Health Information Management

What is a plan sponsor?

HIPAA Weekly Advisor, July 25, 2005

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According to the HHS commentary, the plan sponsor is the employer or employee organization, or both, that establishes and maintains an employee benefit plan. In the case of a plan established by two or more employers, it is the association, committee, joint board of trustees, or other similar group of representative of the parties that establish and maintain the employee benefit plan. This term includes church health plans and government health plans.

Plan sponsors of group health plans are not covered entities. However, the regulations permit group health plans, (and allow them to authorize health insurance issuers or HMOs with respect to the group health plan), to disclose PHI to a plan sponsor if the plan sponsor voluntarily agrees to use and disclose the information only as permitted or required by the regulations. The information may be used only for plan administration functions performed on behalf of the group health plan which are specified in plan documents.

For more information see Section 164.504(f), "Requirements for Group Health Plans," on the Bricker Eckler Web site.

Editor's note: Attorneys from Bricker & Eckler LLP answered this question. This is not legal advice. Consult your attorney for legal matters.



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