I have a policy holder that is currently insured with a Limited Benefit Plan in which the total premiums for all coverage including other Fixed Indemnity and Supplemental Policies is just short of the requirement for ICHIA qualification based on total premium. If an applicant applies for the state high risk plan, would they have to disclose that they are insured with this current policy because the total benefit isnt adequate for meeting ACA requirement? They are both uninsurable with their current conditions but have Limited Benefit coverage. Hope this isnt too confusing to get a good answer. If there are any Indiana Agents that have dealt with this issue please lend me your info if possible, thanks!
Indiana Agents - Need Help
- Thread starter raven585
- Start date
- 4,096
www.onlinehealthplan.com
This is the link to the high risk pool for Indiana.
They could apply for Indiana Comprehensive Health. They will have to pay the high premium and jump through some hoops to get the policy. This plan will end Dec. 31st.
Jan 1st they will be able to a get a policy though the exchange or outside the exchange on GI. So you know GI mean guaranteed Issue.
This is the link to the high risk pool for Indiana.
They could apply for Indiana Comprehensive Health. They will have to pay the high premium and jump through some hoops to get the policy. This plan will end Dec. 31st.
Jan 1st they will be able to a get a policy though the exchange or outside the exchange on GI. So you know GI mean guaranteed Issue.
- Thread starter
- #3
I contacted ICHIA and let them know their current situation. Because they have a limited benefit plan, ICHIA matches their current deductible with the theirs and then will allow acceptance if their current premiums are higher than ICHIA...which it is not. The premium table shows a annual premium of 23,362, and their current LB plan plus supplemental is a few thousand dollars less than that.
If they applied for ICHIA and did not disclose their LB plan would it fly is my main question. Based on the ICHIA and their current coverage, the only real advantage to switching would be for claims above 200k. Their current benefits pay 100% of the next 150,000 after 50,000 (leaving 2,500 + 20% of the 50,000 total OOP. Its almost a wash as far as premiums, but maybe a bit better overall with ICHIA for Catastrophic claims above the 200k threshold.
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- 4,096
They would have to list it, and then let the high risk pool make the determination.
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