FAQs Added on Health Plan Identifier for HIPAA Transactions

Author: Gloria Ju

The health plan identifier (HPID) is a standard, unique identifier to be used in Health Insurance Portability and Accountability Act (HIPAA) standard transactions. A final rule on the HPID, which was established under the Administrative Simplification provisions of the Affordable Care Act, was published in 2012. However, in October, enforcement of the rule was delayed until further notice.

Despite the delay, an employer should be prepared for future implementation of the HPID. In order to help an employer understand HPID requirements, the following FAQs have been added to XpertHR:

• What is a controlling health plan (CHP) for health plan identifier (HPID) purposes?

• What is a subhealth plan (SHP) for health plan identifier (HPID) purposes?

• May a health plan identifier (HPID) be used outside of HIPAA standard transactions?

• Does a health plan identifier (HPID) need to be added to all HIPAA standard transactions?

• Must an employer with a fully insured health plan obtain a health plan identifier (HPID)?

• Must an employer with a self-insured health plan obtain a health plan identifier (HPID)?

• May an employer have its third-party benefits administrator (TPA) obtain a health plan identifier (HPID) for the employer's self-insured plan?

• How are health plan identifiers (HPIDs) handled for wrap plans?