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HIPAA vs. Conversion Plans
Difference between HIPAA, Conversion & COBRA

How Does AB 1401 Change Group Individual Conversion Plans (ICP)?

Generally speaking, AB 1401 requires that all [Group] carriers offer an ICP that mirrors a HIPAA guaranteed issue plan with the same rates, effective September 1, 2003. 12670 et seq.)

The intent of this provision is that all group carriers will offer a HIPAA guaranteed issue plan, not just the carriers that market individual products. (blue shield ca.com)

As far as the conversion and HIPAA rates, yes, they are usually very similar if not exactly the same for most plans. The Conversion plan is an extension of the group/COBRA plan whereas the HIPAA is an individual & family plan.  The rate is usually the prime factor in why someone would chose one versus the other.

The HIPAA is usually what the client would use after COBRA/Cal COBRA is exhausted or if the group has dissolved, and the client does not have the COBRA option.

The Conversion plan is still linked to the group or COBRA, so the group would still have to be in force in order to accept this. Usually a conversion is a plan design close to, or mirroring, the group plan, and is offered thru the same insurance carrier. 

HIPAA is a Federal §300 gg- 41  law that requires all insurance carriers to  offer their top selling plans. Thus, enabling one to shop around.
(Excerpt of the answer to our emailed question to California Department of Managed Health Care (DMHC)).

Sample Conversion Plans

Summaries & Benefits of
 CA Department of Managed Health Care
CA Dept. of Managed Health Care

HIPAA & Conversion Plans
(DMHC Website)

 

Blue Cross - California Individual Conversion Plans9/2010
Conversion Plan
Blue Cross Conversion Plan

Blue Shield Conversion
1/2009 Rates

FROM DMHC Website
Pacificare

  • Individual Conversion Benefit Matrix
  • Individual Conversion Rate Matrix
  • Parent Page Find your Premium? HIPAA Qualification Eligibility When to Enroll? Alternatives Creditable Coverage National HIPAA Conversion Plans Resources Comprehensive Planning?

      

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