COBRA for 18 months then what?

[OkWhy]

My friend says she and her husband have been paying COBRA for 15 months and that after 18 months the insurance company (united health care) will offer them (or is supposed to offer them) individual insurance with no pre-qualification and probably cheaper than what they're paying for cobra. ($800. month)

He's a type II diabetic, she is obese.

Is this true? If they pay cobra for 18 months is it convertable to an individual policy etc?

Is there any advice I should tell my friend to help them? Thanks!

 

[bluemarlin08]

It won't be cheaper and the benefits won't be as good as COBRA.

 

[Dave020]

My friend says she and her husband have been paying COBRA for 15 months and that after 18 months the insurance company (united health care) will offer them (or is supposed to offer them) individual insurance with no pre-qualification and probably cheaper than what they're paying for cobra. ($800. month)

He's a type II diabetic, she is obese.

Is this true? If they pay cobra for 18 months is it convertable to an individual policy etc?

Is there any advice I should tell my friend to help them? Thanks!

Yes, it is true. Carriers can (don't have to) offer individual conversion plans for those leaving group coverage. They are guaranteed issue individual policies.

Another avenue (usually) would be to look at the products available under HIPAA. Each state requires that individual guaranteed issue coverage be provided for those "exhausting" group coverage. Now each state is different in how it handles HIPAA, and it may be that they are the same in your state as the conversion plans, they may not be and may offer better coverage.

With a conversion, it must be with the same carrier that was the group employer-sponsored carrier. With HIPAA, you can choose from any of the available plans regardless of carrier.

I would advise to have them compare the UHC conversion plan against the available HIPAA plans to find the best benefits and pricing.

I know Paul (Moonlight) does HIPAA plans in FL so he might be of help to you.

 

[moonlightandmargaritas]

My friend says she and her husband have been paying COBRA for 15 months and that after 18 months the insurance company (united health care) will offer them (or is supposed to offer them) individual insurance with no pre-qualification and probably cheaper than what they're paying for cobra. ($800. month)

He's a type II diabetic, she is obese.

Is this true? If they pay cobra for 18 months is it convertable to an individual policy etc?

Is there any advice I should tell my friend to help them? Thanks!

It's a good thing they are HIPAA eligible!

Each company that sells individual health insurance in Florida has to make their top two selling plans available to HIPAA eligibles, on a guaranteed issue basis, without pre-existing condition limitation, at a premium of no more than 200% of the standard rate.

While they are underwritten, they always seem to come back with the max rate-up.

This sounds like their only alternative though. They don't have to stay with UHC, they can go with any company.

 

[Frank Stastny]

It has been a long time since I have dealt with anyone on COBRA.

The former employee, I believe, can receive COBRA for 18 months as stated but I believe that the dependents can continue on COBRA for 36 months. If he was the employee and she was the dependent, she can receive COBRA for an additional 18 months.

Since the cost is probably going to be substantially more than they are currently paying this should give them an opportunity for him to get a job and another group plan, if in fact he is looking, without both of them having to go off of COBRA at the same time.

 

[TXINSURANCE]

The issue is your state does NOT have a functioning risk pool - contact your brilliant legislators to discuss. A state risk pool solves this issue of COBRA expiration.

 

[somarco]

A state risk pool solves this issue of COBRA expiration.

A risk pool can be a solution, but is not always a workable solution. FL had (has) a risk pool, but it was poorly designed so it has been closed to new entrants for about a dozen years.

ME also has a risk pool and it is also closed. Again, poor design.

There are no simple, easy answers to "universal" coverage.

 

[indmedins]

It's a good thing they are HIPAA eligible!

Each company that sells individual health insurance in Florida has to make their top two selling plans available to HIPAA eligibles, on a guaranteed issue basis, without pre-existing condition limitation, at a premium of no more than 200% of the standard rate.

While they are underwritten, they always seem to come back with the max rate-up.

This sounds like their only alternative though. They don't have to stay with UHC, they can go with any company.

In FL, and I am sure Paul can attest. The Golden Rule plans available for GI HIPAA is either HSA100 $2,900 ded or Plan100 $2,500 ded, no optional add-ons.

For the rate: They take the base premium and add 10% then times that number by 2 and that is the GI rate in FL for GR.

 

[indmedins]

Need to fill out a paper app though. Also, Assurant pays commish on HIPAA cases in FL.

Plus with Golden Rule, you get 10% commish on those. Better than a sharp stick in the eye.

 

[Dave020]

What does Aetna pay on HIPAA in FL? They told me it is only commissionable in CA and FL, and FL has the better rate. CA we get a whopping 1%.