When am I eligible for a conversion Policy?

• In South Dakota, if you are losing fully insured group health insurance because of divorce, you may have the right to purchase a conversion policy. This is an individual policy you buy from the company that insured your spouse’s group plan.
• If you decide to purchase a conversion policy, you will no longer be considered HIPAA eligible.

What will conversion policies cover?

• You must be offered a policy similar to your previous coverage.

What about coverage for my pre-existing condition?

• Conversion policies cannot impose new pre-existing condition exclusion periods. However, if you were in the middle of a pre-existing condition exclusion period under your group health plan when it ended, you will have to finish it.

What can I be charged for conversion coverage?

• Premiums for conversion coverage are determined by the insurer issuing the policy. The cost is typically much higher than the cost of group coverage. If you have questions about conversion policy premiums, contact the South Dakota Department of insurance.

Can a conversion policy be cancelled?

• Your coverage cannot be cancelled 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.