Many Americans are members of group health insurance plans and the regulations governing such plans in Connecticut are similar to those seen in many of the other states, although there are a number of differences which may apply particularly to public employees.
To join a group health insurance scheme you must first be eligible for memberships of the scheme. For example, in spite of the fact that an employer may operate a group health insurance Connecticut scheme, it does not have to be open to everyone, possibly being meant for full-time but not part-time workers. Alternatively, the scheme may be operated by a Health Management Organization (HMO) and you could find that you are living outside of the service area for the HMO.
Assuming that you are eligible for the scheme then you have to be permitted to join whatever your state of health in Connecticut. In this case your state of health means your present health, including any disability which you may be suffering from, together with your previous medical history. It is also interesting to note that you cannot be excluded from the scheme on the basis of genetic information.
It is important to understand here that, in spite of the fact that your employer may refuse you membership because you do not for example work enough hours, he may not refuse you membership solely on your current or previous medical history.
Virtually every scheme will have an enrollment period during which you must join the scheme which could typically be within 30 days or joining the company. If however you choose not to enroll at this stage then your employer is required to give you an opportunity to join during what is often termed a special enrollment period where certain specified changes happen within your family. These changes could include things like marriage, the birth of a child and loss of alternative health insurance coverage because of things like the cessation of coverage being provided through another family member because of death, divorce, reduction in working hours, legal separation, retirement, termination and similar changes.
The majority of plans also usually include a waiting period for membership which is typically anything from 30 days to 3 months. This waiting period must be applied consistently across all employees and during this time you are not covered under the group scheme in Connecticut.
Where the group scheme which you are joining is being run by an HMO then the HMO can also require a waiting period (generally known as an affiliation period) where you will again not be covered. HMO affiliation periods cannot usually exceed 2 months and when such a waiting period is required the HMO cannot then impose any pre-existing conditions exclusions.
Under the provisions of Connecticut law any group plan which includes dependent cover also has to provide automatic cover for newborns, newly adopted children and children placed for adoption for 31 days after birth, adoption or placement. There may also be a requirement for parents to register such children with the scheme during this 31 day period if cover is to continue thereafter.
To join a group health insurance scheme you must first be eligible for memberships of the scheme. For example, in spite of the fact that an employer may operate a group health insurance Connecticut scheme, it does not have to be open to everyone, possibly being meant for full-time but not part-time workers. Alternatively, the scheme may be operated by a Health Management Organization (HMO) and you could find that you are living outside of the service area for the HMO.
Assuming that you are eligible for the scheme then you have to be permitted to join whatever your state of health in Connecticut. In this case your state of health means your present health, including any disability which you may be suffering from, together with your previous medical history. It is also interesting to note that you cannot be excluded from the scheme on the basis of genetic information.
It is important to understand here that, in spite of the fact that your employer may refuse you membership because you do not for example work enough hours, he may not refuse you membership solely on your current or previous medical history.
Virtually every scheme will have an enrollment period during which you must join the scheme which could typically be within 30 days or joining the company. If however you choose not to enroll at this stage then your employer is required to give you an opportunity to join during what is often termed a special enrollment period where certain specified changes happen within your family. These changes could include things like marriage, the birth of a child and loss of alternative health insurance coverage because of things like the cessation of coverage being provided through another family member because of death, divorce, reduction in working hours, legal separation, retirement, termination and similar changes.
The majority of plans also usually include a waiting period for membership which is typically anything from 30 days to 3 months. This waiting period must be applied consistently across all employees and during this time you are not covered under the group scheme in Connecticut.
Where the group scheme which you are joining is being run by an HMO then the HMO can also require a waiting period (generally known as an affiliation period) where you will again not be covered. HMO affiliation periods cannot usually exceed 2 months and when such a waiting period is required the HMO cannot then impose any pre-existing conditions exclusions.
Under the provisions of Connecticut law any group plan which includes dependent cover also has to provide automatic cover for newborns, newly adopted children and children placed for adoption for 31 days after birth, adoption or placement. There may also be a requirement for parents to register such children with the scheme during this 31 day period if cover is to continue thereafter.
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