Kansas Risk Pool - Health Insurance for the Uninsurable

Risk Pool Name / Acronym
Kansas Health Insurance Association / KHIA

Insurance Regulation Establishing Risk Pool
Kansas Uninsurable Health Insurance Plan

Funding

KHIA is funded partially by the premiums collected by plan members. Deficits are subsidized by assessments paid by health insurance companies operating in the State of Kansas.

Plans Offered

All KHIA plans are PPO plans through two different networks of physicians, depending on your geographic location. There are 6 plans to choose from, Plan A, Plan B, Plan C, Plan D, Plan E and Plan F. Plan D is an HSA qualified plan.

Plan Benefits

All health plans available through KHIA have prescription drug benefits. Each plan has the same coinsurance level, which is 30% in-network and 50% out-of-network. Plan A has a $500 annual deductible. Plan B has a $1,000 annual deductible. Plan C has a $1,500 annual deductible. Plan D has a $2,500 annual deductible. Plan E has a $5,000 annual deductible. Plan F has a $7,500 annual deductible. Plans B, E and F continue to have a 10% coinsurance after the annual deductible and coinsurance maximum have been met. Plan D maximum out-of-pocket expenses are $5,250 both in and out-of-network.

KHIA Plan Summary

Maximum Benefit Limits

Plans B, E and F have calendar year maximums of $100,000. Plans A, C, D have no calendar year maximum. All plans have a $1,000,000 lifetime maximum benefit.

Eligibility
Enrollment Periods

Applications are accepted at anytime. Upon approval, your coverage will begin on the first day of the month following your approval if it complete prior to the cut-off date. If you are applying for coverage under the Federally Eligible category, your application must be submitted within 63 days of the termination date of your previous group health insurance policy.

Premium Payments

Premiums for KHIA plans are based on your plan selection and your age.

Premium Calculations

KHIA premiums are capped at 125% of the standard risk rate for similar type health insurance coverage available to Kansas residents that qualify for standard issue individual health insurance.

Pre-Existing Condition Waiting Periods

There is a 90 exclusionary period on receiving benefits for pre-existing medical conditions if you qualify under the Medical Condition Eligibility category. unless you qualify for a special waiver.

Kansas Uninsurable Health Insurance Plan Contact Information

Kansas Health Insurance Association
KHIA
P.O. Box 1090
Great Bend, KS 67530
Phone: (800) 362-9290
Fax: (620) 792-0535

KHIA Website

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