Continuation of Health Insurance in North Carolina

Most employees in North Carolina as well as in the rest of the country are coverage under group health insurance plans that they may stand to lose should they be terminated or decide to resign from the job. In order to ensure that these employees and their families still continue to enjoy health insurance benefits, several options are offered. One is to avail of continued group rates under the provision of the Consolidated Omnibus Budget Reconciliation Act or COBRA. Under this law, employees and his dependent may choose to continue health coverage although for a specified period of time, though he or she must now shoulder the total payment of the premium. One downside of this provision is the cost of paying group rates, which is typically higher than individual health insurance.

The state of North Carolina also has its own continue law for employees who lost their employment under any circumstances. Under this law, employees are given the period of 18 months to continue their group rates and would need to find alternative means of availing health insurance since there is no extension of the 18-month period, unlike the extension sometimes given to employees who avail of COBRA benefits. To qualify, the employee must be covered by the employer’s group health plans for at least three months prior to leaving the job. If a certain employee becomes eligible for any other health insurance plan within 31 days after termination, he or she cannot avail of the benefits given under the state continuation law. The employer is also required to inform the employee of the option of continuing group coverage under this particular law as part of the exit process. In return, the employee must request coverage continuation in writing. The employee must also pay premiums to the employer, who may or may not subsidize part of the payment. Premiums are paid by the terminated or resigned employee on a monthly basis and must be promptly made, since there is no grace period under the state continuation law.

In the case that the employer goes bankrupt or cancels group health coverage, the right of the former employee to continue coverage also ends and will have to find other ways to answer his or her health care needs.

When coverage under COBRA or the state continuation law has been used up, a former employee who has not found gainful employment can also avail of health insurance through the Health Insurance Portability and Accountability Act (HIPAA) which provides continuing coverage to all eligible individuals. To elaborate, anyone who lost his or her job can be HIPAA eligible provided the individual cannot be covered by Medicaid or Medicare and has no other health insurance coverage. Those who wish to apply for insurance as a HIPAA eligible individual must apply within the first 63 days after ending group coverage. All health insurance providers in the state of North Carolina are required to offer at least two plans to an individual eligible for HIPAA. Insurance providers are not allowed to deny coverage for pre-existing conditions under HIPAA, though they are allowed to impose higher premium rates for it. In comparison, those who apply for the typical individual health plan stand the chance of having their application denied if the insurance provider determines you have a pre-existing condition that they consider may be too risky to ensure. Furthermore, HIPAA eligible individuals availing of a particular plan must be offered the same rate, with the state of North Carolina prohibiting insurance providers from being discriminatory. Health insurance coverage offered under HIPAA, as well as all other kinds of insurance policies in the state, are guaranteed renewable even if the policyholder develops illness or makes numerous claims. There are only several causes in which the insurance provider is allowed by the state to non-renew a policy, such as nonpayment, fraud, or relocation to a different state.

We help our North Carolina customers in Charlotte, Raleigh, Greensboro, Durham, Winston-Salem, Fayetteville, Cary, High Point, Wilmington, NC and other cities in the Old North State lower their premiums and save money on all types of insurance. Use the form above to find low cost auto, homeowners, health, medical, life and long term care insurance. Using our North Carolina insurance agent and broker network, you can easily compare rates from competing insurance companies.

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