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Acronym or name of the risk pool: Kansas Health Insurance Association or KHIA.

Regulation establishing risk pool: Kansas Uninsurable Health Insurance Plan.

Funding: The funds come from the premiums collected. They are also obtained from assessment of insurance companies operational in Kansas.

Plans offered: All the plans offered by KHIA are PPO plans. There are two different networks of physicians, depending on the location of the member. There are six plans from which the member can choose. This ranges from plans A to F. Plan D is an HSA plan.

Plan benefit: All health plans offered by KHIA contain prescription drug benefits. All plans have the same rate of coinsurance. The rate for in network services is 30% and for out of network, it is 50%. Plan A has a deductible of $500; Plan B has a deductible of $1000 annually. For Plan C, the annual deductible is $1500, and for Plan E it is $5000. Plan F has a deductible of $7500 annually. Plans B, E and F have a 10% coinsurance rate after payment of deductibles and coinsurance maximum payments. The maximum out of pocket expenses for Plan D are $5250.

KHIA plan benefits summary: http://www.khiastatepool.com/summary.asp

Maximum benefit limits: For plans B, E and F, the calendar year maximums are $100000. Plans A, C and D do not have annual maximums. All plans have lifetime maximum benefits of $1000000.

Eligibility: (1) The person must be a resident of Kansas for at least 60 days and one of the eligibility conditions mentioned below. (2) Medical eligibility category: (a) The person must have received a notice rejecting his application for insurance from an admitted company in the state within the last 9 months. (b) You were served notice substantially reducing your benefits which made the plan less advantageous to you as compared to others. (c) The premium rate charged was more than that of other similar plans. (d) The last cover was terminated involuntarily. (3) Medical condition category: The person must have one of the conditions provided under KHIA presumptive list. (4) Federal eligibility criteria: (a) The person must have had at least 18 months of cover without a gap lasting more than 63 days. (b) The last coverage must have been a group plan, govt. health plan or a church plan. (c) The person should not be eligible for any other coverage. (d) The person may not be eligible for Medicare or Medicaid. (e) The COBRA coverage must have been ended.

Enrollment periods: Applications may be presented at any time. If approved, coverage starts on the first of the following month if it is before the cutoff date. If you are eligible under federal guidelines, your application must be produced within 63 days of the end of the last cover.

Premium payments: Premiums are dependent on the health plan you select. It is also determined by your age, sex and whether you are a smoker.

Premium calculations: The rate cannot exceed 125% of the standard risk rate. This refers to benefits that people in Kansas can obtain from other private health insurance providers.

Pre existing condition waiting period: The exclusion period for pre existing conditions is of 90 days. This is waived under exceptions. Consult the brochure for details.

Contact information: Kansas health insurance association. KHIA, PO box-1090. Great bend, KS 67530. Phone: 800-362-9290. Fax: 620-792-0535 KHIA Website.

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