This is an HISTORICAL page
click icon at right for NEW Health Care Reform Guaranteed Issue Plans.

When & how should I submit my application?

DO NOT WAIT – TURN YOUR APPLICATION IN EARLY – Let the Insurance Company ask for the additional information!!!  

In general, we suggest that you send a Pre Application Form. and if the response is favorable apply ONLINE (through our website) for an Insurance Companies or HMO Standard Plan, Rates including underwriting and then fill out the HIPAA portion of the application- so that you get the BEST possible rates and coverage.

If you don’t qualify for the preferred rates, you will given the reason for a denial.  AB 356  Insurance Code 10113.9 & 10113.95

Here’s typical underwriting guidelines on the California Insurance Commissioner’s website.

If you are certain that you will not qualify, then do the Paper Application for HIPAA only.
HIPAA Paper Application

HIPAA is GUARANTEED Issue, as long as  you meet the qualifications (rules) and have your Certificate of Credible Coverage, this way you don’t have to worry* about coverage lapsing, while the Insurance Company is checking out your application.

63 day calculator
Calendar Date Calculator

Here’s research where a client applied for HIPAA on the 45th day and did NOT choose the option to get HIPAA if the underwritten plan did not go through.  We did not finish the project… as the reason for denial was minor and we are confident another company would write the coverage standard or with a surcharge, but less than HIPAA rates.

HIPAA Rates & Benefits

When does my coverage start?  Misc. FAQ’s ( top)

Be sure to double check the available start dates of coverage in each Insurance Companies Brochure, and detail pages, especially if you want an HMO and your coverage expires in the middle of the month.

Research Done 12/1/2010 on effective dates

If we send the application to you  today, (12/1/2010) can she get coverage for 12/1/2010?

United Health – PacifiCare Aetna Blue Shield Blue Cross Health Net

Hi, You can request a 12/1/10 effective with the application submitted today.

Yes if you send the application today an effective date of 12/1/10 can be had please write on the top of the application that an effect date of 12/1/10 is needed

Application must be submitted  by 15th of month to get 1st of next month. (Learn more) The soonest effective date as long as everything has been received and payment is received as well is 2/1/2011
Learn More
Yes, we will need to receive the application by today for your client to receive 12.01.10 effective date.

Response from DMHC

HIPAA coverage must be obtained within 62 days of the exhaustion of Federal COBRA or Cal-COBRA.  The coverage will not be effective back to the date Federal and Cal-COBRA ends.  If HIPAA coverage is obtained and paid for before the 15th of the month it is effective the 1st of the following month.  If the coverage is obtained and paid for on or after the 15th of the month it is effective the 1st of the second following month.  Below are links to more HIPAA information.  dol.gov/  dmhc.ca.gov/

I just wrote a policy with PacifiCare, where we submitted the application prior to expiration of the Cal Cobra coverage, but the Certificate of Credible coverage was submitted say a week after and PacifiCare honored the original requested effective date of 4/1/2008, so no lapse in coverage.
I just checked with Blue Shield and they said they would do the same thing, but note that the requested date cannot be before the application was received.   Also, if there was enough documentation, like phone #’s, etc. they might not even ask for the Certificate of Credible Coverage.
See also Friendly competitor Dave Fluker has done an excellent job of research on this.

required documents
Do NOT wait…. Send in your application – Let the Insurance Company Ask for them.

Leave a Reply

Your email address will not be published.