HIPAA Regulations: General Provisions: Definitions - Group Health Plan- § 160.103

As Contained in the HHS HIPAA Rules

Group health plan (also see definition of health plan in this section) means an employee welfare benefit plan (as defined in section 3(1) of the Employee Retirement Income and Security Act of 1974 (ERISA), 29 U.S.C. 1002(1)), including insured and self-insured plans, to the extent that the plan provides medical care (as defined in section 2791(a)(2) of the Public Health Service Act (PHS Act), 42 U.S.C. 300gg-91(a)(2)), including items and services paid for as medical care, to employees or their dependents directly or through insurance, reimbursement, or otherwise, that:

1. Has 50 or more participants (as defined in section 3(7) of ERISA, 29 U.S.C. 1002(7)); or

2. Is administered by an entity other than the employer that established and maintains the plan.

For response to comments relating to “group health plan,” see the response to comments on “health plan” below and the response to comments on § 164.504.