G
Guest
Guest
Didn't Humana consolidate their cust service to Texas as well? MLR may be good for Texas. Makes sense to me.
Is Celtic the Only One That Does This?
- Thread starter somarco
- Start date
Didn't Humana consolidate their cust service to Texas as well? MLR may be good for Texas. Makes sense to me.
- Staff
- #12
and then when we succeed from the rest of the country we be setting pretty.......
G
Guest
Guest
Better think about shutting down the borders on ALL sides before it's too late!!
PS: I think you meant to say: secede? Or perhaps both?
- Thread starter
- #14
Response from the GA DOI
Short term medical coverage is considered creditable coverage. The carrier would need to issue a Certificate of Creditable coverage with the beginning and ending dates of the coverage. If a client is having trouble getting a certificate, you may refer them to our office, 404-656-2070, and we would be able to assist them in obtaining the certificate. You may also contact the carrier yourself and refer to the following code for support.
Georgia
Insurance Code
TITLE 33 -- INSURANCE...Chapter 24 -- INSURANCE GENERALLY...Article 1. General Provisions
33-24-21.1
Continuation of coverage after termination of group health insurance
(a) As used in this Code section, the term:
(1) "Assistance eligible individual" shall have the same meaning as provided by Section 3001 of Title III of the federal American Recovery and Reinvestment Act of 2009, as amended.
(2) "Creditable coverage" under another health benefit plan means medical expense coverage with no greater than a 90 day gap in coverage under any of the following:
(A) Medicare or Medicaid;
(B) An employer based accident and sickness insurance or health benefit arrangement;
(C) An individual accident and sickness insurance policy, including coverage issued by a health maintenance organization, nonprofit hospital or nonprofit medical service corporation, health care corporation, or fraternal benefit society;
(D) A spouse's benefits or coverage under medicare{Footnote 1} or Medicaid or an employer based health insurance or health benefit arrangement;
(E) A conversion policy;
(F) A franchise policy issued on an individual basis to a member of a true association as defined in subsection (b) of Code Section 33-30-1;
(G) A health plan formed pursuant to 10 U.S.C. Chapter 55;
(H) A health plan provided through the Indian Health Service or a tribal organization program or both;
(I) A state health benefits risk pool;
(J) A health plan formed pursuant to 5 U.S.C. Chapter 89;
(K) A public health plan; or
(L) A Peace Corps Act health benefit plan.
(3) "Eligible dependent" means a person who is entitled to medical benefits coverage under a group contract or group plan by reason of such person's dependency on or relationship to a group member.
(4) "Group contract or group plan" is synonymous with the term 'contract or plan' and means:
(A) A group contract of the type issued by a nonprofit medical service corporation established under Chapter 18 of this title;
(B) A group contract of the type issued by a nonprofit hospital service corporation established under Chapter 19 of this title;
(C) A group contract of the type issued by a health care plan established under Chapter 20 of this title;
(D) A group contract of the type issued by a health maintenance organization established under Chapter 21 of this title; or
(E) A group accident and sickness insurance policy or contract, as defined in Chapter 30 of this title.
(5) "Group member" means a person who has been a member of the group for at least six months and who is entitled to medical benefits coverage under a group contract or group plan and who is an insured, certificate holder, or subscriber under the contract or plan.
(6) "Insurer" means an insurance company, health care corporation, nonprofit hospital service corporation, medical service nonprofit corporation, health care plan, or health maintenance organization.
(7) "Qualifying eligible individual" means:
(A) A Georgia domiciliary, for whom, as of the date on which the individual seeks coverage under this Code section, the aggregate of the periods of creditable coverage is 18 months or more; and
(B) Who is not eligible for coverage under any of the following:
(i) A group health plan, including continuation rights under this Code section or the federal Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA);
(ii) Part A or Part B of Title XVIII of the federal Social Security Act; or
(iii) The state plan under Title XIX of the federal Social Security Act or any successor program.
Short term medical coverage is considered creditable coverage. The carrier would need to issue a Certificate of Creditable coverage with the beginning and ending dates of the coverage. If a client is having trouble getting a certificate, you may refer them to our office, 404-656-2070, and we would be able to assist them in obtaining the certificate. You may also contact the carrier yourself and refer to the following code for support.
Georgia
Insurance Code
TITLE 33 -- INSURANCE...Chapter 24 -- INSURANCE GENERALLY...Article 1. General Provisions
33-24-21.1
Continuation of coverage after termination of group health insurance
(a) As used in this Code section, the term:
(1) "Assistance eligible individual" shall have the same meaning as provided by Section 3001 of Title III of the federal American Recovery and Reinvestment Act of 2009, as amended.
(2) "Creditable coverage" under another health benefit plan means medical expense coverage with no greater than a 90 day gap in coverage under any of the following:
(A) Medicare or Medicaid;
(B) An employer based accident and sickness insurance or health benefit arrangement;
(C) An individual accident and sickness insurance policy, including coverage issued by a health maintenance organization, nonprofit hospital or nonprofit medical service corporation, health care corporation, or fraternal benefit society;
(D) A spouse's benefits or coverage under medicare{Footnote 1} or Medicaid or an employer based health insurance or health benefit arrangement;
(E) A conversion policy;
(F) A franchise policy issued on an individual basis to a member of a true association as defined in subsection (b) of Code Section 33-30-1;
(G) A health plan formed pursuant to 10 U.S.C. Chapter 55;
(H) A health plan provided through the Indian Health Service or a tribal organization program or both;
(I) A state health benefits risk pool;
(J) A health plan formed pursuant to 5 U.S.C. Chapter 89;
(K) A public health plan; or
(L) A Peace Corps Act health benefit plan.
(3) "Eligible dependent" means a person who is entitled to medical benefits coverage under a group contract or group plan by reason of such person's dependency on or relationship to a group member.
(4) "Group contract or group plan" is synonymous with the term 'contract or plan' and means:
(A) A group contract of the type issued by a nonprofit medical service corporation established under Chapter 18 of this title;
(B) A group contract of the type issued by a nonprofit hospital service corporation established under Chapter 19 of this title;
(C) A group contract of the type issued by a health care plan established under Chapter 20 of this title;
(D) A group contract of the type issued by a health maintenance organization established under Chapter 21 of this title; or
(E) A group accident and sickness insurance policy or contract, as defined in Chapter 30 of this title.
(5) "Group member" means a person who has been a member of the group for at least six months and who is entitled to medical benefits coverage under a group contract or group plan and who is an insured, certificate holder, or subscriber under the contract or plan.
(6) "Insurer" means an insurance company, health care corporation, nonprofit hospital service corporation, medical service nonprofit corporation, health care plan, or health maintenance organization.
(7) "Qualifying eligible individual" means:
(A) A Georgia domiciliary, for whom, as of the date on which the individual seeks coverage under this Code section, the aggregate of the periods of creditable coverage is 18 months or more; and
(B) Who is not eligible for coverage under any of the following:
(i) A group health plan, including continuation rights under this Code section or the federal Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA);
(ii) Part A or Part B of Title XVIII of the federal Social Security Act; or
(iii) The state plan under Title XIX of the federal Social Security Act or any successor program.
bob, you just made my brain explode with that post... its late man dont do this
- Thread starter
- #16
Well 2am here
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