Comments on: Healthcare Reform: Thinking small, Part 2 http://thehealthcaremaze.us/2009/05/06/healthcare-reform-thinking-small-part-2/ A plea for a more rational system Sat, 14 Apr 2012 14:45:25 +0000 hourly 1 http://wordpress.org/?v=3.0.4 By: jimmy1920 http://thehealthcaremaze.us/2009/05/06/healthcare-reform-thinking-small-part-2/#comment-38 jimmy1920 Thu, 07 May 2009 14:11:51 +0000 http://thehealthcaremaze.wordpress.com/?p=583#comment-38 Thanks for comment. I am always worried about being factualy incorrect. You had me worried. I thought perhaps the Department of Labor web site was wrong. Here is what ifound in the regs. § 54.9801–4(b)(2)(iii) (iii) Significant break in coverage defined—A significant break in coverage means a period of 63 consecutive days during each of which an individual does not have any creditable coverage. (See section 731(b)(2)(iii) of ERISA and section 2723(b)(2)(iii) of the PHS Act, which exclude from preemption State insurance laws that require a break of more than 63 days before an individual has a significant break in coverage for purposes of State law.) I am not a lawyer and there may be case law that differs. there is certainly state law differences. And it may be that the law says two months but the regs say 63 days. either way, it reamins somewhat arbitrary. Thanks for comment. I am always worried about being factualy incorrect. You had me worried. I thought perhaps the Department of Labor web site was wrong.

Here is what ifound in the regs. § 54.9801–4(b)(2)(iii)

(iii) Significant break in coverage defined—A significant break in coverage means a period of 63 consecutive days during each of which an individual does not have any creditable coverage. (See section 731(b)(2)(iii) of ERISA and section 2723(b)(2)(iii) of the PHS Act, which exclude from preemption State insurance laws that require a break of more than 63 days before an individual has a significant break in coverage for purposes of State law.)

I am not a lawyer and there may be case law that differs. there is certainly state law differences. And it may be that the law says two months but the regs say 63 days. either way, it reamins somewhat arbitrary.

]]> By: Dr. Charles Engle http://thehealthcaremaze.us/2009/05/06/healthcare-reform-thinking-small-part-2/#comment-37 Dr. Charles Engle Thu, 07 May 2009 13:38:36 +0000 http://thehealthcaremaze.wordpress.com/?p=583#comment-37 The law actually says two months. Since it is true that twice in the calendar year 31 day months occur back-to-back, the law implies a 62 day period. Thus, 63 days would be outside the period and be considered as break in service. Nothing magic about 63 days except it is always outside of a two month period, while 62 days could be a two month period. The law actually says two months. Since it is true that twice in the calendar year 31 day months occur back-to-back, the law implies a 62 day period. Thus, 63 days would be outside the period and be considered as break in service. Nothing magic about 63 days except it is always outside of a two month period, while 62 days could be a two month period.

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