HIPAA  The Health Insurance Portability and Accountability Act of 1996 (HIPAA) amended the 1975 ERISA, the 1986 Internal Revenue Code and the Public Health Service Act. Basically, Congress enacted HIPAA to improve the portability and continuity of health care coverage in the group and individual markets. This page does not discuss the rules affecting the privacy or security of medical records, only the portability of the coverage. What are the general provisions of HIPAA? Exclusions are limited for pre-existing medical conditions Credit is now given for prior qualifying health coverage towards covering pre-existing conditions. This provision also outlined a process for providing evidence of prior coverage with a HIPAA certificate. Employees have new rights allowing enrollment for health coverage if they lose coverage or have a new dependent. For example, the employee waived his coverage  due to having coverage through a spouse's employer. The spouse loses coverage, they  have a new opportunity to enroll in the employer's plan. Same thing applies if an employee gets married or adds a new child. Prohibits discrimination in premiums or enrollment due to an employee or dependent's health status. The carrier can not deny or limit coverage, or offer different premiums. (Of course, the group overall rates can be affected, just not an individual employee or dependent.) Guarantee health coverage availability and renewability to employers, large or small. States were again guaranteed the right to regulate health insurance and to provide flexibility of requiring greater protection regulations. Some important definitions were created. A pre-existing condition limitation is defined as "limitation or exclusion of benefit relating to a condition based on the fact that the condition was present before the first day of coverage, whether or not any medical advice, diagnosis or treatment was recommended or received before that day." A group plan may not impose an exclusion on a any pre-existing condition unless the individual received medical advice, care, diagnosis or treatment within the six months prior to enrolling for the new coverage. If a pre-existing condition does exist, it can not be excluded for more than 12 months, except for late enrollees, then it is 18 months. The period of time that a company can exclude a pre-existing condition is reduced by the existence of qualifying prior coverage, the days of "creditable coverage." A break in coverage of 63 days between prior coverage and new coverage eliminates this requirement. With a break in coverage the 12 month pre-existing coverage limitation does apply. Pre-existing conditions can not be imposed on a pregnancy, to a new born or adopted child.