When do Insurers have to sell me a conversion policy?

• In Idaho, if you have coverage through an employer’s fully insured group health plan and you leave that job, and meet certain other requirements you are guaranteed the right to buy a conversion policy. This is an individual health insurance policy offered through the insurance company that covered your former group.
• Idaho health insurance companies that do not sell individual health insurance are required to offer you a conversion policy if you lose eligibility for your fully insured group health plan.

What will conversion policies cover?

• The conversion policy must provide benefits at least equal to those covered under a standard small employer health benefit plan.

What about coverage for my pre-existing condition?

• You will not have a new pre-existing condition exclusion period for your conversion policy.

What can I be charged for a conversion policy?

• There are limits on what you can be charged for a conversion policy. Idaho sets these limits to be 25% higher than premiums typically charged to employers for comparable group policies.

Can a 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 pay the premiums, do not defraud the company, and, in the case of managed care plans, continue to live in the plan service area.