As part of the health care reform measures included in the Health Insurance Portability and Accountability Act of 1996 (HIPAA), employer-sponsored group health plans and health insurers providing group health insurance coverage must provide a "certificate of creditable coverage" to a covered individual whenever any of the following "qualifying events" occurs: (i) the individual becomes entitled to elect COBRA continuation coverage; (ii) coverage of the individual under the group health plan otherwise ceases; and (iii) the individual's COBRA continuation coverage ceases. These certification requirements are effective beginning June 1, 1997 for qualifying events occurring on or after July 1, 1996.

As set forth in newly-issued federal regulations, employer group health plans and health insurers must do the following to comply with these provisions:

Prior to June 1, 1997, a certificate must be provided to affected individuals for qualifying events occurring between October 1, 1996 and June 1, 1997. This requirement may be satisfied by sending a notice of the individual's right to a certificate. A model notice is available for this purpose. A certificate must be issued upon request in response to the notice.

For qualifying events that occurred between July 1, 1996 and October 1, 1996, certificates must be provided to affected individuals only upon request.

For qualifying events occurring after June 1, 1997, certificates must be provided automatically to affected individuals. In addition, certificates must be provided to affected individuals upon requests made within 24 months after coverage ceases.

All certificates must provide information about the duration of the individual's health insurance coverage and the date on which coverage ceased. This information will enable subsequent group health plans and insurers to calculate the extent to which a preexisting condition exclusion may be applied to the individual under the substantive provisions of HIPAA which go into effect for plan years beginning after July 1, 1997. A model form of the certificate of coverage is available.

Because action is required prior to June 1, you should coordinate with your plan administrator and/or insurance provider now to ensure compliance with these new provisions.