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Relocating - Starting a Business - HIPPA and High Risk Health Insurance Pools
Feb 14, 2011

I am planning to relocate a start a business and have some questions regarding how this decision will impact my access to health care incurance.

I am have been covered by the same employer's group policy for the past 10 years. The policy includes an 18 month COBRA provision. My employer currently provides coverage in the states of NY, NJ, PA, MD, DE & VA.

When I relocate, if I remain in one of the states where my employer provides coverage would I be eligible for a HIPPA guaranteed conversion policy. If so, what are the limitations and is there any protection against future rate increases or policy cancelations?

I am also considering whether to relocate to states where my employer does not provide insurance coverage (FL, CA, IL, WA, OR). Can I continue COBRA coverage even though it would be higher deductible for out of network providers? Would I qualify for a HIPPA guaranteed conversion policy in these states?

Some states (CA, WA, OR & IL) on my list of high risk insurance pools. Are there any potential risks (i.e. waiting lists, no prescription coverage, major medical only, catastrophic only, exposure to future rate increases) that I should be aware of with these types of policies?

Finally, some states plan to have the federal government administer their high risk insurance pool under new federal legislation. When will these policies be available? Are there any limitations (i.e. waiting list, no prescription drug coverage) under the federal program.

I know this is a lengthy / complicated question but would appreciate any insight you can provide. As I'm sure you can understand - medical insurance can be an impossible maze to try and navigate.

Thank you.

Response from Ms. Franzoi

I will try to answer each of your questions.

First, with respect to COBRA, if your employer has a self-insured plan that has both an in and out of network benefit, you should be able to get COBRA coverage even if you move to a state where your employer has no employees. However, if it is an insured plan, you would only be able to have coverage in the states where he is offering coverage. Contact the COBRA administrator to determine how your plan options would work in different states.

HIPAA is a federal law. So, assuming you exhaust COBRA or aren't eligible for COBRA, you would be eligible to purchase a HIPAA policy from any provider in the state you move to provided they offer such policies and you have not had a 63-day break in coverage.

The health insurance exchanges go into effect in 2014. However, some states might implement early. The terms of the plans would have to comply with the regulations so there would be prescription drug coverage, wellness benefits, etc.



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