If you lose coverage under a fully insured group health plan in Florida and meet other requirements, you are guaranteed the right to buy a conversion policy. This is an individual health policy sold by the insurance company that covered your former group.

When am I eligible for a conversion policy?

· In Florida, if you have 3 months of coverage through an employer’s fully insured group health plan and you lose eligibility for the plan, you may be eligible to buy a conversion policy. This is an individual policy you get from the company that insured your employer’s group plan. Your covered dependents are also eligible for conversion.

· Your coverage cannot have been terminated because you failed to pay your premium. However, if your group coverage was canceled because your employer failed to pay the premium, you can buy a conversion policy.

· If your terminated coverage is replaced by similar group coverage within 31 days, you cannot buy a conversion policy.

· Generally, your written application and first payment must be provided to the insurer within 63 days of losing coverage.

What does a conversion policy cover?

· You must be offered two standardized conversion policies that meet state requirements for minimum coverage. In addition, if your group health plan covered maternity, dental, or mental health and substance abuse benefits, these benefits must be covered under your conversion policy. Insurers can offer non-standard conversion policies as well. Ask the Florida Department of Financial Services if you have questions about coverage under a conversion policy.

What about coverage for my pre-existing condition?

· You will not have a new pre-existing condition exclusion period for your conversion policy. The conversion policy can only exclude coverage for pre-existing conditions that were excluded under the prior group health plan.

How much can I be charged for my conversion policy?

· Florida limits the premiums that can be charged for conversion policies. The premium for your conversion policy cannot be more than 200% of the standard rate for an individual policy. These policies may cost more than your prior group coverage. Contact the Florida Department of Financial Services if you have questions about conversion policy premiums.

Can my conversion policy be canceled?

· Your coverage cannot be canceled because you get sick. This is called guaranteed renewability. You have this protection provided that you do not lose your prior coverage because of failure to pay the premiums.