NRPM: Standard Health Care Provider Identifier. 8. Small health plan.

05/07/1998

We would define a “small health plan” as a group health plan with fewer than 50 participants.

The HIPAA does not define a “small health plan” but instead leaves the definition to be determined by the Secretary. The Conference Report suggests that the appropriate definition of a “small health plan” is found in current section 2791(a) of the Public Health Service Act, which is a group health plan with fewer than 50 participants. We would also define small individual health plans as those with fewer than 50 participants.