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South Carolina Risk Pool - Health Insurance for the Uninsurable

Risk Pool Name / Acronym
South Carolina Health Insurance Pool

Insurance Regulation Establishing Risk Pool
South Carolina Code of Laws
Title 38; Chapter 74

South Carolina Health Insurance Pool

The South Carolina Health Insurance Pool (SCHIP), created by the South Carolina General Assembly by Act 127 of 1989, offers health insurance coverage to residents of South Carolina who are unable to obtain health insurance because of a medical condition. You may also apply for the SCHIP coverage after the exhaustion of COBRA or State Continuation benefits.

Funding

The SC Risk Pool is funded by premiums collected from the plan members and assessment of insurance companies and HMOs operating in the state of South Carolina.

Plans Offered

The South Carolina Risk Pool is administered by Blue Cross Blue Shield of South Carolina who one of their available individual health plans under the risk pool program.

Plan Benefits

The health plan available through BCBS of South Carolina has a $500 annual deductible and a 20% coinsurance which you pay after meeting the plan deductible. For further information about the plan benefits, contact BCBS of SC.

Maximum Benefit Limits

For further information about the plan maximums, contact BCBS of SC.

Eligibility
  • You must be a resident of South Carolina for at least 30 days
  • You have been declined for health insurance from a private health insurance company because of pre-existing medical conditions
  • You were accepted for private health insurance, but have had a pre-existing condition exclusion placed on your coverage for more than 12 months
  • You were accepted for private health insurance and are paying an insurance premium that is higher than 150% of the premium amount charged by SCHIP
  • In some cases, you are also eligible for SCHIP enrollment if you lost your previous health insurance coverage under a group health plan
Enrollment Periods

For further information about enrollment guidelines, contact BCBS of SC.

Premium Payments

For further information about premium payments, contact BCBS of SC.

Premium Calculations

According to SC state law, "rates established must provide fully for the expected costs of claims and expenses of operation taking into account investment income and any other cost factors but may not exceed two hundred percent of rates established as applicable for individual standard risks subject to the limitations described in this section. All rates and rate schedules must be submitted to the director or his designee for approval."

Pre-Existing Condition Waiting Periods

SCHIP does not cover any charges or expenses incurred during the first six months after your effective date under this policy for pre-existing conditions. The pre-existing condition limitations will be waived for a Federally Defined Eligible Individual. or a Qualified TAA Eligible Individual if the person had creditable coverage for a total period of three months without a break of 63 days in coverage.

South Carolina Health Insurance Pool Contact Information

South Carolina Health Insurance Pool
P. O. Box 61173
Columbia, SC 29260
Phone: 803-868-2500 ext 46401

South Carolina Risk Pool Website

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