[Federal Register Volume 62, Number 127 (Wednesday, July 2, 1997)]
[Rules and Regulations]
[Pages 35904-35906]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-17379]



[[Page 35903]]

  
  
  
  
  
  
  
  
  
_______________________________________________________________________

Part IV

Department of the Treasury
Internal Revenue Service
26 CFR Parts 54 and 602
  
Department of Labor
Pension and Welfare Benefits Administration
29 CFR Part 2590
  
Department of Health and Human Services
Health Care Financing Administration
45 CFR Parts 146 and 148
_______________________________________________________________________



Approval of Information Collection Requirements for the Joint Interim 
Rules for Health Insurance Portability for Group Health Plans, and the 
Individual Market Health Insurance Reform: Portability From Group to 
Individual Coverage; Federal Rules for Access in the Individual Market; 
State Alternative Mechanisms to Federal Rules; Interim Rules

  Federal Register / Vol. 62, No. 127 / Wednesday, July 2, 1997 / Rules 
and Regulations  

[[Page 35904]]



DEPARTMENT OF THE TREASURY

Internal Revenue Service

26 CFR Parts 54 and 602

[T.D. 8716]
RIN 1545-AV05

DEPARTMENT OF LABOR

Pension and Welfare Benefits Administration

29 CFR Part 2590

RIN 1210-AA54

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

45 CFR Parts 146 and 148

RIN 0938-AI08; RIN 0938-AH75


Approval of Information Collection Requirements for the Joint 
Interim Rules for Health Insurance Portability for Group Health Plans, 
and the Individual Market Health Insurance Reform: Portability From 
Group to Individual Coverage; Federal Rules for Access in the 
Individual Market; State Alternative Mechanisms to Federal Rules

AGENCIES: Internal Revenue Service, Department of the Treasury; Pension 
and Welfare Benefits Administration, Department of Labor; Health Care 
Financing Administration, Department of Health and Human Services.

ACTION: Interim rules with request for comments; approval of 
information collection requirements.

-----------------------------------------------------------------------

SUMMARY: On April 8, 1997, the Department of the Treasury, the 
Department of Labor, and the Department of Health and Human Services 
(Departments) published joint interim rules governing the access, 
portability and renewability requirements for group health plans and 
issuers offering group health insurance coverage in connection with a 
group health plan. The rules implemented changes made to certain 
provisions of the Internal Revenue Code of 1986 (Code), the Employee 
Retirement Income Security Act of 1974 (ERISA), and the Public Health 
Service Act (PHS Act) enacted as part of the Health Insurance 
Portability and Accountability Act of 1996 (HIPAA). In the April 8 
publication, the Departments submitted the group market information 
collection requirements, for, among other things, establishing 
creditable coverage, notice of special enrollment rights, and notice of 
pre-existing condition exclusion periods, to the Office of Management 
and Budget (OMB) for emergency review under the Paperwork Reduction Act 
of 1995 (PRA 95). In addition, on April 8, 1997 the Department of 
Health and Human Services submitted the HIPAA individual market 
information collection requirements to OMB for emergency review under 
PRA 1995. This document amends the April 8 Federal Register documents 
to properly display the OMB control numbers.

DATES: These amendments are effective June 1, 1997.

FOR FURTHER INFORMATION CONTACT: Russ Weinheimer, Internal Revenue 
Service, at 202-622-4695; Gerald Lindrew, Office of Policy and 
Research, U.S. Department of Labor, Pension and Welfare Benefits 
Administration, 200 Constitution Avenue, Room N-5647, Washington, DC 
20210, at 202-219-4782; John Burke, Department of Health and Human 
Services, Health Care Financing Administration, at 410-786-1325. (These 
are not toll-free numbers.)

SUPPLEMENTARY INFORMATION: The interim regulations published on April 
8, 1997 (62 FR 16894 and 16985), contained distinct information 
collection requests (ICRs) for the group and individual insurance 
markets. The ICRs issued by the Department of the Treasury and the 
Department of Labor apply to employers and group health plans. The ICRs 
issued by the Department of Health and Human Services apply to health 
insurance issuers.

