As part of the federal Health Care Reform law, employer-sponsored group health plans are no longer permitted to apply pre-existing condition exclusion periods to individuals covered under the plan. A pre-existing condition exclusion period is the time period during which a health plan will not pay for care relating to a pre-existing health or medical condition, such as asthma, diabetes, or cancer.
Prior to this change, employer-sponsored group health plans were generally required to issue documents demonstrating an employee’s prior health coverage (called “certificates of creditable coverage”) that could be used to reduce the pre-existing condition exclusion period that a plan could apply to the individual. The prohibition on pre-existing condition exclusions means that these certificates are now unnecessary. As a result, the requirement to issue certificates of creditable coverage was eliminated as of December 31, 2014.