| Q. |
How do I enroll in the HRA program? |
| A. |
You must: |
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2.
3. |
Select a plan.
Complete the applicable application form.
Send the application and the first month premium to HRA along with
any other required documentation. (i.e. If you are applying for the
Special Health Care low income plan, you must send a copy of your
most recent filed Federal Tax Return to show your Adjusted Gross Income.
If you are applying for a Portability plan, please send in a copy
of your Certification of Group Coverage form.) |
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| Q. |
Does HRA count as creditable prior coverage? |
| A. |
Yes, but please note that HRA is individual
(not group) insurance. |
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| Q. |
When I terminate my group benefits can
I choose the HRA Portability Plan instead of COBRA? |
| A. |
No. You are not eligible for the HRA Portability
Plan if you are eligible for other group coverage, including COBRA.
This also includes Medicare eligibility. You may be eligible for the
HRA Individual or Conversion plans. Please review the eligibility
criteria for those plans. |
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| Q. |
My COBRA coverage canceled for non-payment
of premium. Am I eligible for the HRA Portability Plan? |
| A. |
No. You are not eligible if your prior
group benefits terminated for non-payment of premium or fraud. You
may be eligible for the HRA Individual or Conversion plans. Please
review the eligibility criteria for those plans. |
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| Q. |
I work in CT, but live in NY. Am I eligible
for coverage through HRA? |
| A. |
No. You must be a resident of CT. |
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| Q. |
I am currently enrolled under an HRA
plan. Can I keep my coverage if I move out of state? |
| A. |
You may remain on the HRA plan only until
you are eligible for coverage in your new state of residency. |
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| Q. |
I am currently enrolled with HRA and
am approaching my 65th birthday. Can I keep the HRA plan when I turn
65? |
| A. |
You may only keep your HRA plan if you
qualified for and elected the Portability plan prior to turning age
65. HRA is not required to renew coverage issued to an insured in
the Individual or Conversion plans who becomes age 65 and is eligible
for Medicare. |
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| Q. |
I'm already enrolled in HRA, can I switch
to a different HRA plan? |
| A. |
Yes. You are allowed to change plans once
a year on the anniversary of your initial enrollment into HRA. |
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| Q. |
Am I "locked" into coverage through
HRA for any period of time? |
| A. |
No, you may cancel your insurance through
HRA at any time. |
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| Q. |
If I cancel my health insurance policy
with HRA, can I get coverage through HRA again? |
| A. |
Yes. As long as you met the eligibility
requirements at the time you reapply, enrollment back into another
HRA plan is possible. |
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| Q. |
My child is turning 19 and is not a full
time student and will lose coverage on my HRA plan - OR - My child is turning
23 and will lose coverage on my HRA plan. Can my child continue to be enrolled
on an HRA plan? |
| A. |
Yes. They are eligible to enroll in their
own HRA plan. |
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| Q. |
If I have been enrolled on an individual
insurance policy, does that coverage count towards "creditable coverage"
with an HRA Conversion or Portability plan? |
| A. |
For the Conversion plan, you must be coming off of an employer sponsored group health insurance plan or qualifying individual coverage. Qualifying coverage is defined as: Medicare or Medicaid; any group health insurance plan; an individual health insurance plan that provides benefits which are actuarially equivalent to or exceeding the benefits provided under a small employer health care plan, as defined in Connecticut statutes, whether issued in this state or any other state.
For the Portability plan, the prior individual insurance policy would count toward the “creditable coverage”, but when applying for an HRA plan, at least the last day of coverage must be employer group insurance. |
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| Q. |
Is there an annual maximum benefit on
prescription drugs? |
| A. |
If the plan covers prescription drugs,
there is no annual limit on prescription coverage. |
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| Q. |
What does Out of Pocket Maximum mean? |
| A. |
This is the most you would pay during the
course of a year before your plan paid 100% of reasonable and customary
charges. |
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| Q. |
What is the difference between HMO and PPO plans? |
| A. |
With the Health Net HMO plan you must use only physicians or facilities that
participate in the Health Net of the Northeast network. Out of network services or expenses will not be covered. The HMO plan requires co-pays at the time of service.
The United Healthcare PPO plan covers both in network and out of network physicians and facilities. The PPO plan uses deductibles. The deductible is lower and the insurance reimbursement is higher when you use in network providers. |
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| Q. |
What is the difference in benefits between Portability Plans and Conversion Plans? |
| A. |
Portability plans include state mandated benefits that Conversion plans do not. Some examples are:
Portability plans cover Behavioral Health or Alcohol/Substance Abuse as any other illness. ( Conversion plans have specific day or dollar limits for treatment of behavioral health or alcohol/substance abuse)
A baseline mammogram for women 35-39 and an annual routine mammogram for any woman 40 or older.
Prostate screening for any man 50 or older.
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