Do you have employees who do not have access to health insurance coverage because they have exhausted COBRA coverage or another reason? The Health-Insurance Risk-Sharing Plan (HIRSP) Authority may be able to help. The HIRSP Authority administers the HIRSP and HIRSP Federal Plans in Wisconsin. These plans offer health insurance options to Wisconsinites without access to other coverage.
HIRSP has been providing health coverage for over 30 years and with the recent passage of the Patient Protection & Affordable Care Act, HIRSP now offers even more coverage options.
The HIRSP and HIRSP Federal Plans offer comprehensive medical and drug benefits at reasonable rates. The Federal Plan premiums are set at approximately 100 percent of what a healthy person would pay for similar coverage in the private, individual market. HIRSP Wisconsin rates are slightly higher.
The HIRSP Federal Plan is only available to people who have been rejected by private individual providers due to a medical condition and who have been uninsured for at least 6 months. HIRSP Wisconsin plans offer eligibility options to those who are medically uninsurable (like the Federal Plan) or have lost group coverage under HIPAA.
If you know of an individual who has recently lost their group coverage, cannot obtain individual coverage due to a pre-existing condition or has been uninsured for six months or more, they may qualify for HIRSP or HIRSP Federal coverage.
Employees who have exhausted their continuation (COBRA) coverage and do not have access to group coverage, Medicare or Medicaid may qualify for HIRSP and would not be subject to the six month waiting period for coverage of their pre-existing conditions. The employee must apply to HIRSP within 63 days of exhausting their continuation benefits in order to qualify without the waiting period.
Those who have been dropped for group insurance for at least six months can qualify for the Federal Plan and also HIRSP Wisconsin. If they are within 63 days of losing their employer sponsored coverage and have exhausted their COBRA (if offered) they can come to HIRSP via HIPAA without a waiting period for coverage of their pre-existing conditions and HIRSP Wisconsin offers premium subsidies. If applying to the Federal Plan, these individuals would still need one letter of rejection from a private, individual insurer. They do not need a letter if they qualify for HIRSP Wisconsin via HIPAA.
HIRSP offers a variety of plan choices at varying levels of premium to meet the needs of individuals with pre-existing conditions. HIRSP plans offer a premium, deductible and drug out-of-pocket maximum discount if the applicant’s household income is below $34,000 annually.
For general information about HIRSP and the new HIRSP Federal Plan, or to apply for coverage, please visit www.hirsp.org or call HIRSP Customer Service at 1.888.253.2698. You can also find more information about eligibility requirements and premium rates in this document (.pdf).