The federal government has many regulations and laws that have established oversight for health insurance through the Employee Benefits Security Administration or EBSA. The EBSA is part of the United States Department of Labor which has oversight over many types of employer group health insurance plans. These can include specific programs and legislative acts passed by Congress.
COBRA continuation health coverage is a health benefit that was passed by Congress in 1986 called the Consolidated Omnibus Budget Reconciliation Act. This act amended the Employee Retirement Income Security Act or ERISA to continue health coverage that would normally been discontinued by an employer. COBRA is normally less expensive than a typical individual health insurance plan. The coverage period for COBRA will last for eighteen months.
HIPAA is a federal law known as the Health and Insurance Portability Act. The law was passed in 1996 that offers protections for individuals that need access to health care. The law has many features which include setting limits on new employer health plans to include a pre-existing condition exclusion. An additional feature is the ability of an individual to enroll in a group health plan if coverage is lost or a life event occurs. The law also guarantees that an individual has the ability to renew their individual health insurance policy.
Newborns’ and Mothers’ Protection Act
This act was signed into law on September 26, 1996 and includes protections for mothers and newborn children in a hospital following childbirth. The Newborns’ Act places limitations on group health plans, insurance companies and health maintenance organizations for hospital stays. Benefits cannot be restricted to less than a forty-eight hour period following natural childbirth. If a cesarean section was performed the restriction is ninety-six hours.
Womens’ Health and Cancer Rights Act
This law known as WHCRA was signed into law on October 21, 1998. The act provides protections for women who want to have breast reduction surgery after a mastectomy. This act modified the Employee Retirement Income Security Act of 1974 and the Public Health Service Act. Included in the act was the requirement for group health plans, insurance companies and health maintenance organization to provide reconstructive surgery coverage following a mastectomy.
Mental Health Parity Act
The Mental Health Parity Act or MHPA was signed into law on September 26, 1996. The law required that the coverage limits for medical and surgical benefits be the same for mental health benefits. This means that group health plans, insurance companies and HMOs that offer mental health coverage cannot have limits that are lower than medical and surgical benefits. The law also states that if no limit is set for medical and surgical benefits there can also be no limit for mental health benefits.