At Health Cost Solutions, we strive to offer quality resources for our clients. It is important that our clients are well informed and have access to useful materials, so we have provided information and links to various sources.

  • Forms
  • Education
  • Government
  • Healthcare Reform




File Name

Group Enrollment

Use this form for employee enrollment additions or changes.

Statement of Claim

Use this form for submitting claims to Health Cost Solutions.

Request for Confidential Communications

Use this form to request alternate or confidential communications.

Request for Restrictions on Use or Disclosure of Protected Health Information

For use to request a restriction on the use of disclosure of health information.

Request for an Accounting of Certain Disclosures of Health Information

For requesting an accounting of certain disclosures of protected health information.

Request for Amendment of Protected Health Information

Use this form to request the addition of information to your health information.

Request for Access to Protected Health Information

To request access or copies of Protected Health Information.

FSA Dependent Care Reimbursement Form

Use this form to submit eligible dependent care expenses for reimbursement.

FSA Health Care Expenses Reimbursement Form

Use this form to submit health care expenses for reimbursement.

Educational Links Healthcare reform


The following information should not be considered “legal advice”. You should consider carefully your firm’s individual needs for outside consulting or legal advice.

About HIPAA:

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was enacted to provide security and privacy of individuals health information. Group health plans were subject to the original act on the dates listed below. As of February 17, 2010, Business Associates of Group health plans legally became subject to HIPAA.

Original Key Compliance Dates:

Small Health Plans*

HIPAA Privacy Requirements

April 14, 2004

HIPAA EDI Requirements

October 16, 2004

* Small Health Plans are defined as less than $5 million in gross receipts.

To quote the CMS FAQs, “Self-insured plans, both funded and unfunded, should use the total amount paid for health care claims by the employer, plan sponsor or benefit fund, as applicable to their circumstances, on behalf of the plan during the plan’s last full fiscal year. Those plans that provide health benefits through a mix of purchased insurance and self-insurance should combine the proxy measures to determine their total annual receipts.”


The Health Information Technology for Economic and Clinical Health Act (HITECH Act) is part of the American Recovery and Reinvestment Act of 2009 (ARRA). Portions of the HITECH Act directly affect HIPAA as they deal with privacy and security issues of electronic transmission of health information. HITECH increases potential legal liability for non-compliance with HIPAA; increases and expands current HIPAA privacy and security protections and penalties; and provides more resources and tools for enforcement of privacy and security rules. As of February 18, 2011 the Office of Civil Rights (OCR) began enforcement of civil monetary penalties for HIPAA violations.