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* Provides rights and protections for participants and beneficiaries in group health plans, including protection for coverage that limit exclusions for pre-existing conditions

* Allows for opportunities to enroll in or purchase group or special health plans HIPAA has Implications for Youth with Disabilities

* States are required to provide people losing group coverage access to individual insurance regardless of their health status as long as they meet certain criteria. This can help adult children who qualify through their parent’s group coverage but may lose eligibility when they reach the age limit

* Youth with disabilities can apply for individual coverage as a “HIPAA eligible individual” through the Blues

- Eligible individuals include those who have had insurance for at least 18 months where the most recent coverage was under a group health plan or COBRA (Consolidated Omnibus Budget Reconciliation Act of 1986) coverage

- Applications must be made within 63 days of losing the group coverage

- It is critical that the person who has paid the premiums for the insurance request a certificate of coverage for portability from the Benefits office of their company. This proves the person with a disability had insurance

-- The youth then needs to present this document to their new employer. This will eliminate or reduce the waiting period for pre-existing conditions

COBRA - Consolidated Omnibus Budget Reconciliation Act of 1986

* Allows individuals and their dependent children the right to temporarily continue health coverage at group rates when the employee is laid off, resigns, and sometimes when fired

* Continued coverage will cost more than the normal group rate (COBRA plans include the employer’s share and the employee’s share of the health plan), but it is less expensive than many individual health plans and provides time to find other health insurance

* The law generally covers group health plans for employers who have 20 or more employees (to include part-time employees) except for plans sponsored by the federal government

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Appendix F: Social Security Administration (SSA)

Banner resource information:

To Apply for Social Security Benefits: Call toll-free 1(800)772-1213 To get more information or apply online at www.socialsecurity.gov

A. General Information

* Considers filing for benefits

* Knows how to contact their Social Security office located in their county

* Is aware of the appropriate use of SSI or Social Security payments

* Complies with reporting requirements to prevent penalties/loss of benefits

- Change in income, resources, or living arrangements

- Change of address, drop out of school, get or change a job, get married

- If going on to post-secondary schooling

* Considers contacting an advocacy agency for assistance in getting a job

- OVR, County MH/MR, ARC, Ticket to Work, Employment Network

* Recipients may be scheduled for review/determination of continued eligibility

* Is aware that appeals can be filed and follows them through

* Knows and follows time lines

B. Supplemental Security Income (SSI)

* Under age 18 years

- Eligibility is based on income and resources of the parents and of the child

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