Wyoming Risk Pool - Health Insurance for the Uninsurable
Risk Pool Name / Acronym
Wyoming Health Insurance Pool / WHIP
Insurance Regulation Establishing Risk Pool
Wyoming Legislature
1990
Wyoming Health Insurance Pool (WHIP)
The Wyoming Health Insurance Pool, created by the 1990 Wyoming Legislature, provides health insurance coverage to residents of Wyoming who are denied adequate health insurance because of existing health problems
Funding
The Wyoming Risk Pool is funded by insurance premiums paid by program members and assessments of insurance carriers and HMOs along with a partial tax credit offset provided against premium taxes paid by the insurance carriers.
Plans Offered
There are two PPO medical insurance plans offered through WHIP: WHIP Brown, qualifies as a high deductible health plan and can be set up as a Health Savings Account, and WHIP Gold.
Plan Benefits
The WHIP Brown plan offers an annual deductible of $5,000. The WHIP member is responsible for 100% of all costs incurred until the deductible has been met. Once the deductible has been met, WHIP pays 100% for all covered medical services. The maximum out-of-pocket limit on this plan is $5,000. The WHIP Gold plans offers an annual deductible of $1,000. For most in-patient covered medical services, the WHIP member is required to pay a 20% coinsurance. For most out-patient covered medical services, the WHIP member is required to pay a 20% coinsurance. The maximum out-of-pocket limit for this plan is $2,000.
Maximum Benefit Limits
The lifetime maximum benefits for the WHIP Brown plan are $500,000, with lifetime maximum benefits for the WHIP Gold plan being $750,000.
Eligibility
- You must be a resident of the state of Wyoming and meet one of the following requirement
- You have been denied health insurance coverage from an insurance company and can provide a copy of the declination letter
- You were offered coverage, or have existing coverage, that is more restrictive than WHIP on providing health care benefits due to exclusionary waivers or waiting periods
- You were offered coverage, or have existing coverage, that has a higher monthly premium for similar coverage than is available through WHIP
- You are eligible under federal HIPAA regulations
And all of the following must also be true:
- You do not have other coverage in effect on the date that you want your WHIP coverage to start
- You are not eligible for other group medical insurance
- You are not covered by Medicare or Medicaid
- You have not had previous coverage under WHIP within the past 12 months, or have exhausted your maximum benefits under the same plan
- You are not an inmate of a public institution
Enrollment Periods
You may apply for Wyoming Health Insurance Pool coverage at anytime. Upon approval your coverage will begin on the 1st or the 16th of the month.
Premium Payments
Premiums for the WHIP plans are based on your plan selection, gender and age. Payments may be automatically withdrawn from your checking account or may be billed monthly, quarterly or semi-annually.
Premium Calculations
Premiums are determined by reviewing similar health plans available in the state of Wyoming that are available to standard eligible persons. WSHIP premiums are capped 200 percent of that rate.
Pre-Existing Condition Waiting Periods
Under the Wyoming Health Insurance Pool there is a 12 month waiting period from your effective date of coverage in which medical treatments for pre-existing medical conditions will not be paid by the pool. With proof of prior creditable coverage, you may be eligible for a full or partial waiver of this waiting period.
Wyoming Health Insurance Pool Contact Information
Wyoming Health Insurance Pool
4000 House Avenue
P.O. Box 2419
Cheyenne, WY 82003
Phone: 1-888-557-2519
WHIP Website
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