When you leave group coverage, you may be able to buy a conversion policy.  This is an individual health policy from the insurance company that covered your former group.

When do I have to be offered conversion policy?

• If you were covered under a fully insured group health plan for 3 months, you may be able to buy a conversion policy. You can buy a conversion policy if you lost your group coverage because you left your job or because the group coverage was terminated. However, before being eligible for a conversion policy, you must exhaust and COBRA or state condition coverage that was available to you. If the group coverage was terminated, you will immediately have the right to buy a conversion policy. If you had family coverage under your prior group plan, your dependents can elect conversion coverage as well.
• 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 will a conversion policy cover?

• The benefits under a conversion policy will probably not be the same as those under your former plan. The conversion policy’s benefits may be less generous than those you used to have.

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.

How much can I be charged for a conversion policy?

• Conversion policies may cost much more than your previous group plan. There is no limit on what you can be charged for a conversion policy. You may be charged higher rates based on your health, age, gender, and other factors. Contact the Tennessee Department of Insurance if you have questions about conversion policy premiums.

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.