• Aetna
• Assurant
• Blue Cross and Blue Shield

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• GoldenRule
• Humana

• Supplemental Medigap Insurance
• Medicare Advantage Insurance
• Blue Cross and Blue Shield

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• CIGNA
• SecureHorizons by UnitedHealthcare
• Unicare
• Universal American
• WellCare

Frequently Asked North Carolina Health Insurance Questions

Frequently Asked Questions

When I apply for insurance, what information will I be asked to provide?
To determine your eligibility, companies generally ask for medical and personal information.

Can an insurance company void my policy if I made a mistake in completing the application?
Health insurance companies may void contracts within the first two years, if the applicant provides inaccurate or incomplete responses to the application questions, and if the company relied on those responses in deciding to issue the policy. Always verify that answers and information submitted on any application for insurance are complete and accurate.

What are my rights to continue my health insurance if I lose my job?
You may be eligible to continue your group health insurance for up to 18 months by means of COBRA or State Continuation. The employer and/or insurance company cannot require you to pay more than 102 percent of your full group premium rate.

What is association group health insurance coverage?
Under an association group arrangement, the master group policy is typically issued to the association, and coverage is offered to the association's members. Generally, each individual applicant must meet the company's underwriting guidelines. Applicants who fail to qualify may be denied coverage or exclusionary riders may be attached to the policy.

Am I guaranteed the right to purchase individual health insurance?
No. Except under certain circumstances, insurance companies have the right to fully review your application and determine whether you are an acceptable risk. If not, your application may be declined.

What is HIPAA (Health Insurance Portability and Accountability Act)?
HIPAA affects individuals who change from one employer group plan to another, and to those individuals who lose their eligibility for group coverage. Two of the most important features of HIPAA are health plan "portability" and the availability of "guaranteed issue" individual health insurance.

Does the Department of Insurance set the rates and tell companies how much they can charge?
No, the North Carolina Department of Insurance does not have the authority to set health insurance rates. However, carriers are required to justify their rates and demonstrate that they are actuarially sound and not unfairly discriminatory.

I have a child who is going to be attending school outside my HMO's (or other managed care plan) service area. Will my child be covered?
Children who live and attend school outside the HMO's service area are subject to the same requirements as all other persons covered by the plan. The child must return to the plan's service area in order to receive full benefits. However, the plan must cover emergency treatment outside of the service area.

I am currently covered under my employer's HMO. I plan to leave my job and move to another state. Do I have any COBRA or North Carolina State Continuation rights?
If you move out of the plan's service area, your coverage will most likely be terminated.

I have an exclusion rider on my individual health policy. How long will it remain in effect?
The rider will remain in effect for the length of time specified by the terms of the rider. If there is no time limitation specified, it will remain in effect for the duration of the policy unless the insurance company agrees to remove it.