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Wyoming Risk Pool - Health Insurance Provided for the Uninsurable

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FAQ

Acronym or name of the risk pool: Wyoming Health Insurance Pool or WHIP.

Regulation establishing risk pool: Wyoming Legislature.

Funding: It is partially funded by payment of premiums from the participants. Plans are funded through assessment of insurance companies and HMOs. A partial tax credit offset is also provided against taxes on premiums paid by carriers.

Plans offered: Two PPO medical insurance plans are offered through WHIP. WHIP Brown is a high deductible plan that can be set up with a Health Savings Account.

Plan benefits: The WHIP brown plan has an annual deductible of $5000. The member has to pay 100% of the costs till the deductibles are met. Once they are met, WHIP pays all the costs of covered medical costs. The maximum out of pocket limit is $5000.

The gold plan offers deductibles of $1000. Members pay a 20% coinsurance for inpatient and outpatient services. The out of pocket limit is $2000.

WHIP summary: http://insurance.state.wy.us/consumfm/

Maximum benefit limits: The maximum life time benefits are capped at $500000 for the brown plan. For WHIP gold plan, the lifetime maximum is $750000.

Eligibility: (1) The person must be a resident of Wyoming and have one of the following eligibilities. (2) The person must have declined health coverage by a company and the person can furnish proof. (3) The cover being provided to you is more restrictive and has such clauses as waiting periods for preexisting conditions which make the plan less attractive. (4) The cover being provided to you has higher premiums than the one provided by WHIP. (5) You have eligibility under HIPAA.

The person must have the following conditions also: (1) You are not covered under any other plan the day your cover starts under WHIP. (2) The person is not eligible for any other group plan. (3) The person is not covered by Medicare or Medicaid. (4) The person has not had covers under WHIP in the last 12 months. (5) The person is not an inmate.

Enrollment periods: Applications are accepted at any time. Once approved, the cover becomes effective on the 1st or 16th of a month.

Premium payments: Your age, gender, tobacco usage and plan selection determines the premium you pay. Payments can be made through checks, bank withdrawals and money orders.

Premium calculations: The rate capped is at 200% of the standard rate charged by other plans in the state.

Pre existing condition waiting period: Under this plan, no covers are provided for costs incurred in the 12 month waiting period from the day your cover becomes effective. If proof is available, the applicant can apply for a full or partial waiver of the waiting period.

Contact information: Wyoming Health Insurance Pool. 4000, House Avenue. POBox-2419. Cheyenne, WY 82003. Phone- 18885572519. WHIP Website.

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