Pennsylvania law provides individuals with some rights to purchase a conversion policy when certain events occur. A conversion policy is an individual policy sold by the insurer that provided your prior coverage. Conversion policies may be more expensive and not covered the same benefits as your prior policy.

When am I eligible for a conversion policy?

· In Pennsylvania, if you have three months of coverage through an employer’s fully insured group health plan and you leave that job, you may be eligible to buy conversion coverage. This is an individual policy you get from the company that insured your employer’s group plan. In addition, at the time of your application, you cannot be covered under or eligible for similar benefits through a group health plan, individual health insurance policy or Medicare.

· You must elect the option for a conversion policy within 31 days after receiving notice of your conversion rights.

· Conversion rights are also available to dependents covered under the employer’s group plan.

What will the conversion policy cover?

· Conversion policies are required to meet minimum standards set out in state regulations. Even so, the benefits may be less generous than what you received under your former group coverage.

What about coverage for my pre-existing condition?

· Your conversion policy 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 group coverage.

What can I be charged for my conversion policy?

· Conversion policies will likely cost more than your previous group plan. Conversion policy premiums are limited to 120% of what you would pay under a similar group policy.

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