What Our Clients Say
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"I taught school for many years and never really had to worry about insurance. I am now self-employed finding the right health insurance has been a big worry. I tried one insurance company but had to pay for everything up front, even office calls. I switched to BCBS and, though I have only used it one time, everything went very smoothly and I only had to pay the copay. Thank you BCBS and Healthquotes!!"
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Is there another way that a group health plan or issuer can credit coverage under HIPAA? |
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Yes. A plan or issuer may elect the alternative method for crediting coverage for all employees.
Under the alternative method of counting creditable
coverage, the plan or issuer determines the amount of an individual's
creditable coverage for any of the five specified categories of benefits.
Those categories are mental health, substance abuse treatment,
prescription drugs, dental care and vision care. The standard method
is used to determine an individual's creditable coverage for benefits that
are not within any of the five categories that a plan or issuer may use.
(The plan or issuer may use some or all of these categories.)
When using the alternative method, the plan or issuer
looks to see is an individual has coverage within a category of benefits
(regardless of the specific level of benefits provided within that
category).
For example, if an individual who is a regular enrollee
(not a late enrollee) has 12 months of creditable coverage, but coverage
for only 6 of those months provided benefits for dental care, a
preexisting condition exclusion period may be imposed with respect to that
individual's dental care benefits for up to 6 months (irrespective of the
level of dental care benefits).
If your employer's plan requests information from your
former plan regarding any of the five categories of benefits under the
alternative method, your former plan must provide the information
regarding coverage under the categories of benefits.
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Speak with a licensed, experienced health insurance professional.
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Call 1-800-345-0789 to speak to a health specialist or fill out an online quote form
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