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Mr. Mip and PCIP are now combined

NEW Obama's High Risk Pool
Calif. Pre Exisiting Condition Plan

MR. MIP (Major Risk Medical Insurance Plan)  is a  California State Sponsored GUARANTEED ISSUE Plan and covers Pre-Existing Conditions! see brochure for details - partially funded by Tobacco Tax and GUARANTEES coverage to individuals unable to get it through a regular Insurance Company or HMO.  Mr. MIP is similar to a High Risk or Assigned Risk Plan for Auto Insurance. There may be a waiting list to get into Mr. MIP...1-800-289-6574

Learn about AB 1887

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Mr. MIP  information is posted as a Public Service
(Leviticus 19:9). 
We suggest you contact and submit your application to Mr. MIP directly.  If we write other business for you or your family, we are happy to consult with you on this coverage.

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Customer Service Contact Info. 
Explanatory Info. on CA DOI Website.

CA Insurance Commissioner now posts Underwriting - Pre-Existing Guidelines 

 

80% have less than $5K in claims - Page VII 61 Mr. Mip Report Click on screen below to enlarge


Wait(ing)  list status for the Major Risk Medical Insurance Program (MRMIP); however, slots are limited. We recommend that you get your application in as soon as possible because when there is a wait list, slots are offered by the first complete applications received.

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Technical Links

California Insurance Code on Mr. Mip  PART 6.5.

For 29 pages of detail, on how it's funded, and technical stuff click here.

California Healthline 3/20/2010 article  on challenges in creating high risk pool

 

 

Insurance Code 12725.5.  (a)
 It shall constitute unfair competition ...
 for an insurer, an insurance agent
or broker, or an administrator, ... to refer
an individual employee, or his or her dependents,
 to the program, or
arrange for an individual employee, or his or her dependents, to
apply to the program,
for the purpose of separating that employee, or
his or her dependents, from
group health coverage provided in
connection with the employee's employment.
   (b) ...for
any employer to refer an individual employee,
 

See page 27 Question 6 of the application
6. I declare that no individual listed on this application was excluded from group health coverage solely for the purpose of being
made eligible for the MRMIP.



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HIPAA after COBRA

BILL NUMBER: AB 1887    AMENDED
        BILL TEXT

        AMENDED IN ASSEMBLY  MAY 28, 2010
        AMENDED IN ASSEMBLY  APRIL 28, 2010

INTRODUCED BY   Assembly Member Villines
   (Coauthor: Assembly Member Monning)

                        FEBRUARY 16, 2010

   An act to add Part 6.45 (commencing with Section 12699.70) to
Division 2 of the Insurance Code, relating to health care coverage
 , and declaring the urgency thereof, to take effect immediately
 .



        LEGISLATIVE COUNSEL'S DIGEST


   AB 1887, as amended, Villines. Temporary high risk pool.
   Existing law, the federal Patient Protection and Affordable Care
Act
, requires the United States Secretary of Health and Human
Services to establish a temporary  high-risk 
high risk  health insurance pool program to provide health
insurance coverage for eligible individuals until January 1, 2014

.
Existing law authorizes the secretary to carry out this program
directly or through contracts to eligible entities, including states,
and requires that money made available pursuant to these provisions
be used to establish a qualified high risk pool that meets certain
requirements.
   Existing law establishes the California Major Risk Medical
Insurance Program,
which is administered by the Managed Risk Medical
Insurance Board (MRMIB), to provide major risk medical coverage to
persons who, among other matters, have been rejected for coverage by
at least one private health plan.
   This bill would require MRMIB to establish a temporary high risk
pool to provide health care coverage to specified individuals who
have preexisting conditions and have not been covered under
creditable coverage, as defined, for the 6 months prior to applying
for coverage in the pool.

