When do I have to be offered A conversion policy?
- In Iowa, if you have coverage through an employer’s fully insured group health plan and you lose eligibility for that coverage, 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.
To qualify, though, you must have been covered under the employer’s plan for the entire 3 months immediately prior to termination. You do not need to be HIPAA eligible to buy a conversion policy, however you must have used up any COBRA or state continuation coverage that was offered to you. In addition, you cannot be eligible for any other insurance plan that covers similar benefits as the conversion policy.
You must apply within 10 days after notification of your right to elect a conversion policy. In addition, you must pay premiums for the conversion policy within 31 days of the date that your group coverage ended.
What will a conversion policy cover?
- You must be offered the choice of at least three basic conversion policies covering hospital stays and surgery. Each of the three basic options offers the same hospital room and board services, but with different levels of coverage (i.e. 100%, 75%, and 50% of covered services).
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 condition exclusion period from your former health plan.
What can I be charged for MY CONVERSION policy?
- Conversion coverage will be more costly than your former plan. Conversion premiums are not subject to the same limits applied to other individual health insurance. Contact the Iowa Division of Insurance if you have questions about your conversion policy premium.
Can my conversion policy be canceled?
- Conversion policies, like other individual health insurance policies, are guaranteed renewable. Your coverage cannot be canceled if you get sick.
