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California HIPAA Health Insurance

Are you considering HIPAA health insurance options in California? Do you understand how HIPAA (Sometimes mistakenly referred to as HIPPA) and COBRA provisions work together to protect your health coverage options? As a CA resident you may find it to your advantage to know how the Health Insurance Portability and Accountability Act of 1996 and the Consolidated Omnibus Budget Reconciliation Act of 1986 work together to protect you in the area of health insurance.

Many are familiar with how COBRA works as they have often heard the term bounced around at their workplace if they work for a medium to large company (minimum of 20 employees) that offers health benefits. Generally speaking, COBRA allows those that are leaving their job for almost any reason other than gross negligence to be able to continue health coverage for a pre-determined time span (usually 18 months and sometimes 36 months).

This COBRA continuation coverage is simply a continuation of the exact same group coverage that the former employer offers to their employees. COBRA regulates how much can be charged of the normal group premium (up to 102%) and other eligibility criteria. (It is important to note that the 102% is 102% of the entire premium amount – most companies offer a benefits package where the employer pays most if not all of the health insurance premium for at least the employee and many times the employee’s family as well. After the employee leaves the company and elects COBRA – of course not many companies will continue to pay a portion of the premium cost).

If the employee elects COBRA and exhausts the coverage (uses up all 18 months or 36 months) then at that point the employee may be eligible for a California HIPAA health insurance plan. A CA HIPAA plan is not a group plan as the COBRA plan is. The HIPAA plan is an individual health plan with some important differences. The HIPAA plan is underwritten on a guaranteed issue basis – meaning that if there are some major pre-existing condition issues in the applicant’s past then that fact alone will not allow the insurance company to decline their application even though on a regular California individual health insurance plan they would probably be declined.

It follows then that HIPAA health insurance plans are more expensive than the exact same CA individual plan because of the differences in underwriting requirements. So how does one know whether they should search for a CA HIPAA plan or whether they should even elect a CA COBRA continuation plan in the first place? Here is a good general rule of thumb to keep in mind:

1. If you (and anyone else that will be on your coverage) are healthy (no health issues in the last 10 years) then it almost always makes sense to shop for a California individual health insurance plan on the open market rather than electing COBRA or HIPAA. Why? Individual health insurance premiums are approximately half of the cost of a comparable group health insurance plan due again to the difference in underwriting and the fact that on the individual side the applicant must meet the insurance companies set criteria for being healthy. However, there are a few exceptions:

A) If you or someone on your coverage is pregnant then you will not be eligible for most all California individual health insurance plans until after the pregnancy.

B) If you or someone on your coverage is considering becoming pregnant then keep in mind that maternity is not covered automatically as with most CA group health plans so be sure and compare CA group plan rates versus CA individual plan rates that include maternity coverage.

Compare your COBRA insurance premiums against regular California individual health insurance plans and against CA HIPAA plans side by side at California Health Insurance 360 by requesting free California health insurance quotes now!

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