The bill would require coverage in the pool
to meet specified requirements and would require premiums to be
established at a standard rate for a standard population and not have
 an  age rating greater than 4 to 1. The bill would require
MRMIB to apply for federal funding in order to operate the pool and
would enact other related provisions.
    The bill would declare that it is to take effect immediately as
an urgency statute.
   Vote:  majority   2/3  . Appropriation:
no. Fiscal committee: yes. State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Part 6.45 (commencing with Section 12699.70) is added
to Division 2 of the Insurance Code, to read:

      PART 6.45.  TEMPORARY HIGH RISK POOL


   12699.70.  For purposes of this part, the following definitions
shall apply:
   (a) "Board" means the Managed Risk Medical Insurance Board created
pursuant to Section 12710.
   (b) "Creditable coverage" has the same meaning as defined in
Section 10198.6.
   (c) "Pool" means the temporary high risk pool established by the
board pursuant to this part.
   12699.72.  (a) The board shall establish a temporary high risk
pool to provide health care coverage to eligible individuals.
   (b) Each individual who meets all of the following requirements is
eligible to apply for coverage through the pool:
   (1) Is a citizen or national of the United States, or is lawfully
present in the United States, as determined in accordance with
Section 1411 of the Patient Protection and Affordable Care Act
(Public Law 111-148).
   (2) Has not been covered under creditable coverage for the six
months prior to applying for coverage through the pool.
   (3) Has a preexisting condition.
   (c) The benefits and coverage provided through the pool shall, at
a minimum, have an actuarial value of at least 65 percent of total
allowed costs, an out-of-pocket limit no greater than the applicable
amount for high deductible health plans linked to health savings
accounts
, and no preexisting condition exclusions.
   (d) Premiums for coverage provided through the pool shall be
established at a standard rate for a standard population and not have
an age rating greater than four to one.
   (e) The board shall apply for federal funding pursuant to Section
1101
of the Patient Protection and Affordable Care Act (Public Law
111-148) to operate the pool created by this part.
   12699.74.  Nothing in this part shall be construed to preclude the
board from creating more expansive standards and benefits, lower
cost-sharing requirements, or eligibility criteria that would result
in the inclusion of more enrollees if permitted under federal law and
funded exclusively with federal funds.
   SEC. 2.    This act is an urgency statute necessary
for the immediate preservation of the public peace, health, or safety
within the meaning of Article IV of the Constitution and shall go
into immediate effect. The facts constituting the necessity are:
 
   In order to allow the state to apply for federal funding made
available by Section 1101 of the federal Patient Protection and
Affordable Care Act (Public Law 111-148) at the earliest possible
time, it is necessary that this act take effect immediately.

how to view sections

Proposal from Federal Government to States to Offer High Risk Pool Program

A.1 PURPOSE AND BACKGROUND
The Department of Health and Human Services (HHS), as provided by Section 1101 of the Patient Protection and Affordable Care Act (?Affordable Care Act,? Public Law 111-148) seeks contracts with States to establish and operate temporary high risk health insurance pool programs to provide coverage for eligible individuals beginning in 2010 and ending on December 31, 2013. This solicitation seeks proposals from States that wish to enter into noncompetitive contracts with HHS to establish and administer these high risk pools.

 PART 6.5.  CALIFORNIA MAJOR RISK MEDICAL INSURANCE PROGRAM
     CHAPTER 1.  GENERAL ...............................................  12700
     CHAPTER 2.  DEFINITIONS ...........................................  12705
     CHAPTER 3.  POWERS AND DUTIES ................................ 12710-12714
     CHAPTER 4.  POLICIES ISSUED BY THE BOARD ..................... 12715-12718
     CHAPTER 5.  PARTICIPATING HEALTH PLANS ....................... 12720-12723
     CHAPTER 6.  SUBSCRIBER ELIGIBILITY AND ENROLLMENT ............ 12725-12733
     CHAPTER 7.  PLAN RATES AND COMPENSATION FROM THE FUND ........ 12735-12738
     CHAPTER 8.  MAJOR RISK MEDICAL INSURANCE FUND .............. 12739-12739.4

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