• Aetna
• Assurant
• Blue Cross and Blue Shield

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• Celtic
• Humana Health Insurance Company of Florida

• Supplemental Medigap Insurance
• Medicare Advantage Insurance
• American Pioneer Life Insurance Company

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• Blue Cross and Blue Shield
• PUP
• Pennsylvania Life Insurance
• SecureHorizons by UnitedHealthcare
• Unicare Life & Health Ins. Company
• WellCare

Types of Major Florida Medical & Health Insurance Coverage

Types of Major Medical Coverage

Group Plans

Fulfilling your insurance needs may prove relatively simple if your employer offers a group plan or a choice of plans. Group plans cover several people or groups under one policy. You will receive a certificate that acts as your policy when you obtain insurance through a group plan. Most group policies are suitable for the average person and may include provisions to cover family members.

Businesses with one to 50 employees have access to guaranteed-issue group plans, often referred to as small group health coverage. Guaranteed-issue coverage for a one-life group (a self-employed individual with no eligible employees) is only available during the month of August each year, with the policy being effective on October 1. These plans are available to small-business employers regardless of the health claims experience of an employee group or the health status of an employee. Insurance companies and HMOs that offer small group coverage must offer employers the option of purchasing a basic or standard plan. Most insurers or HMOs offer other health-benefit plans in addition to the basic and standard plans.

For more information on small group basic and standard plans and the Small Group Health Access Act, you may request a free copy of the guide Small-Business Owners' Insurance by calling the Consumer Helpline toll-free at 1-877-MY-FL-CFO (1-877-693-5236), or you may download it from the DFS Web site at www.MyFloridaCFO.com.

Individual Plans

Individual plans cover one person or all members of a family under one policy. Usually, people buy individual plans because they lack access to employer-based group policies or want to supplement these policies. Others use individual health policies during periods of unemployment when they lack coverage under group policies, or because they want to supplement Medicare benefits. If you buy an individual policy, you may take 10 days from the date you receive the policy to decide whether to keep or cancel it. For a full refund, you must return the policy to the company within the allowed time. If you reject the policy, you should return it by registered or certified mail. This may help you avoid a potential dispute with a particular insurer.

Out-of-State Association-Based Coverage

An insurance company that markets health coverage to members of an association must be licensed by the state of Florida to sell such coverage to members who are state residents. However, if the association is located in a state other than Florida, the coverage offered to members will likely be governed by the laws of that state - not Florida. This means that many of the Florida consumer protection laws will not apply to this coverage - most notably rate approval requirements. While this "out-of-state association" type of coverage may appear affordable in the beginning, the absence of laws protecting the consumer from renewal rate abuses may become more apparent in future years.

This would become an issue should you develop a chronic health condition and are unable to medically qualify again for a more affordable policy. The decision to purchase out-of-state association coverage must be carefully considered in light of personal circumstances, with an emphasis on how long one anticipates needing the coverage and other options for coverage should it become unaffordable. In general, the longer one will need the coverage, the more important it becomes to consider coverage that is governed by all of Florida's consumer protections laws - not just some of them.

The forms and the rates charged are not approved in Florida. When your coverage terminates, you are eligible for a guaranteed-issue conversion policy. Your coverage document should contain information about this conversion option.