When am I eligible for a conversion policy?

· In Connecticut, if you were covered under a fully insured group health plan and you leave that plan, you may be able to buy a conversion policy. This is an individual health policy sold through the Connecticut Health Reinsurance Association (HRA). In addition, besides the one offered through the HRA, your former group insurer may offer a non-HRA conversion policy.

· To qualify for a conversion policy, you must have lost group health insurance that you had been covered under for at least 12 months. In addition, you must not be covered under another comparable group health plan or individual health insurance policy.

· You must elect conversion within 120 days, in the case of voluntary termination of employment, or 150 days, in the case of involuntary termination of employment.

· You do not have to elect COBRA continuation coverage or state continuation coverage before you are allowed to buy a conversion policy. However, if you decide to purchase a conversion policy, you will no longer be considered HIPAA eligible.

What will my conversion policy cover?

· HRA offers a choice of three plans comparable to plans offered to small employers: HMO coverage, PPO coverage (in-network and out-of-network options) and a Special Health Care Plan. The benefits covered are generally the same under each plan, but the Special Health Care Plan does not cover outpatient prescription drugs. Plans also differ with respect to deductibles and other coinsurance requirements. All eligible family members must be covered.

· Non-HRA conversion policies must meet certain minimum benefit requirements, which may not be the same as those under your former plan. In addition, these conversion policies may not include important state mandated benefits that are otherwise required in HRA conversion policies.

What about coverage for my pre-existing condition?

· Conversion policies cannot impose a new pre-existing condition exclusion period. However, you might have to satisfy the unexpired portion of any pre-existing exclusion period from your former health plan.

How much can I be charged for a conversion policy?

· There are limits on what you can be charged for HRA conversion policy. Generally, the premium rates are 25% to 50% higher than the average rate of certain employer group premiums in Connecticut. For a male below the age of 30, for example, the HRA HMO plan monthly premium would be $311.97. For a 60 year-old male, on the other hand, the rate would be $1,355.01. There might be different rates for the Special Health Care Plan depending on your income. Contact the Connecticut Health Reinsurance Association for more information about premiums.

· There is no limit on what your insurer can charge for a non-HRA conversion policy. Premiums are determined based on the age and classification of risk of each person applying for a converted policy. These policies are often more expensive than your prior group coverage.

Can a conversion policy be canceled?

· You can remain enrolled as long as you pay your premium and continue to meet eligibility requirements.