2011 HIPAA guaranteed health insurance for California residents …

Anthem Blue Cross – Blue Shield – Aetna – Health Net

If you have had health insurance for the last 18 months without a gap of more than 63 days, you may have the right to buy a California HIPAA individual health insurance policy. However, you must first use up Federal COBRA/Cal-COBRA if you qualified for that coverage.

So in other words, for those who are exhausting their COBRA benefits or are losing group health coverage with no employer contribution offering, HIPAA regulations allow you to purchase guaranteed-issue health coverage under the following rules:

• COBRA or Cal-COBRA benefits must be exhausted.
• You must have had health insurance for the last 18 months, and apply for a HIPAA plan within 63 days of this coverage ending.
• Your most recent health insurance must have been in an employer-sponsored group health plan.
• You must not have other health insurance, such as�group health insurance, Medi-Cal or Medicare.
• You did not lose your most recent health insurance because you failed to pay the premiums or because you tried to deceive the health insurance company.

California HIPAA Plans …

Health insurance companies which offer California HIPAA plans must offer their two most popular individual health insurance plans as their HIPAA choices:

Anthem Blue Cross:

• Anthem Blue Cross HIPAA – Rates & Brochure  (10/1/2010)
• Anthem Blue Cross HIPAA – Application
• Checking Account deduction form
• Credit Card form

Blue Shield:

• Blue Shield HIPAA Rates  (2/1/2011)
• Blue Shield HIPAA – Application
• Blue Shield – PPO 5000 & 5500
• Blue Shield – HSA 4000
• Blue Shield – HMO Plans

Health Net:

• Health Net HIPAA Benefit Brochure & Rate guide  (1/1/2011)
• Health Net HIPAA – Application

Aetna:

• Aetna HIPAA Rates   (7/1/2010)
• Aetna HIPAA – Application
• Aetna HIPAA Value MCOA POS 2500
• Aetna HIPAA Advantage MCOA POS 3500

HIPAA Plan Effective Dates:

• HMO HIPAA plans only offer a first of the month effective date.  So if your COBRA coverage ends in the middle of the month, you may be uninsured until the first of the month when your new HMO plan starts.
• PPO HIPAA plans – Start dates vary by each health insurance company:
• Start Dates: Please call for clarification – All HMO plans are the 1st of the month only.  PPO plans are 1st and 15th, depending on the carrier.
• Anthem Blue Cross -  Effective dates from October 1, 2010 forward: Individuals whose applications and payment are sent (or postmarked) between the 1st and 15th of any given month will be assigned an effective date of the 1st of the following month. For example, if someone sends in an application and payment on October 12, 2010, the earliest effective date for that member would be November 1, 2010.
  Individuals whose applications and payment are sent (or postmarked) after the 15th of the month will be assigned an effective date of the 1st of the second following month. For example, if someone’s application and payment is postmarked on October 25, 2010, the earliest effective date for that member would be December 1, 2010.
  Please note: The applicant’s option to request an effective date was removed from the application. We recommend applicants apply 30-60 days before the end of coverage to avoid a lapse in coverage.1st of the month only.  If you submit your completed application with premium within the first 15 days of the month Blue Cross will retro the effective date back to the 1st of the month.  Or you can the a future 1st of the month effective date.
• Blue Shield of California – 1st or 15th after application approval.
• Health Net – 1st or 15th after application approval.
• Aetna – 1st or 15th after application approval.

How to Apply …

1. Print and complete the appropriate company application.
2. Include a copy of the “Certificate of Credible Coverage” or a letter from your previous employer or insurance carrier reflecting 18 months of continuous coverage.
3. Include a copy of the COBRA/Cal-COBRA expiration/Termination letter or a letter from previous employer or insurance carrier showing COBRA was exhausted or not available.
4. Fax or Mail this paperwork to me.  I’ll do the rest for you.

Need help or have questions?

John Conner
Health & Medicare
www.JohnConner.com
john@johnconner.com
800-700-1246 – phone
800-995-9913 – fax