Florida Association Health Plans
Q: I hope that you can help me. I am looking for an insurance company that I can actually join as part of a group plan even though I am an individual. I have a hospital/surgical blue cross, but I do need surgery and the pre-ex clause is not letting me get it, so I need to be on a group and can show them continous coverage. Any information that you can gimve me would be greatly appreciated. Thanks in advance.
A:Some states require insurance companies to provide group health insurance to self-employed groups of 1, but these are not typically guaranteed issue like most small group health plans with 2 or more members. With a pending surgery, you will definitely need to find “guaranteed issue” coverage. And, even if you do find guaranteed issue coverage, there could be a pre-existing condition waiting period, even on a group plan, for any medical condition that was excluded from your previous coverage.
What state do you live in? The health insurance laws vary from state to state.
I live in Florida. I also do have a Blue Cross hospital/surgical policy so can prove continuous coverage, but I have only had that policy for about 6 months now. That is why I need to be in a group or association policy, so that the pre-ex is a moot point. If you do have any information it will at lease be a starting point for me.
Comment by Linda — February 6, 2007 @ 3:09 pm
Florida is actually one of the few states that offers guaranteed issue coverage to qualified, self-employed groups of one. The problem is, its only once a year during an open enrollment period. Applications are accepted in August of each year, for an October 1st effective date. And, to further complicate matters, these guaranteed issued one-man group plans have a 2 year pre-existing condition waiting period, just like the one imposed on your individual policy. You can apply your 6 months of coverage to that waiting period, but that still leaves you with 18 months of having to wait to be covered for your surgery. The pre-existing condition waiting period is never moot, regardless of the new type of coverage you are obtaining. Even if you went to work for a company that offered group health insurance, there may still be a 12 month waiting period on pre-existing conditions.
Association plans are group health plans that are sometimes available to persons in a like trade, or part of a union or other association. They are not free-for-all plans available to everybody. So, if you are a member of some type of association, you can check with them to see if they have a group health plan option available to members. If there are association plans available in Florida, and allow open enrollment to the public, we are not aware of them. You might also try contacting the Florida Department of Financial Services consumer helpline at 800-342-2762. Perhaps they are aware of a solution that we are not familiar with.
Comment by admin — February 6, 2007 @ 3:10 pm