Alaska Risk Pool - Health Insurance for the Uninsurable
Risk Pool Name / Acronym
Alaska Comprehensive Health Insurance Association / ACHIA
Insurance Regulation Establishing Risk Pool Alaska Legislature
Alaska Statute Title 21, Chapter 55
Funding
Funds to operate ACHIA come from premium payments, but in recent years, these premium payments have fallen way short of the claims ratio. Any deficit incurred by the plan is recouped by assessments that are collected from health insurance companies operating in the State of Alaska.
Plans Offered
There are several different comprehensive health insurance plans available through ACHIA. The primary difference between the plan options available is the deductible amount and the annual-out-pocket maximum limits you select at time of enrollment. For qualified participants under the age of 65, you may choose between a PPO plan and a traditional indemnity plan.
Plan Benefits
Under the PPO plan offered through ACHIA, you can choose a deductible ranging from $1,000 to $10,000. The traditional indemnity plan offers one deductible of $1,000. For all available plans, you pay a 20% coinsurance for all covered services performed in-network, and 40% for services out-of-network on the PPO plans. The out-of-pocket depends on your selected deductible and ranges from $2,500 to $15,000 respectively.
Maximum Benefit Limits
The maximum payable benefit under ACHIA health coverage is $1,000,000. Your coverage will terminate if you exceed this limit during the length of time you are insured under this program.
Eligibility
- Must be a resident of Alaska for at least 12 months
- Not eligible to be covered under a small group health insurance plan that is offered to businesses with between 2 and 50 employees
- Not eligible for medical insurance under a federal or state sponsored health care program
- Do not have other health insurance coverage in force
- And, have one of the following apply: received a notice of rejection from another health insurance company in the past 6 months, been offered health insurance with exclusionary riders that significantly reduce your benefits levels or have one of the medical conditions set forth in the ACHIA eligibility guidelines
Enrollment Periods
You may apply for ACHIA coverage at anytime. Policies will become effective on the first of month following date of acceptance. In some cases, your coverage may be made retroactive to the date that your previous group heath insurance terminated.
Premium Payments
Premiums are based only on your health plan selection and your age.
Premium Calculations
Monthly premiums are limited to 150% of the standard risk rate, which is determined by the board. A standard risk rate is based on what other Alaskans can obtain similar coverage for that if they are eligible for standard issue private health insurance.
Pre-Existing Condition Waiting Periods
There is a six month exclusionary period toward receiving benefits toward the treatment of pre-existing medical conditions. This waiting period can be waived if you had previous health insurance that was not voluntarily terminated and you applied for ACHIA coverage within 31 days of the termination date of that previous coverage. The six month waiting period will be reduced by the amount of time that your previous coverage was in effect.
Alaska Comprehensive Health Insurance Association Contact Information
Alaska Comprehensive Health Insurance Association
P.O. Box 1090
2015 16th St
Great Bend, Kansas 67530
Phone: 888-290-0616
ACHIA Website
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