Health insurance guys, pre-existing.....

[lendaddy]

I am switching our company to another carrier and am being told that if there is even a 30 day lapse in coverage that any pre-existing conditions will not be covered. I thought there was a 60 day window?

So if I cancel my policy with XYZ company and there is a 30 day period prior to the Blue Cross policy kicking in, then my guys are screwed on anything pre-existing?

This will not necessarily play out as we will not lapse but is this correct?

[Hugh R]

No expert here, but I believe insurance companies can write just about any rules that they want. Why would you want to have a lapse anyway? If you or one of your guys get hit by a truck during the lapse.....

[Neilk]

Per Wiki, you should be fine thanks to HIPAA

"Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.

Title I also limits restrictions that a group health plan can place on benefits for preexisting conditions. Group health plans may refuse to provide benefits relating to preexisting conditions for a period of 12 months after enrollment in the plan or 18 months in the case of late enrollment.[1] However, individuals may reduce this exclusion period if they had health insurance prior to enrolling in the plan. Title I allows individuals to reduce the exclusion period by the amount of time that they had “creditable coverage” prior to enrolling in the plan and after any “significant breaks” in coverage.[2] “Creditable coverage” is defined quite broadly and includes nearly all group and individual health plans, Medicare, and Medicaid.[3] A “significant break” in coverage is defined as any 63 day period without any creditable coverage.[4]"

[lendaddy]

Originally Posted by Hugh R

No expert here, but I believe insurance companies can write just about any rules that they want. Why would you want to have a lapse anyway? If you or one of your guys get hit by a truck during the lapse.....

There actually won't be a lapse, it's a unique situation.

[lendaddy]

Originally Posted by Neilk

Per Wiki, you should be fine thanks to HIPAA

"Title I of HIPAA regulates the availability and breadth of group and individual health insurance plans. It amends both the Employee Retirement Income Security Act and the Public Health Service Act.

Title I also limits restrictions that a group health plan can place on benefits for preexisting conditions. Group health plans may refuse to provide benefits relating to preexisting conditions for a period of 12 months after enrollment in the plan or 18 months in the case of late enrollment.[1] However, individuals may reduce this exclusion period if they had health insurance prior to enrolling in the plan. Title I allows individuals to reduce the exclusion period by the amount of time that they had “creditable coverage” prior to enrolling in the plan and after any “significant breaks” in coverage.[2] “Creditable coverage” is defined quite broadly and includes nearly all group and individual health plans, Medicare, and Medicaid.[3] A “significant break” in coverage is defined as any 63 day period without any creditable coverage.[4]"

Thanks Neil, I spoke directly with my broker and he said we would be fine as well. Though he stated it is now 45 days??? Either way we are covered.