Is it marketing for an insurance plan or health plan to send enrollees notices about changes, replacements, or improvements to existing plans?

Answer:

No. The HIPAA Privacy Rule excludes from the definition of “marketing,” communications about replacements of, or enhancements to, a health plan. Therefore, notices about changes in deductibles, co-pays and types of coverage, such as prescription drugs, are not marketing. Likewise, a notice to a family warning that a student reaching the age of majority on a parental policy will lose coverage, then offering continuation coverage, would not be considered marketing. Nor are special health care policies such as guaranteed issue products and conversion policies considered marketing. Similarly, notices from a health plan about its long term care benefits would not be considered marketing.

It would be considered marketing, however, for a health plan to send to its members promotional material about insurance products that are considered to be “excepted benefits” (described in section 2791(c)(1) of the Public Health Service Act), such as accident only policies. It would likewise be marketing for health plans to describe other lines of insurance, such as life insurance policies. Generally, such communications require authorizations.

Date Created: 12/20/2002