Department of the Treasury and Department of Labor ICRs

    The ICRs on group health plans' obligations regarding Establishing 
Prior Creditable Coverage and Notice of Enrollment Rights are 
prescribed by the statute. The ICRs regarding the certification and 
special enrollment notice obligations of health insurance issuers are 
addressed separately in the Department of Health and Human Services' 
ICR.
    The first ICR implements statutorily prescribed requirements 
necessary to establish Prior Creditable Coverage. This is accomplished 
primarily through the issuance of certificates of prior coverage by 
group health plans or by service providers with which the group health 
plans contract in order to provide these documents. In addition this 
ICR permits the use of a notice that may be used by the plans to meet 
their obligations in connection with periods of coverage ending during 
the transition period, October 1, 1996 through May 31, 1997, saving the 
respondents both hours and cost during that period. This ICR also 
covers the requests that certain plans will make regarding additional 
information they require because they are using the Alternative Method 
of Crediting Coverage. Finally, this ICR also includes the occasional 
circumstances where a participant is unable to secure a certificate and 
needs to provide some supplemental form of documentation in order to 
establish prior creditable coverage.
    The second ICR, Notice of Enrollment Rights, imposes disclosure 
obligations on plans to inform a participant, at the time of 
enrollment, of the plan's special enrollment rules.
    The third ICR, Notice of Pre-existing Condition Exclusion, concerns 
the disclosure requirements on those plans that contain pre-existing 
condition exclusion provisions. This ICR has two components: a notice 
to all participants at the time of the enrollment stating the terms of 
the plan's pre-existing condition provisions, the participant's rights 
to demonstrate creditable coverage, and that the plan or issuer will 
assist in securing a certificate as necessary; and notice by the plan 
of its determination that an exclusion period applies to an individual.

Department of Health and Human Services ICRs

    The Department of Health and Human Services separately issued two 
Information Collection Requirements. The first one, titled Information 
Collection Requirements referenced in HIPAA for the Individual 
Insurance Market, will ensure that the issuers in the individual market 
will provide individuals with documentation necessary to demonstrate 
prior creditable coverage. These information collection requirements 
will also give the States the flexibility to implement State 
alternative mechanisms to protect HIPAA eligible individuals.
    The second information collection requirements, titled Information 
Collection Requirements referenced in HIPAA for the Group Health Plans, 
will ensure that the issuers in the group market will provide 
individuals with documentation necessary to demonstrate prior 
creditable coverage, and that group health plans notify individuals of 
their special enrollment rights in the group health insurance market.

Approval

    OMB reviewed the Department of the Treasury's collection of 
information collection in accordance with the

[[Page 35905]]

Paperwork Reduction Act of 1995 (PRA 95). On May 30, 1997, under OMB 
control number 1545-1537, OMB approved the information collection 
requests contained in (1) 26 CFR 54.9801-3T, 54.9801-4T and 54.9801-5T 
on rules relating to the notices regarding preexisting condition 
exclusion periods; (2) 26 CFR 54.9801-5T on rules relating to 
establishing prior coverage; and (3) 26 CFR 54.9801-6T on rules 
relating to special enrollment periods. These information collection 
provisions are currently approved until November 30, 1997.
    OMB also reviewed the Department of Labor's collection of 
information requirements in accordance with the PRA 95, 44 U.S.C. 
chapter 35, and 5 CFR 1320.11. On May 30, 1997, OMB approved the 
information collection requirements contained in 29 CFR 2590.701-6 for 
Notice of Special Enrollment Rights under OMB control number 1210-0101. 
OMB also approved the information collection requirements contained in 
29 CFR 2590.701-3, 2590.701-4, and 2590.701-5 for Notice of Preexisting 
Condition Exclusion under OMB clearance number 1210-0102. In addition, 
OMB approved the information collection requirements contained in 29 
CFR 2590.701-5 for Establishing Prior Creditable Coverage under OMB 
control number 1210-0103. These information collection provisions are 
currently approved until December 31, 1997.
    Finally, OMB reviewed the Department of Health and Human Services' 
collection of information requests in accordance with the PRA 95. On 
May 30, 1997, under OMB control number 0938-0702, OMB approved the 
information collection requests contained in 45 CFR 146.111, 146.115, 
146.117, 146.150, 146.152, 146.160 and 146.180 for issuers in the group 
market on demonstrating prior creditable coverage and notice of special 
enrollment rights. On the same day, under OMB control number 0938-0703, 
OMB also approved the information collection requests contained in 45 
CFR 148.120, 148.122, 148.124, and 148.128 for issuers in the 
individual market on demonstrating prior creditable coverage and State 
alternative mechanisms. These information collection requests are 
currently approved until December 31, 1997.

