When am I eligible for a conversion policy?

· In Kentucky, if you have coverage through an employer’s fully insured group health plan and you lose that coverage, you are eligible to buy a conversion policy. A conversion policy is an individual policy you get from the company that insured your employer’s group plan.

· To qualify for a conversion policy, you must have had at least 3 months of continuous coverage through an employer’s fully insured group health plan. In addition, you must not be covered under, or eligible for coverage under Medicare or another group health plan. Finally, you must apply and pay your first premium within 31 days after receiving notice of your conversion rights.

· Conversion rights are also available to a surviving spouse and children upon the death of the insured, to a child when the child reaches that age at which dependent coverage is terminated, and to a former spouse and children at divorce.

· You do not need to be HIPAA eligible to buy a conversion policy. However, if you do elect a conversion policy, you will lose your HIPAA eligibility status.

What does a conversion policy cover?

· Conversion policy benefits must meet certain minimum benefit requirements, which may not be the same as those under your former plan.

What about coverage for my pre-existing condition?

· A conversion policy cannot impose a new pre-existing condition exclusion period. However, if you were in the middle of an exclusion period under your former group health plan coverage, you may have to finish it.

How much can I be charged for a conversion policy?

· Conversion policy premiums may be much more expensive than your former group plan premiums. Kentucky does place limits on how much you can be charged, but your age and health status will be taken into account in figuring your premiums.

Can my conversion policy be canceled?

Conversion policies, like other individual health insurance policies, are guaranteed renewable. Your coverage cannot be canceled because you get sick. You have this protection provided that you pay the premiums, do not defraud the company, and, in the case of managed care plan, continue to live in the plan service area. Also, if you become eligible for Medicare or other insurance with similar benefits, you will no longer be eligible for a conversion policy.