When you lose coverage under a fully insured group health plan in Arizona, in limited cases you are guaranteed the right to buy a conversion policy. This is an individual policy sold by the insurance company that covered your former group.

When am I eligible for conversion Coverage?

• In Arizona, if you lose coverage under an employer’s fully insured group health plan, you may be eligible to buy a conversion policy.   This is an individual policy you get from the company that issued your employer sponsored health insurance.
• Conversion rights are available to certain individuals.  People who may be eligible for a conversion policy include a surviving spouse and children upon the death of the insured, a young adult who reaches the age at which dependent coverage is terminated, and a former spouse and children at divorce.  In addition, if you are covered as a spouse or dependent under an individual policy in Arizona, you also have conversion rights.  You are eligible to buy a conversion policy upon the death or divorce of the insured policyholder or when you reach the age at which your dependent coverage terminates.
• If you had coverage through an employer’s fully insured HMO plan and you lose that coverage, you may be eligible to buy a conversion policy.  Conversion rights are available to you and your dependents if you lose your job, in the case of the death of the insured, divorce from the insured, or if you age off the policy.

What does a conversion policy cover?

• Coverage under a conversion policy may be less generous than under your previous policy.

What about coverage for my pre-existing condition?

• Conversion policies cannot impose a new pre-existing condition exclusion period. However, if you were in the middle of an exclusion period under your former group health plan coverage, you may have to finish it.

How much can I be charged for conversion coverage?

• Conversion policy premiums may be much more expensive than your former plan premiums. There are no limits on what you can be charged for a conversion policy.

  Contact the Arizona Department of Insurance if you have questions about conversion policy premiums.

Can my policy be cancelled?

• Your conversion coverage cannot be cancelled because you get sick. This is called guaranteed renewability. You have this protection provided that you pay the premiums, do not defraud the company, and, in the case of managed care plans, continue to live in the plan service area.