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To be eligible
under Health Insurance Portability &
Accountability Act (HIPAA) criteria, you must:
-
Have had
a minimum of 18 months of continuous
coverage with no single gap of more than 95
days, the last of which was group coverage;
and
-
Apply to
the Pool within 95 days of your prior
coverage ending; and
-
You do
not have, nor are eligible for, other group
insurance. (Eligibility for individual
insurance does not disqualify you under
HIPAA.)
COBRA
If you are
offered group continuation coverage through
COBRA or some other continuation coverage, you
do not have to accept such coverage prior to
being eligible for the Pool. HOWEVER, if you are
offered COBRA/continuation coverage and you
elect it, you generally must exhaust it prior to
transferring to the Pool. Exceptions to the
requirement that COBRA be exhausted, if elected,
include:
-
The
premium rate for COBRA/continuation coverage
is above the Pool’s
qualifying rate.
-
COBRA/continuation coverage is no longer
offered where you live (Coverage for that
area is no longer available OR you have
moved out of the coverage area.)
-
Some
other special circumstances. Contact the
Pool if you have COBRA/continuation
coverage, and don’t wish to exhaust such
coverage, to discuss your circumstances.
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