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Alaska Comprehensive Health Insurance Association

Alaska Comprehensive Health Insurance Association - ACHIA

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Acronym or name of the risk pool: Alaska Comprehensive Health Insurance Association or ACHIA.

Regulation establishing risk pool: Alaska legislature. See Alaska statute title 21, chapter 55.

Funding: Usually, funds from which the plan is operated come from payments of premiums. However, nowadays the premiums are falling short of claims ratios. If deficits are incurred, they are adjusted with assessments by ACHIA among insurers who are participating.

Plans offered: Several comprehensive health insurance plans are offered by ACHIA. The main difference is between the amounts of deductibles that are charged. Differences are also applicable to the annual out of pocket limits you opt for at the time of enrollment. A qualified participant under 65 may choose between a PPO plan and a traditional indemnity plan.

Plan benefit: Under a PPO Plan, you can choose between deductibles ranging from $1000 to $10000. The traditional indemnity has a deductible of$1000. A coinsurance of 20% is payable for all available plans for services covered in network. A 40% coinsurance is applicable for out of network services on PPO plans. The out of pocket varies from $2500 to $15000. It depends on the deductible selected.

Maximum benefit limits: The maximum benefits payable under ACHIA is $1000000. If you exceed this amount within the time you are insured, your coverage will end.

Eligibility: (1) The applicant must be a resident of Alaska for 12 months at the least. (2) They should not be eligible for covers under small health insurance plans offered to businesses with 2 to 50 employees. (3) They should not be eligible for covers under state or federal plans. (4) They should not be receiving any other health coverage under any other plan. (5) They should be having one of the following conditions - (i) if the person should be having a notice of rejection from an insurance company in the preceding 6 months, (ii) the person should have been offered insurance with riders that would have reduced his benefits significantly, and (iii) he should have at least one of the medical conditions mentioned in the ACHIA guidelines.

Enrollment periods: ACHIA coverage may be applied for at any time. The policy becomes effective on the first of the following month. Coverage may be retroactive to the date of the end of the last insurance cover.

Premium payments: Premiums are determined by the health plans you opt for and your age.

Premium calculations: The board decides on the monthly premiums and it is usually restricted to 150% of the standard risk rate. This refers to other benefits that Alaskans can obtain from private health insurance providers.

Pre existing condition waiting period: A six month waiting period is applicable before covers start on pre-existing conditions. The waiting period can be waived if the person has had insurance cover that was not ended voluntarily. Additionally, ACHIA coverage was must have been applied for within 31 days of termination of the previous policy.

Contact information: Alaska Comprehensive Health Insurance Association, P.O. Box 1090, 2015 16th St., Great Bend, Kansas 67530, Phone: 888-290-0616. ACHIA Website.

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