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Information on McKinley Life Insurance Company's New Open Enrollment Program Ohio's state budget (HB 1) passed in 2009. It includes new requirements that help uninsured adults to get coverage. The requirements include changes to open enrollment, which insurance companies offer each year to people who would not otherwise be able to get coverage. The new open enrollment program starts in January 2010. Q: What is open enrollment, and what changes have been made to this program? A:
Open enrollment is the time when people who don't have health coverage can apply for it.
People who cannot get health insurance coverage because of pre-existing medical
conditions, and those who have not been previously covered through an employer's
plan, may apply for individual coverage through "open enrollment".
Beginning in January 2010, every Ohio insurance
company must hold open enrollment until the company has taken its required
percentage of newly insured individuals. There are a few changes to the program.
First, insurers will be limited in how much they can
charge people with pre-existing or chronic conditions who buy individual health
policies through open enrollment.
Second, there is a rate cap. The cap on premium charges is two times the lowest rate being charged for
similar benefits for a person of similar age and gender who does not have these
conditions. The cap on charges applies only to open enrollment individual
coverage, not employer groups. Q: How do I enroll in coverage during the open enrollment period?
A:
Beginning January 1, 2010, you may ask for an application to be mailed to your
home address or complete the application below and mail to us for review. You do
not need to apply in person.
Click here for an Open Enrollment Application. Complete the
application and mail to the following address:
AultCare Q: Is there an enrollment quota that insurers must accept under the new
Open Enrollment program? A: Yes. Open Enrollment plans are required to take a percentage of
Federally Eligible Individuals and Non Federally Eligible Individuals during
their open enrollment period. That percentage is based on the total enrollment
in their other individual products. Q:
What does it mean to be a Federally Eligible Individual under the Open
Enrollment Program? A:
Ohio law requires us to accept a certain number of individuals for open
enrollment coverage without regard to health status. If you qualify as a
Federally Eligible Individual (FEI), your coverage will be effective immediately
without any pre-existing condition exclusion period. If you do not qualify as a
FEI, you may apply for non-FEI open enrollment coverage. You are a Federally Eligible Individual
if you meet all of the following conditions - 1. You had health coverage for at least 18 months without a break in coverage
greater than 63 days.
If we have not yet met our enrollment quota, we will offer you the Ohio health
care Basic or Standard benefit plans for purchase. You may need to submit proof of previous creditable coverage.
You are a Non-Federally Eligible
Individual if you meet the following conditions -
1. You are not applying for coverage as an employee of
an employer, member of an association or member of any other group.
If we have not yet met our enrollment quota, we will offer you the Ohio health
care Basic and Standard benefit plans for purchase.
We are not required to accept applicants who at the time of enrollment,
are confined to a health care facility due to chronic illness or permanent
injury. As a Non-Federally Eligible
Individual coverage may be limited for pre-existing conditions for the first 12
months, however, we will credit time you were covered under a recent previous
health plan.
Click here to view an outline
of the terms of the Basic and Standard benefit plans we offer. Q: What options are there if your plan meets the
enrollment quota? Is there a waiting list? A: If our plan has met the enrollment quota, you can access information on other carriers by going to www.insurance.ohio.gov. Otherwise, we do have a waiting list. If we have met our enrollment quota when you apply for coverage, we can add you to our waiting list. This list is monitored daily. When we have an opening in the open enrollment program we will contact you. If you are still interested in applying for the open enrollment program at that time, we will review your application for enrollment. Q: What are the factors that may be considered when you set open enrollment
rates? A: Ohio law allow insurers to take into account the age, gender and place of
residence of those we insure when determining rates. We must set open enrollment
rates based on an average of the costs associated with each of these categories.
A pre-existing condition can be used to exclude an individual from coverage for
a particular condition for a period of time, but cannot be used to determine a
rate.
Click here for Stark County
Rates Q: Once
enrolled, when will my first payment be due? A: Your first payment is due at the time you choose to buy a plan. Your check should be mailed with the acceptance letter. Premiums are then due the first of each month. Payments can be made either by Electronic Funds Transfer or by check. Q: When will my coverage be effective? A: Coverage begins the beginning of each month. Upon your acceptance of the plan your coverage will begin the first of
the following month.
Click here for the Basic Open Enrollment Policy Q: Where can I get more information about open enrollment? A: Call us at 330-363-6360 locally or 1-800-344-8858 long distance or Contact Us via
email for more information. |
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