Health Insurance Portability and Accountability Act (HIPPA) Practice Exam

Is an employer with fewer than 50 employees and self-insured considered a covered entity under HIPAA?

1. True

2. False

3. Depends on the state laws

4. Only if they deal with PHI

The correct answer is: False

An employer with fewer than 50 employees and self-insured is not considered a covered entity under HIPAA. Covered entities, as defined by HIPAA, include health plans, healthcare providers who transmit any health information electronically in connection with a HIPAA transaction, and healthcare clearinghouses. Self-insured employers, while they may provide health insurance for their employees, generally do not qualify as health plans under HIPAA unless they meet certain criteria. The size of the employer and the self-insured nature means that they do not fall under the category of health plans that must comply with HIPAA regulations, provided they do not engage in activities that involve the processing of PHI (Protected Health Information) in a manner that would categorize them as a covered entity. Therefore, the answer that states the employer with fewer than 50 employees and self-insured is not a covered entity aligns with the specific definitions and criteria set forth in HIPAA regulations.