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New HIPAA Portability Regulations, Effective July 1, 2005

Dear Employer Groups with BCBSNC Coverage,

Please see the documents below for important information about HIPAA compliance.

BCBSNC is modifying several processes to comply with the "final" HIPAA portability rules that clarify the existing law that has been in place since 1997.

The change that is most important to BCBSNC employer groups is the introduction of language in the enrollment applications regarding general notice of the pre-existing condition exclusion (if applicable).

Effective immediately, BCBSNC is providing federally recommended language regarding pre-existing conditions in the enrollment application.

1. For groups of 1 to 24, the Enrollment / Change Form for 1-24 Employees has been revised to include the pre-existing language. (This form is also known as the "Enroll 1.")
2. All other groups should use the Enrollment / Change Form for 25+ Employees (also known as the "Enroll 2"), and one of the following inserts should be provided based on the pre-existing waiting period exclusion option selected:
   • Pre-existing Notice for Late Only Adds (For 51+ Groups Only)
   • Pre-existing Notice for Subsequent Only Adds (For 51+ Groups Only)
   • Pre-existing Notice for Original and Subsequent Adds (for all groups 25-50 and most groups 51+)
3. If the waiting period for pre-existing conditions is waived, no action is required.
4. For groups enrolling through eBenefitsNow, the appropriate notices will be included in the enrollment tool in July 2005. Please note if members are not logging directly into the eBenefitsNow tool, the Plan must provide the insert to the member during the enrollment process.

Below you will find an overview of the HIPAA portability changes and pdfs of the new forms.

You can always find the most current of these forms on the Administrative Forms page of "Group Administrator". These forms are also available for you to order.

BCBSNC is diligently working to further automate required notices in the near future.

If you have any questions about these procedures, please contact your producer or BCBSNC account manager.

Thank you.

Attachments:

• New HIPAA Portability Regs Overview for Employers July 05