Statutory Authorities

    The Department of the Treasury temporary rule is adopted pursuant 
to the authority contained in 26 U.S.C. 7805 and in 26 U.S.C. 9806, as 
added by Section 401 (Pub. L. 104-191, 101 Stat. 1936).
    The Department of Labor interim final rule is adopted pursuant to 
the authority contained in 29 U.S.C. 1027, 1059, 1135, 1171, 1194; 
Section 101, Public L. 104-191, 101 Stat. 1936 (29 U.S.C. 1181); 
Secretary of Labor's Order No. 1-87, 52 FR 13139, April 21, 1987.
    The Department of Health and Human Services interim final rule is 
adopted pursuant to the authority contained in Sections 2701 through 
2723 of the Public Health Service Act (PHS Act, 42 U.S.C. 300gg, et. 
seq.), Sections 2741 through 2763 of the PHS Act, and 2791 through 2792 
of the PHS Act as amended by HIPAA.

List of Subjects

26 CFR Part 54

    Excise taxes, Health insurance, Pensions, Reporting and 
recordkeeping requirements.

29 CFR Part 2590

    Employee benefit plans, Employee Retirement Income Security Act, 
Group health plans, Health care, Health insurance, Reporting and 
recordkeeping requirements, Welfare benefit plans.

45 CFR Parts 146 and 148

    Health care, Health insurance, Reporting and recordkeeping 
requirements, State regulation of health insurance.

Internal Revenue Service

26 CFR Chapter I

    Accordingly, 26 CFR Part 602 is amended as follows:

PART 602--[AMENDED]

    1. The authority citation for Part 602 continues to read as 
follows:

    Authority: 26 U.S.C. 7805.

    2. In Sec. 602.101, paragraph (c) is amended by adding entries in 
numerical order to the table to read as follows:


Sec. 602.101  OMB Control numbers.

* * * * *
    (c) * * *

------------------------------------------------------------------------
                                                            Current OMB 
   CFR part or section where identified and described       control No. 
------------------------------------------------------------------------
                                                                        
                  *        *        *        *        *                 
54.9801-3T..............................................       1545-1537
54.9801-4T..............................................       1545-1537
54.9801-5T..............................................       1545-1537
54.9801-6T..............................................       1545-1537
                                                                        
                  *        *        *        *        *                 
------------------------------------------------------------------------

Dale D. Goode,
Federal Register Liaision, Assistant Chief Counsel (Corporate).

Pension and Welfare Benefits Administration

29 CFR Chapter XXV

    Accordingly, 29 CFR Part 2590 is amended as follows:

PART 2590--[AMENDED]

    1. The authority citation for Part 2590 continues to read as 
follows:

    Authority: 29 U.S.C. 1027, 1059, 1135, 1171, 1194; Sec. 101, 
Pub. L. 104-191, 101 Stat. 1936 (29 U.S.C. 1181); Secretary of 
Labor's Order No. 1-87, 52 FR 13139, April 21, 1987.

    2. In Sec. 2590.701-3, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 2590.701-3  Limitations on preexisting condition exclusion period.

* * * * *
(Approved by the Office of Management and Budget under control 
number 1210-0102.)

