Health Insurance Risk Pools - Resources and Information
Nebraska Health Insurance Risk Pool - Health Insurance Provided for the Uninsurable
Acronym or name of the risk pool: Comprehensive Health Insurance Pool or CHIP.
Regulation establishing risk pool: Nebraska legislature Under Neb.Rev.Stat. 44-4201 to 44-4235.
Funding: Funds for CHIP are basically gathered from premiums paid. It is also collected from a legislation that directs the department of insurance to set up a special fund from the taxes on premium of all health and accident premiums.
Plans offered: Only one medical insurance plan is offered through CHIP. It is a PPO type of plan with 9 different deductibles. CHIP also offers a health savings account plan.
Plan benefit: The CHIP PPO plans offer a variety of deductibles for in network services. These range from $50 to $10000. Most of the covered medical expenses have a 20% coinsurance and a $10 co pay is required for doctor office visits. For services that are out of network, the CHIP participants are required to pay 20% coinsurance. The maximum limit out of pocket is $1500 after deductibles have been completed. You must contact the plan administrator for details of the HSA details.
CHIP plan details: http://www.doi.ne.gov/brochure/
Maximum benefit limits: All CHIP PPO plans offer lifetime maximum benefits of $1000000.
Eligibility: There are two sets of eligibility criteria for these plans. These are standard requirements and eligibility for HIPAA.
Standard eligibility requirements - (1) The person must be a resident of Nebraska for at least 6 months. (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) You are not receiving benefits from any other plans, state or federal. (4) No other health coverage is being provided to the individual. (5) You are paying premiums at a rate that is more than the rate for CHIP. (6) The person has one of the conditions specified under CHIP brochure.
HIPAA eligibility requirements: (a) The person must be a resident of Nebraska for any length of time. (b) The person may not be eligible for Medicare or Medicaid. (c) The person must have at least 18 months of insurance coverage, most recently for a group insurance. (d) The last payment should not have been terminated because of non -payment of premium. (e) You have exhausted your last coverage under COBRA. (f) You have applied for CHIP within 63 days of termination of the last cover.
Enrollment periods: CHIP covers become effective on the first of the month following approval.
Premium calculations: The rates for CHIP coverage vary according to the standard rate charged by five the largest health insurers in Nebraska. The rate assigned is 135% of the standard and the premium charges for children are fixed at 50% of the standard charges.
Pre existing condition waiting period: Benefits are not payable for the first 6 months of coverage under a preexisting condition. Exceptions apply under waivers. The waiver is determined at the time of review of your application.
Contact information: CHIP customer service centre. C/O Blue Cross and Blue Shield of Nebraska P.o.box-3248. Omaha, Nebraska 68180001. Phone- 4023901814. Outside Omaha- 8773484304. NECHIP Website.
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