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Acronym or name of the risk pool: Missouri Health Insurance Pool or MHIP.

Regulation establishing risk pool: House Bill No. 437 (MO 92nd General Assembly).

Funding: It is funded by assessments on commercial insurance companies, HMOs and stop loss agencies. These funds are added on to those generated by premiums paid by members of the plans.

Plans offered: 4 medical plans are offered through the MHIP programmes. All of them are PPO plans. They offer deductibles between $500 and $5000.

Plan benefit: For all of the plans, a coinsurance of 20% is required when using providers from the network. For plans outside the network, a coinsurance of 50% is required. Plan 1 has an annual out of pocket limit of $2500 and a deductible of $500. Plan 2 has a deductible of $1000 and out of pocket limit of $5000 after deductibles. For plan 3, the annual deductible is $2500 and the maximum limit is $5000. Plan 4 has a deductible of $5000 and the maximum limit is 5000 after deductibles have been deducted.

MHIP summary: http://www.mhip.org/MHIP_brochure.pdf

Maximum benefit limits: Each of the PPO plans have a lifetime maximum benefit of $1000000.

Eligibility: (1) The person must be a resident of Missouri. (2) The person must have received a notice rejecting his application for insurance from an admitted company in the state within the last 6 months. (3) The person must have been offered coverage or HMO covers in the last 6 months but at a rate that is more than 300% of the standard rate for individual covers. (4) The person was receiving covers from another state risk pool and is applying within 30 days of becoming a resident of Missouri. (5) The person was receiving cover under a group insurance plan under COBRA and as completed his coverage under it. (6) The person was terminated involuntarily from an early cover.

Enrollment periods: Applications for MHIP may be made at any time. The covers take effect on the first day of the following month. The applicant can make it effective immediately after the termination of your previous 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. The bills are made either on a monthly or quarterly basis. They can also be automatically deducted from the bank account of the person.

Premium calculations: The rates for MHIP coverage varies according to the standard rate charged by five of the largest health insurers in Missouri. The minimum rate assigned is 150% of the standard and the maximum rate is 200% of the basic rate.

Pre existing condition waiting period: For all policies under MHIP, benefits are not payable for the first 6 months of coverage under a preexisting condition. Exceptions apply under waivers. An MHIP representative can guide you on these clauses.

Contact information: MHIP, Penntower building. 3100 Broadway, suite 210. Kansas city, Missouri 64111 2553. Phone-800 821 2231. MHIP Website.

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