When do I have to be offered a conversion policy?
- In Rhode Island, if you had coverage through a fully insured group health plan for at least 3 months and you leave that job, you are 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 first have used up any COBRA or state continuation coverage. You can buy a conversion policy without regard to health status.
What will a conversion policy cover?
- Insurers must offer you the choice of a variety of conversion policies. The benefits under a conversion policy will probably not be the same as those under your former plan.
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 a conversion policy?
- A conversion policy will be more costly than your former plan. Premiums will vary depending on your health status and may be high if you have a pre-existing condition. Also, your premiums also can vary depending on other characteristics such as age and gender.
Contact the Rhode Island Insurance Division if you have questions about your conversion policy premium.
Can my conversion policy be cancelled?
- 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.
