What Happens If I Lose My Group Health Insurance Coverage?
You May Be Eligible For COBRA Coverage:
If you were enrolled in your employer's group health plan, your employer had 20 or more employees, and you lost your health insurance coverage, the federal Consolidated Omnibus Reconciliation Act of 1985 ("COBRA") may provide you with the right to continue on your employer's group coverage for a limited period of time (generally 18 months, but in some cases up to 36 months).
You May Be Eligible For Conversion Coverage:
If you lost your coverage through an employer group health insurance plan, you may be eligible to convert that coverage to an individual health insurance policy ("conversion coverage").
To qualify for conversion coverage, you:
- must have been continuously covered under your group plan for at least 3 months prior to termination;
- must have had your coverage terminated for a reason other than non-payment of a required contribution;
- must not be covered or eligible for similar group coverage or Medicare benefits;
- must have exhausted your COBRA coverage if your employer was subject to COBRA coverage requirements.
In order to enroll in a conversion policy, you must submit your application for conversion coverage and pay your initial premium within 31 days after we provide you with official notice of your conversion rights.
What are my options if I don't qualify for COBRA or Conversion?
If you've lost your employer's group coverage, you may be eligible for a HIPAA* conversion policy. You will need evidence of "creditable coverage" from your last employer's insurer when you apply. In Pennsylvania, only Blue Cross Blue Shield companies sell HIPAA conversion policies. You have 63 days from the end of your employer group health plan or COBRA coverage for the Blue Cross Blue Shield health plan to receive your HIPAA conversion applications or you will lose this conversion right.
In addition, Blue Cross/Blue Shield plans in Pennsylvania serve as the carriers of last resort and offer individual guaranteed issue policies.
For more information from the Pennsylvania Insurance Department about your coverage, please click here.
Please Note: You should consult the terms of your coverage document for the specific requirements regarding COBRA coverage and conversion coverage.
* Health Insurance Portability and Accountability Act of 1996 ("HIPAA")
