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State Insurance Pool: Can it help you?
It is noteworthy that state insurance pools vary from state to state; however, they usually function within the confines of a state formed not-for-profit alliance, which is governed by a board of directors. In general, this board has representative members from the insurance industry, individual insurance customers, and members of the specific state insurance department. Operating very much like a clearing house, the board enters into contracts with an insurance company, and then oversees the day to day operations of collecting members’ premiums, receiving and paying out claims, and answering questions on eligibility for treatment. While coverage is frequently comparable to the coveted 80/20 major medicals and outpatient coverage, prospective members may still be denied plan benefits because of perceived issues of being uninsurable, yet this limitation is often restricted to a 12-month period. Thereafter, acceptance is all but guaranteed. While this is good news for patients seeking insurance protection, it is important to remember that this coverage, while state sponsored, is not free. As a matter of fact, premium costs are usually quite a bit higher than comparable plans offered on the open market by competing insurance companies, yet because of state law regulations, there is a firm cap on the amount of money a patient may be charged for insurance. In general, this cap runs between 125 to150 percent of the base individual market rate. While the cap is firm, there is still some elasticity in the rates, and they sometimes may vary based on plan participants’ ages, or even domicile addresses. Quite often copies of rejection notices must accompany an application for coverage under the umbrella of a state insurance pool from state-licensed insurance carriers. Additionally, anyone wishing to take advantage of a state-run plan must be a resident of the state in which the plan is offered. In lieu of a rejection by an insurance carrier, an individual who can evidence 18 months or more of uninterrupted health care coverage and is considered HIPAA eligible will quite often qualify for pool coverage. Coverage for dependants is available as well. In short, a state insurance pool is of invaluable help to anyone who has been denied health insurance because of pre-existing conditions or has exhausted the allotted time period of COBRA benefits, and needs assistance in receiving needed medical care without fear of exorbitant out-of-pocket expenses. As of 2003, thirty-three states offered high-risk pools to their residents. Twelve states have chosen to opt out of these programs by providing alternatives. For example, the District of Columbia has contracted with Carefirst Blue Cross Blue Shield to have an open enrollment period where interested individuals may purchase coverage regardless of medical conditions, and enjoy full benefits after only a short two-month waiting period. Rhode Island and Pennsylvania have contracted with Blue Cross/Blue Shield to offer year-round enrollment for otherwise deemed uninsurable patients. Interestingly, this health care concept has since been expanded to also apply to hurricane insurance. “Windstorm Coverage Pools” are an alternative for homeowners who are unable to purchase individual coverage for their residences. Homeowners in a few coastal counties of Georgia and New York are even to participate in pool coverage for wind and hail damage through a program entitled “FAIR” (Fair Access to Insurance Requirement). DISCLAIMER: This information is for educational and informational purposes only. The content is not intended to be a substitute for professional advice. Always seek the advice of a licensed Insurance Agent or Broker with any questions you may have regarding any Insurance Matter. Wake Up Richer Every Morning... Instant Internet Business Makes Money Automatically... Thomas Hunter is an Internet marketer, author and publisher and has helped hundreds of people become successful Niche Marketers. Explore the highly profitable world of Niche Marketing at http://SixFigureNiches.com our popular membership website. Article Source: http://netsalesinc.com If you have a website or ezine you may freely post this article on your site as long as you include the full resource box above. All links must be active / clickable with no syntax changes.
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