Children’s Health Insurance in Washington State: eHealthInsurance Answers FAQs about New Open Enrollment Period
March 16, 2011 | Consumer Advice
Mountain View, CA – March 16, 2011 - Today eHealthInsurance (NASDAQ: EHTH), the leading online source of health insurance for individuals and families, published answers to frequently asked questions for consumers who wish to enroll their children in individually purchased “child-only” health insurance policies in the state of Washington.
“Child-only” plans are those made available to children under age 19 with no parent or guardian listed on the same policy. An open enrollment period for child-only health insurance in Washington began on March 15, 2011 and will continue through April 30, 2011. A second open enrollment period will begin September 15, 2011 and continue through October 31, 2011.
The 2010 Patient Protection and Affordable Care Act prevents health insurance companies that offer child-only plans from declining an applicant based solely on his or her pre-existing medical conditions. However, this provision of the federal law is being implemented in different ways by different states.
eHealthInsurance has compiled answers to the following frequently asked questions (FAQs) in order to help consumers understand how federal law and Washington law work together, and how these provisions apply to them.
FAQs about the Washington Child-only Open Enrollment Period
Question: “The federal health reform law is supposed to allow me to enroll my child in private health insurance regardless of my child’s health condition. When can I begin doing that in Washington?”
Answer: Beginning in 2011, the state of Washington has established two open enrollment periods for child-only health insurance policies. The first occurs from March 15, 2011 through April 30, 2011 and the second occurs from September 15, 2011 through October 31, 2011. During these enrollment periods, any child under age 19 can be enrolled in a private, individual health insurance plan.
According to guidance issued by the Washington State Insurance Commissioner, these biannual open enrollment periods will recur each year until 2014. In addition to these special enrollment periods, it may also be possible to enroll children under age 19 in individual health insurance in the following circumstances:
- Loss of coverage due to divorce of a parent
- Loss of employer-sponsored coverage
- Loss of coverage resulting from a move to a locale where the prior plan is not available
Outside of the biannual enrollment periods or qualifying events noted above, health insurance companies are not required to accept applications for child-only plans.
Question: “Why do there need to be specific enrollment periods? Why aren’t children simply allowed to enroll in child-only individual health coverage any time of year?”
Answer: A number of states have established annual enrollment periods for child-only health insurance policies to prevent consumers from simply waiting until a child gets sick before signing them up for coverage. If children were only enrolled when ill, it could possibly cause a spike in the cost of child-only coverage. The creation of specific biannual enrollment periods for child-only health insurance policies may be an effort by the state of Washington to promote broader consumer access to individual health insurance for children under the age of 19.
Question: “Are rates for child-only health insurance policies going to change?”
Answer: It is not yet clear how federal health care reforms or Washington state regulations will affect the cost of premiums over the long term.
Question: “What counts as a pre-existing medical condition?”
Answer: A pre-existing medical condition may be any past or present medical diagnosis, whether or not the child is still suffering from or being treated for the condition. Not all medical conditions are of concern to health insurance carriers and different carriers may be more, or less, concerned by different conditions.
Question: “Will a sick child with documented health problems pay the same monthly health insurance premium as children in good health if enrolled during the open enrollment period?”
Answer: In Washington, yes. While some other states may allow insurers to charge children with pre-existing medical conditions more for their coverage, this is not the case in the state of Washington. Rates may vary depending on the child’s age and where he or she lives, but not based on the child’s health history.
Question: “Where can I go to find health insurance policies for children in Washington during the new enrollment periods?”
Answer: eHealthInsurance.com is a good resource for consumers who want to find, compare and enroll in child-only health insurance plans during the Washington state open enrollment periods. eHealthInsurance.com offers 24-hour support, seven days a week, from licensed agents. It allows consumers to compare health insurance policies side by side, find plans accepted by their favorite doctors, and apply for coverage online.
New child-only products may be added to the eHealthInsurance.com website throughout the year. Consumers interested in a particular insurance company whose products are not currently listed on the eHealthInsurance website can contact the insurer directly or contact eHealthInsurance’s Customer Care Center at 1-800-977-8860 for more information.
To learn more about your options, you may wish to contact the Washington State Office of the Insurance Commissioner online or by phone at 1-800-562-6900.
eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, the nation's leading online source of health insurance for individuals, families and small businesses. Through the company's website, www.eHealthInsurance.com, consumers can get quotes from leading health insurance carriers, compare plans side by side, and apply for and purchase health insurance. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 180 of the nation's leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia, making it the ideal model of a successful, high-functioning health insurance exchange. Through the company’s eHealthTechnology solution (www.eHealthTechnology.com), eHealth is also a leading provider of health insurance exchange technology. eHealthTechnology’s exchange platform provides a suite of hosted e-commerce solutions that enable health plan providers, resellers and government entities to market and distribute products online. eHealth, Inc. also provides powerful online and pharmacy-based tools to help seniors navigate Medicare health insurance options, choose the right plan and enroll in select plans online through its wholly-owned subsidiary, PlanPrescriber.com (www.planprescriber.com) and through its Medicare website www.eHealthMedicare.com.
For more health insurance news and information, visit the eHealthInsurance consumer blog: Get Smart – Get Covered.