When am I eligible for a basic conversion policy?
In Georgia, if you have coverage through an employer’s fully insured group health plan for at least 6 months and you lose eligibility for that coverage, you may be able to buy a basic conversion policy. This is an individual policy you get from the company that insured your employer’s group plan.
What does a basic conversion policy cover?
What your basic conversion policy covers depends on the type of group plan you had.
If your former group plan was a fully insured group HMO, you must be offered at least one basic conversion policy that includes the same benefits that were covered under your prior HMO group plan.
If your former group plan was not an HMO, the conversion policy does not have to cover the same benefits as your former group health plan. Benefits may be less generous than what you received under you prior plan.
What about coverage for my pre-existing condition?
· If you are buying a conversion policy, you will not have a new pre-existing exclusion period. Basic conversion policies cannot impose a new pre-existing condition exclusion period but you may be required to satisfy any un-expired portion of a pre-existing condition exclusion period from your former group health plan.
How much can I be charged for basic conversion coverage?
· Your basic conversion policy may cost much more than your previous group health plan. There is no limit on what you can be charged for a conversion policy. You may be charged higher rates based on your health, age, and other factors. Contact the Georgia Office of Insurance if you have questions about basic conversion policy premiums.
Can my basic conversion coverage be canceled?
· Your coverage cannot be canceled 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. However, your premiums can increase substantially as you age and other factors.
