CA question: After COBRA... HIPAA or MRMIP?

al3 · 09-08-2007, 07:11 PM

Maybe one of you guys experienced in CA plans (Dave, Rick, et. al.) can answer this:

After you exhaust your 18 (or 32?) months of COBRA you can transition into HIPAA which is GI (right?). Do you ALSO have the option of taking the state risk pool (MRMIP?)

Thanks,

Al

Dave020 · 09-08-2007, 08:34 PM

Hi Al,

I don't believe that HIPAA eligibility necessarily precludes MRMIP eligiblity, esp if the HIPAA premium is above the MRMIP premium.

A decline for IFP would be required for MRMIP or a rate above the MRMIP premium rate (if rated or if HIPAA costs more).

I would not use MRMIP in lieu of HIPAA, it would be disadvantageous to the client. MRMIP has severe benefit limitations as well as a three-year max run before graduation. HIPAA PPOs have 5-6 Mill lifetime max with continuation option to 65 - HMO HIPAA unlimited lifetime max with same age option. MRMIP is $750k max lifetime (which you can't hit anyway due to the annual limitation) and graduate plans have same $750k max lifetime giving client only 1.4 Mill max.

As I recall MRMIP only requires decline/higher rating on IFP and you are ineligible if you can go on MediCal, Medicare or another group plan.

Dave