Hippa Coverage

[mzubek]

In Florida, if the employer cancels group coverage must the employee (who has pre x where they wouldn't be able to be underwritten) have to go on a cobra plan to become HIPPA eligible? Also if the group is below 20 lives, does the employee have the ability to offer cobra thus making the employee immediatley Hippa eligible?

Thanks in advance for your help.

 

[moonlightandmargaritas]

When the group is cancelled, there is no COBRA. The individual does become HIPAA-eligible, and qualifies for a GI plan.

 

[mzubek]

I am trying to help a3 person group that is with United Health Care. One has gone over to individual BCBS. The second has a quote that saves him around 400 a month. The third didnt like the rider of her thyroid with BCBS.

I called BCBS GI dept. and they said they need a letter of conversion from United Health. From your post I take it that their are no conversion options.

Am I taking the right approach?

 

[moonlightandmargaritas]

I called BCBS GI dept. and they said they need a letter of conversion from United Health.

No they don't.

They pull this because they don't want the GI business. If the people are HIPAA eligible, they can get it from ANY company - no "conversion letter" needed.

 

[DS4]

When did the employer plan cancel?

The canceled employee's should have rec'd "Certificate of Creditable Coverage" (CoCC) letters.

When applying for HIPAA guarantee issue, you generally need the CoCC, and, in this case, a letter(if possible) from the employer indicating the employer canceled the group health plan.

So you are trying to help the person that rec'd a waiver on their thyroid?
HIPAA guarantee issue is quite expensive. Probably 2X or 3X more than waivered policy.
Might be better to take the policy with the waiver.

 

[moonlightandmargaritas]

HIPAA guarantee issue is quite expensive. Probably 2X or 3X more than waivered policy.
Might be better to take the policy with the waiver.

In Florida, carriers are limited to 200% of the standard premium for HIPAA GI plans.

 

[DS4]

Cali is pretty rough on the HIPAA's.
As an example,
Zip 95928, male,
Age 35 for an underwritten $4000 deductible plan, $113/mo.
Age 35 for HIPAA $4000 deductible plan, $571/mo.

 

[mzubek]

Thanks a lot for the info!!

HIPAA guarantee issue is quite expensive. Probably 2X or 3X more than waivered policy.
Might be better to take the policy with the waiver.

I wish she would take it. She is 60 yrs old and has thyroid nodules which her Doctor is monitoring every 6 months. Should I suggest talking too her Doc and getting a cost on the worst case scenario (removing thyroid I would guess)? Then comparing that cost to her monthly savings by going on individual.

 

[somarco]

You need to walk away from this one.

 

[ABC]

You need to walk away from this one.

100% agree