Massachusetts Health & Accident Insurance Practice Exam

Which type of plans do HIPAA rules apply to?

1. Workers compensation plans

2. Disability income plans

3. Group health plans

4. Short-term insurance plans

The correct answer is: Group health plans

The Health Insurance Portability and Accountability Act (HIPAA) primarily applies to group health plans. This includes employer-sponsored health plans and group insurance policies, as these plans often handle protected health information (PHI) of their participants. HIPAA sets forth regulations to ensure the privacy and security of individuals' health information, which is crucial in group settings where sensitive data could be exposed or mishandled. On the other hand, workers compensation plans are specifically designed to cover work-related injuries and illnesses and are regulated separately from HIPAA. Similarly, disability income plans generally provide coverage for loss of income due to disability but do not fall under the HIPAA regulations since they may not primarily deal with the management of health information. Short-term insurance plans, which provide temporary coverage for a limited duration, also do not meet the criteria for group health plans under HIPAA. Therefore, the applicability of HIPAA is clear and primarily revolves around the operation of group health plans.