What is a summary plan description?

Plan administrators covered by the Employee Retirement Income Security Act (ERISA) are obliged to provide plan holders and their beneficiaries a summary plan description (SPD).

The SPD is a vital document that provides plan participants all the information they need regarding their policy. In the SPD, participants are informed about how their plan operates and the benefits that will be provided to them. Plan amendments and other changes can also be seen in SPD. Calculation of benefits and services, and how benefits are released should be included in the SPD. Plan holders may request an SPD in writing from their administrators for free.

ERISA was created to protect the rights of policyholders and their beneficiaries from wrongfully being denied their benefits. If you believe that you have an ERISA claim in Indiana, The Hankey Law Office attorneys may represent you. Call us today at 800-520-3633 to find out how we may work for you.

Understanding ERISA

ERISA or the Employee Retirement Income Security Act of 1974 was created and amended to protect the rights of private health and pension policyholders and their beneficiaries in the United States.

Under ERISA, companies providing private health plans and pension plans are required to provide policyholders applicable information regarding their coverage, and must act within their policyholders’ best interest. Under a recent amendment to this act, it is now illegal to be denied coverage for preexisting conditions. ERISA also offers more protection against discrimination for vulnerable groups such as new mothers and those with mental illness.

The lawyers of The Hankey Law Office understand that  many people are wrongfully denied their benefits as a result of private health plans violating facets of ERISA. If you are in such a situation, our lawyers may be able to work for you to pursue claims against irresponsible parties. Find out how we may possibly help you today by calling 800-520-3633.

Entities that are regulated by HIPAA

Under the Health Insurance Portability and Accountability Act (HIPAA) of 1996, certain “individually identifiable health information” that covered entities have is protected. Usually, HIPAA enforces information privacy on the following:

  • Private and federal health insurance providers.
  • Health care providers, like hospitals, doctors, and most medical practitioners.
  • Any companies that receive workers’ medical information either digitally or on paper from another company regulated by HIPAA.
  • Business associates, like any third-party person or company that require access to workers’ medical information.

The protections to patients afforded by HIPAA is especially important when it comes to ERISA, as it provides employees and their covered family members from being denied health coverage due to pre-existing conditions. Unfortunately, as our team at the Hankey Law Office knows, many people in Indiana find themselves faced with ERISA-related issues. To get the legal help that you need when filing an ERISA claim, call (800) 520-3633.

Protections Afforded by HIPAA

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 was established to protect workers with preexisting medical conditions from being denied claim benefits.

Under HIPAA rules, certain policyholders’ information is kept private. This includes the following:

  • The information in the medical record of a policyholder.
  • Any communications or conversations between a policyholder and medical practitioners.
  • Any digital information of a policyholder stored in the computer of insurance company.
  • Policyholders’ billing transactions in their respective clinics.
  • Policyholders’ medical information that is held by health firms covered by HIPAA.

Though HIPAA is in place to protect policyholders from being denied medical coverage, many people find themselves facing difficulty getting the long-term disability care and insurance they need. To get help in such a situation, talk with our Indiana lawyers at the Hankey Law Office by calling (800) 520-3633 today.