GrosJean & Associates Inc Life - Health -LTC Member: National Association of Insurance and Financial Advisors - Association of Health Insurance Advisors - National Association of Health Underwriters - Arizona Association of Health Underwriters

The Health Insurance Portability and Accountability Act of 1996 or HIPAA took affect in July 1997.  This Federal law has significantly altered the small group health insurance marketplace.

Groups of 2 to 50 employees are now guaranteed to be accepted for health insurance regardless of any pre-existing conditions in the group.  The group cannot be declined for health coverage.

Credit is now given for most prior coverage's.  As long as it was continuous, and without a lapse of 63 days, your pre-existing conditions cannot be excluded by a new group health plan.

co9verage is now portable so that when you move from on job to another or from employment to unemployment you are not denied health insurance because of a pre-existing condition.

Health care insurers are able to ask health questions, even though coverage is guaranteed to be issued, and can actually base part of the final premium that will be charged on the health conditions in the group.  Also, employees who are waiving coverage now, for whatever reason, are also obligated to answer any health questions.   Even though they are waiving coverage they could decide later to enroll in your health plan.  They would be accepted on a guaranteed issue basis, along with any pre-existing conditions.  This is why the health care insurer wants to know of all possible conditions in your group.

This has resulted in the following:

•  Considerable premium increases for groups with any notable pre-existing conditions and on-going medical conditions.
• Insurers who are unwilling to quote a firm until the health history is pre-screened.

In order to properly quote your group, it is necessary for each employee (Whether they apply for coverage or not) to complete the attached medical questionnaire. Any rate you receive without providing this information will, basically, be a "guestimate" and subject to change during the underwriting process.

Please return them to me.  The question on the census form will provide me with an idea of what you are looking for.

P O Box 8110 Glendale AZ 85312-8110 (623)435-8400 Fax (623)435-2500 (800)903-8780 henry@grosjean.com Serving Arizona's Small Business Community Since 1979