    3. In Sec. 2590.701-4, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 2590.701-4  Rules relating to creditable coverage.

* * * * *
(Approved by the Office of Management and Budget under control 
number 1210-0102.)

    4. In Sec. 2590.701-5, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 2590.701-5  Certification and disclosure of previous coverage.

* * * * *
(Approved by the Office of Management and Budget under control 
numbers 1210-0102 and 1210-0103.)

    5. In Sec. 2590.701-6, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 2590.701-6  Special enrollment periods.

* * * * *
(Approved by the Office of Management and Budget under control 
number 1210-0101.)

    Signed at Washington D.C. this 24th day of June, 1997.
Alan D. Lebowitz,
Deputy Assistant Secretary for Program Operations, Pension and Welfare 
Benefits Administration, Department of Labor.

Health Care Financing Administration

45 CFR Subtitle A, Subchapter B

    Accordingly, 45 CFR Parts 146 and 148 are amended as follows:

[[Page 35906]]

PART 146--[AMENDED]

    1. The authority citation for Part 146 continues to read as 
follows:

    Authority: Secs. 2701 through 2763, 2791, and 2792 of the PHS 
Act, 42 U.S.C. 300gg through 300gg-63, 300gg-91 and 300gg-92.

    2. In Sec. 146.111, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 146.111  Limitations on preexisting condition exclusion period.

* * * * *
(Approved by the Office of Management and Budget under control 
number 0938-0702.)

    3. In Sec. 146.115, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 146.115  Certification and disclosure of previous coverage.

* * * * *
(Approved by the Office of Management and Budget under control 
number 0938-0702.)

    4. In Sec. 146.117, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 146.117  Special enrollment periods.

* * * * *
(Approved by the Office of Management and Budget under control 
number 0938-0702.)

    5. In Sec. 146.150, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 146.150  Guaranteed availability of coverage for employers in the 
group market.

* * * * *
(Approved by the Office of Management and Budget under control 
number 0938-0702.)

    6. In Sec. 146.152, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 146.152  Guaranteed renewability of coverage for employers in the 
group market.

* * * * *
(Approved by the Office of Management and Budget under control 
number 0938-0702.)

    7. In Sec. 146.160, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 146.160  Disclosure of information.

* * * * *
(Approved by the Office of Management and Budget under control 
number 0938-0702.)

    8. In Sec. 146.180, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 146.180  Treatment of non-Federal governmental plans.

* * * * *
(Approved by the Office of Management and Budget under control 
number 0938-0702.)

PART 148--[AMENDED]

    9. The authority citation for Part 148 continues to read as 
follows:

    Authority: Secs. 2741 through 2763, 2791, and 2792 of the Public 
Health Service Act (42 U.S.C. 300gg-41 through 300gg-63, 300gg-91 
and 300gg-92).

    10. In Sec. 148.120, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 148.120  Guaranteed availability of individual health insurance 
coverage to certain individuals with prior group coverage.

* * * * *
(Approved by the Office of Management and Budget under control 
number 0938-0703.)

    11. In Sec. 148.122, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 148.122  Guaranteed renewability of individual health insurance 
coverage.

* * * * *
(Approved by the Office of Management and Budget under control 
number 0938-0703.)

    12. In Sec. 148.124, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 148.124  Certification and disclosure of coverage.

* * * * *
(Approved by the Office of Management and Budget under control 
number 0938-0703.)

    13. In Sec. 148.128, by adding a parenthetical at the end of the 
section to read as follows:


Sec. 148.128  State flexibility in individual market reforms--
alternative mechanisms.

* * * * *
(Approved by the Office of Management and Budget under control 
number 0938-0703.)

    Dated: June 26, 1997.
Edwin J. Glatzel,
Director, Management Analysis and Planning Staff, Office of Financial 
and Human Resources, Health Care Financing Administration, Department 
of Health and Human Services.
[FR Doc. 97-17379 Filed 7-1-97; 8:45 am]
BILLING CODE 4120-03-P; 4830-01-P; 4510-29-P