Know your options

Question

Asked: Apr 29, 2010

Can a small business deny an employee coverage for a preeisting condition?

Can a Small Business deny an employee or employee's family coverage for a preexisting condition?

Categories: In Pennsylvania > Group Health

Watch this Question | Email to a Friend

Answers

Small Business is guaranteed issue in all 50 states, under federal Regulations. This means that no “eligible” employee may be denied coverage due to a pre-existing medical condition. However, an employee may be denied enrollment if they do not meet the eligibility requirements outlined on the contract between the employer and the insurance company. Common reasons for ineligibility are: 1) have not yet met new hire waiting period, 2) do not work the minimum hour requirements, 3) reside outside of the service area of the insurance company, or 4) applying dependents are not immediate family members of the employee. Even though the insurance company can’t deny coverage if all of the eligibility requirements have been met, they can impose a pre-existing condition waiting period if the employee has not had prior and creditable health insurance coverage. The common eclusionary period is 6 months. During this time, the insurance company can deny paying claims on any of the pre-existing medical conditions or health issues related to these conditions. - Wednesday, November 18, 2009 @ 2:05 pm

Source: 

Answered: Apr 29, 2010

 

Top Group Health Experts

RANK LEADER POINTS
1. Phil_daigle 40
2. Ihealthbrokers 30
3. Luisad 20
4. Phildaig 20
5. Bree 10
6. Lynnp 10
7. Sugarplumfairy 10
View More