Proposed Extension of Information Collection Request Submitted for Public Comment and Recommendations; Notice of Pre-Existing Condition Exclusion, Health Insurance Portability for Group Health Plans

DEPARTMENT OF LABOR

Pension and Welfare Benefits Administration

Proposed Extension of Information Collection Request Submitted

for Public Comment and Recommendations; Notice of Pre-Existing

Condition Exclusion, Health Insurance Portability for Group Health

Plans

ACTION: Notice.

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SUMMARY: The Department of Labor, as part of its continuing effort to

reduce paperwork and respondent burden, provides the general public and

Federal agencies with an opportunity to comment on proposed and/or

continuing collections of information in accordance with the Paperwork

Reduction Act of 1995 (PRA 95) ( 44 U.S.C. 3506(c)(2)(A)). This program

helps to ensure that requested data can be provided in the desired

format, reporting burden (time and financial resources) is minimized,

collection instruments are clearly understood and the impact of

collection requirements on respondents can be properly assessed,

Currently, the Pension and Welfare Benefits Administration is

soliciting comments concerning the proposed extension of a currently

approved collection of information, Notice of Pre-Existing Condition

Exclusion. A copy of the proposed information collection request (ICR)

can be obtained by contacting the addressee identified below.

DATES: Written comments must be submitted on or before February 28,

2000.

ADDRESSES: Gerald B. Lindrew, Department of Labor, Pension and Welfare

Benefits Administration, 200 Constitution Avenue, NW, Washington, DC

20210, (202) 219-4782, FAX (202) 219-4745 (not toll-free numbers).

SUPPLEMENTARY INFORMATION:

Background

Subtitle B of title 1 of ERISA, Part 7, section 707, added by the

Health Care Portability and Accountability Act of 1996 (Pub. L. 104-

191, Aug. 31, 1996) (HIPAA) authorizes the Secretary of Labor, in

coordination with the Secretary of Health and Human Services (HHS) and

the Secretary of the Treasury, to promulgate such regulations as may be

necessary or appropriate to carry out the provisions of the statute.

Accordingly, Interim Rules implementing the Portability Requirement for

Group Health Plans were published on April 8, 1997 (62 FR

[[Page 72698]]

16920 through 16923) (April 8 Interim Rules).

In order to meet HIPAA's goal of improving portability of health

care coverage, participants need to understand their right to

demonstrate prior creditable coverage when entering a group health plan

that imposes pre-existing condition exclusion provisions. In addition,

participants entering plans that use an alternative method of

determining creditable coverage also need to be informed of the plan's

provisions. Therefore, the Department has determined that plans that

contain these provisions must disclose that fact to new participants,

as well as inform individual participants of the extent to which a pre-

existing condition exclusion applies to them.

Review Focus

The Department of Labor (Department) is particularly interested in

comments which:

Evaluate whether the proposed collection of information is

necessary for the proper performance of the functions of the agency,

including whether the information will have practical utility;

Evaluate the accuracy of the agency's estimate of the

burden of the proposed collection of information, including the

validity of the methodology and assumptions used;

Enhance the quality, utility, and clarity of the

information to be collected; and

Minimize the burden of the collection of information on

those who are to respond, including through the use of appropriate

automated, electronic, mechanical, or other technological collection

techniques or other forms of information technology, e.g., permitting

electronic submissions of responses.

Current Actions: The Department has not modified the ICR

incorporated in the April 8 Interim Rules, but intends to submit the

ICR to OMB for continued clearance. Comments received in response to

this notice will be incorporated in the submission of OMB. The existing

collection of information should be continued because it implements

disclosure requirements mandated by the portability provisions enacted

in section 701 of HIPAA. Under the April 8 Interim Final Rules, a group

health plan or health insurance issuer may not impose any pre-existing

condition exclusions on a participant unless the participant has been

notified in writing that the plant contains preexisting condition

exclusions, that a participant has a right to demonstrate any period of

prior creditable coverage, and that the plan or issuer will assist the

participant in obtaining a certificate of prior coverage from any prior

plan or issuer, if necessary. Plans that use the alternative method of

crediting coverage must disclose their method at the time of enrollment

in the plan.

In addition, the April 8 Interim Rules require that before a plan

or issuer imposes a preexisting condition exclusion on a particular

participant, it must first disclose that determination in writing,

including the basis of the decision, and an explanation of any appeal

procedure established by the plan or issuer.

Agency: Department of Labor, Pension and Welfare Benefits

Administration.

Title: Notice of Pre-Existing Exclusion.

Type of Review: Extension of a currently approved collection.

OMB Number: 1210-0102.

Affected Public: Business or other for-profit, Not-for-profit

institutions, Individuals or households.

Frequency of Response: On occasion.

Respondents: 6,900.

Responses: 1,612,750.

Total Estimated Burden Hours: 6,875.

Total Burden Cost (Operating and Maintenance): $710,000.

Comments submitted in response to this notice will be summarized

and/or included in the request for Office of Management and Budget

approval of the information collection request; they will also become a

matter of public record.

Dated: December 22, 1999.

Gerald B. Lindrew,

Deputy Director, Office of Policy and Research, Pension and Welfare

Benefits Administration.

[FR Doc. 99-33600 Filed 12-27-99; 8:45 am]

BILLING CODE 4510-29-M