C. 1027, 1059, 1135, 1171, 1194; Sec. 101,
Pub. L. 104-191, 101 Stat. 1936 (29 U.S.C. 1181); Secretary of
Labor's Order No. 1-87, 52 FR 13139, April 21, 1987.
2. In Sec. 2590.701-3, by adding a parenthetical at the end of the
section to read as follows:
Sec. 2590.701-3 Limitations on preexisting condition exclusion period.
* * * * *
(Approved by the Office of Management and Budget under control
number 1210-0102.)
3. In Sec. 2590.701-4, by adding a parenthetical at the end of the
section to read as follows:
Sec. 2590.701-4 Rules relating to creditable coverage.
* * * * *
(Approved by the Office of Management and Budget under control
number 1210-0102.)
4. In Sec. 2590.701-5, by adding a parenthetical at the end of the
section to read as follows:
Sec. 2590.701-5 Certification and disclosure of previous coverage.
* * * * *
(Approved by the Office of Management and Budget under control
numbers 1210-0102 and 1210-0103.)
5. In Sec. 2590.701-6, by adding a parenthetical at the end of the
section to read as follows:
Sec. 2590.701-6 Special enrollment periods.
* * * * *
(Approved by the Office of Management and Budget under control
number 1210-0101.)
Signed at Washington D.C. this 24th day of June, 1997.
Alan D. Lebowitz,
Deputy Assistant Secretary for Program Operations, Pension and Welfare
Benefits Administration, Department of Labor.
Health Care Financing Administration
45 CFR Subtitle A, Subchapter B
Accordingly, 45 CFR Parts 146 and 148 are amended as follows:
[[Page 35906]]
PART 146--[AMENDED]
1. The authority citation for Part 146 continues to read as
follows:
Authority: Secs. 2701 through 2763, 2791, and 2792 of the PHS
Act, 42 U.S.C. 300gg through 300gg-63, 300gg-91 and 300gg-92.
2. In Sec. 146.111, by adding a parenthetical at the end of the
section to read as follows:
Sec. 146.111 Limitations on preexisting condition exclusion period.
* * * * *
(Approved by the Office of Management and Budget under control
number 0938-0702.)
3. In Sec. 146.115, by adding a parenthetical at the end of the
section to read as follows:
Sec. 146.115 Certification and disclosure of previous coverage.
* * * * *
(Approved by the Office of Management and Budget under control
number 0938-0702.)
4. In Sec. 146.117, by adding a parenthetical at the end of the
section to read as follows:
Sec. 146.117 Special enrollment periods.
* * * * *
(Approved by the Office of Management and Budget under control
number 0938-0702.)
5. In Sec. 146.150, by adding a parenthetical at the end of the
section to read as follows:
Sec. 146.150 Guaranteed availability of coverage for employers in the
group market.
* * * * *
(Approved by the Office of Management and Budget under control
number 0938-0702.)
6. In Sec. 146.152, by adding a parenthetical at the end of the
section to read as follows:
Sec. 146.152 Guaranteed renewability of coverage for employers in the
group market.
* * * * *
(Approved by the Office of Management and Budget under control
number 0938-0702.)
7. In Sec. 146.160, by adding a parenthetical at the end of the
section to read as follows:
Sec. 146.160 Disclosure of information.
* * * * *
(Approved by the Office of Management and Budget under control
number 0938-0702.)
8. In Sec. 146.180, by adding a parenthetical at the end of the
section to read as follows:
Sec. 146.180 Treatment of non-Federal governmental plans.
* * * * *
(Approved by the Office of Management and Budget under control
number 0938-0702.)
PART 148--[AMENDED]
9. The authority citation for Part 148 continues to read as
follows:
Authority: Secs. 2741 through 2763, 2791, and 2792 of the Public
Health Service Act (42 U.S.C. 300gg-41 through 300gg-63, 300gg-91
and 300gg-92).
10. In Sec. 148.120, by adding a parenthetical at the end of the
section to read as follows:
Sec. 148.120 Guaranteed availability of individual health insurance
coverage to certain individuals with prior group coverage.
* * * * *
(Approved by the Office of Management and Budget under control
number 0938-0703.)
11. In Sec. 148.122, by adding a parenthetical at the end of the
section to read as follows:
Sec. 148.122 Guaranteed renewability of individual health insurance
coverage.
* * * * *
(Approved by the Office of Management and Budget under control
number 0938-0703.)
12. In Sec. 148.124, by adding a parenthetical at the end of the
section to read as follows:
Sec. 148.124 Certification and disclosure of coverage.
* * * * *
(Approved by the Office of Management and Budget under control
number 0938-0703.)
13. In Sec. 148.128, by adding a parenthetical at the end of the
section to read as follows:
Sec. 148.128 State flexibility in individual market reforms--
alternative mechanisms.
* * * * *
(Approved by the Office of Management and Budget under control
number 0938-0703.)
Dated: June 26, 1997.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial
and Human Resources, Health Care Financing Administration, Department
of Health and Human Services.
[FR Doc. 97-17379 Filed 7-1-97; 8:45 am]
BILLING CODE 4120-03-P; 4830-01-P; 4510-29-P
