Problem with 'Risk Management Plan'
originally posted: 11/22/2006 reposted: 2/18/2011 This post has not been recently reviewed or revised by the author and may be out of date. If in doubt, please send a new question or ask for an update.
Q: I am self-employed residing in Alabama, I previously worked for a private organization and thought I would have coverage under their Adventist Risk Management Plan but would have to pay more for it. Unfortunately, I have a pre-existing condition (diabetes) and am not eligible. This was not communicated to me although I spoke with the HR representative twice before leaving that institution. I need health insurance coverage, currently I have the Fortis Plan which "stinks". Could you help me?
A: Sure. Start by reading the article "Health Insurance for Diabetics" at FreedomBenefits.net and then make a phone call to OnlineAdviser to review the options as they apply to your specific situation. Please be aware that Fortis does not issue coverage to diabetics so you may actually not have any coverage at all. The policy could be rescinded (retroactively cancelled) in the event that they discovered the diabetes. This is a serious problem. If the policy was purchased through an agent who knew about your diabetes, you may have a valid errors and omission claim to recoup the money you have paid. Also, just for the benefit of other readers it is significant to note that a non-insurance plan (called a 'risk management plan' in your question) is not subject to the same state laws as govern group insurance plans but are subject to federal COBRA and ERISA laws. Uninsured health plans like carry significantly more risk for members. It is unclear from your question why federal continuation provisions did not apply to the Adventist plan. It seems possible that you received bad advice on both counts.
Summary
More resources:
Health Insurance for Diabetics
FreedomBenefits.net