Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
Under HIPAA's portability provisions, when an employee changes group health plans, the new plan's pre-existing condition exclusion must:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
HIPAA's portability rules address the job-lock problem by requiring group plans to credit employees for prior continuous coverage. Creditable coverage, previous employer coverage, COBRA, and other qualifying coverage, reduces any pre-existing condition exclusion by the amount of prior coverage, provided the gap between plans does not exceed the statutory limit. This lets workers change jobs without losing protection. HIPAA is among the federal laws listed in the California A&H objectives affecting group medical plans.
Why the other options are wrong
- B) Ignoring prior coverage would defeat the purpose of portability; HIPAA requires crediting prior creditable coverage.
- C) There is no fee-based waiver; the credit for prior coverage is statutory, not purchased.
- D) Pre-existing exclusion rules apply to both employees and dependents; the portability credit is not limited to one side.
Memory hook
Creditable coverage is your insurance credit score; it rolls from job to job and shrinks pre-existing exclusions.