Risk Pool Name / Acronym
Indiana Comprehensive Health Insurance Association / ICHIA
Insurance Regulation Establishing Risk Pool
Indiana Department of Insurance
Health Insurance Portability and Accountability Act of 1996
Indiana Comprehensive Health Insurance Association (ICHIA)
In 1982, the state of Indiana established a high risk pool known as the Indiana Comprehensive Health Insurance Association (ICHIA) offers coverage to individuals who are unable to purchase an individual health insurance coverage because they have pre-existing health conditions. To be eligible, you must apply for individual coverage and be rejected by at least one health insurance company before you become eligible got ICHIA unless you are HIPPA-eligible. People who are fall under the category of HIPPA-eligible include those people who have had at least 18 months of continuous creditable coverage and those people who have exhausted all COBRA continuation coverage.
Funds to operate ICHIA come from premiums collected and assessments on the health insurance companies operating in the State of Indiana, along with a partial tax credit offset against insurance premium taxes paid by the insurance companies.
ICHIA offers four different comprehensive PPO plans, Plan 1, Plan 3, Plan 3A and Plan 4. Each plan has its own deductible, coinsurance and out-pocket maximum.
All 4 plans have a 20% coinsurance in-network and a 40% coinsurance out-of-network. Plan 1 has a $500 deductible and an annual out-of-pocket maximum of $1,500. Plan 3 has a $1,000 deductible an annual out-of-pocket maximum of $3,000. Plan 3A has a $1,500 deductible and an annual out-of-pocket maximum of $4,000. Plan 4 has a $2,500 deductible and an annual out-of-pocket maximum of $5,000.
Maximum Benefit Limits
To get information regarding the maximum lifetime benefit, contact ICHIA.
ICHIA has two general requirements and three eligibility categories. To qualify for health insurance under ICHIA, you must meet all of the general requirements and at least one of the eligibility categories.
You may first apply for Medicare within 60 days prior to submitting an application to ICHIA and provide a fully executable Medicaid Application verification form. Cover will be effective the later of the date your application is approved; the day after your previous medical insurance terminates; or a future date of your choosing as long as it is within 60 days of submitting your application.
Premiums are based on your health plan selection, your gender, your age and the geographical area in Indiana in which you reside.
Premiums for the ICHIA plan is capped at 150% of standard risk rates available for plans of similar benefit levels.
Pre-Existing Condition Waiting Periods
ICHIA plans exclude paying benefits on pre-existing conditions for three months following the effective date of coverage. The pre-existing exclusionary period will be waived if you lost your previous health insurance within 6 months of the date you apply for ICHIA coverage. Proof of prior coverage must be provided at time of application.
Indiana Comprehensive Health Insurance Association Contact Information
ACS Healthcare Solutions
4550 Victory Lane
Indianapolis, IN 46203
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