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Dealing with Job Change or Loss of Insurance

Job change / Job loss

Keeping health insurance can be guaranteed by state and federal law. Once covered, you cannot lose coverage because you have an accident or get sick. Your health insurance cannot be cancelled unless the employer stops paying the premium for your employer-sponsored plan, or you stop paying the premium for a plan you own.

In general, if you leave a job where you participated in an employer group health plan, you may be able to stay covered no matter what happens next. Keeping health insurance is your right. Any new plan may be different and will likely cost you more, but if you follow the rules, you can keep your family covered.

I'm leaving a job with employer group coverage for a new job that also provides group coverage. What are my rights?

You have rights under the Health Insurance Portability and Accountability Act (HIPAA). HIPAA reduces or eliminates the period you would otherwise have to wait for the new plan to cover pre-existing conditions.

HIPAA applies if you have an employer health plan, leave for a new job and the new employer offers health insurance.

ANY plan your new employer offers:

• Must include all family members who meet the new plan's eligibility requirements.
• Cannot reject you or charge you higher premiums because of a family member's health problems.
• May offer a special enrollment period if you add a new dependent due to marriage, birth, adoption or loss of other coverage. Any family member can join during a special enrollment period without having to wait for coverage of pre-existing conditions.
• May cost you more than the old plan.

If the new plan is through a traditional health insurance company:

• Enroll within 63 days after your previous coverage ends in order to use your creditable coverage. By applying creditable coverage, you reduce any period of time the plan requires before it covers your pre-existing conditions.
• If you (or a family member) are pregnant when you switch jobs, the new plan covers the pregnancy only if the new plan includes maternity coverage.
• The new plan may have a waiting period before you can enroll. Talk with the new employer about specifics.

If the new plan is through an HMO:

• The plan may have an "affiliation period" which could delay your coverage for a maximum of 90 days after you submit the enrollment form.
• No pre-existing condition waiting period is allowed. All benefits must be covered the day coverage goes into effect.
• Maternity must be covered if the plan is full service.

I'm leaving a job with employer group insurance for a job that does not offer a health plan (or to become self-employed). -- OR -- I've been laid off from a job with employer group insurance. What are my options?

Generally, you will be able to choose from two options...

Continuation of the group benefits:

Temporary coverage that lasts no less than six months.

Conversion to an individual policy / Purchasing your own individual policy:

Permanent coverage that lasts as long as you pay premiums.