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Broker News | Vol. 9, No. 6 | May 16, 2014
Broker News | Vol. 9, No. 6 | May 16, 2014

Health Care Reform Update: Health Plan Identifier (HPID)

What is a Health Plan Identifier (HPID)?

A Health Plan Identifier (HPID) is a 10-digit ID that will be used to identify a health plan in HIPAA standard transactions. The HPID was created to eliminate the need for multiple identifiers and streamline HIPAA standard transactions, such as enrollment and eligibility transactions.

Who will use a HPID?

“Controlling health plans” are required to obtain and use a HPID. A "controlling health plan" is one that controls its business activities, actions and policies. "Subhealth plans" may, but are not required to, obtain a HPID. A "subhealth plan" is a plan whose activities, actions or policies are directed by a controlling health plan.

Self-funded plans are considered health plans and are required to use HPIDs. If you self-fund you are likely considered a “controlling health plan.”

HPID Timeline:

  • November 5, 2014: Deadline to apply for a HPID if your annual receipts are more than $5 million.
  • November 5, 2015: Deadline to apply for a HPID if your annual receipts are less than $5 million.
  • November 7, 2016: Begin using your HPID in all HIPAA standard transactions.

How to apply:

Have questions or want more information?


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