FAQ’s from Free Advise.com on Health Insurance Law

Please note that the answers are VERY GENERAL in nature and IMHO they don’t necessarily reflect California Law.
 WHAT IS HEALTH INSURANCE? WHAT IS PRIVATE INDEMNITY INSURANCE? WHAT ARE HEALTH CARE MAINTENANCE ORGANIZATIONS? WHAT ABOUT EMPLOYER SPONSORED PLANS?See also – AB 1672 CIC 10700 ARE THERE GOVERNMENT SPONSORED PROGRAMS?

See our page for links

 WHAT IS A HEALTH INSURANCE POLICY?

 WHAT IS A HEALTH INSURANCE PLAN?

 HOW DOES A HEALTH INSURANCE POLICY OR HEALTH PLAN PROTECT ME?

 HOW DO I DETERMINE WHAT MY HEALTH CARE COVERAGE OR BENEFITS ARE?

 SUPPOSE THE CONTRACT OR BOOKLET IS AMBIGUOUS OR UNCLEAR?

 WHAT ARE “DEFINITIONS,” “BENEFITS,” “LIMITATIONS,” AND “EXCLUSIONS?”

 ARE THERE ANY GOVERNMENT AGENCIES THAT REGULATE HOW HEALTH INSURANCE COMPANIES OR PLANS OPERATE?

California Department of Insurance Department of Managed Health Care

 WILL ONE OF THESE MANY AGENCIES BE ABLE TO HELP ME?

 IS A BUSINESS REQUIRED TO PROVIDE HEALTH INSURANCE TO EMPLOYEES?

 HOW DO I OBTAIN HEALTH INSURANCE?

Call Steve Shorr  310.519.1335 or click here to get rates & benefits

See AB 1672 – CIC 10700for groups of 2 – 50 there are “standard rates – the maximum surcharge or discount is 10%

 CAN A HEALTH INSURANCE COMPANY OR HEALTH SERVICE PLAN CANCEL MY POLICY FOR MEMBERSHIP FOR ANY REASON?

 CAN THE INSURER OR PLAN CANCEL OR RESCIND AT ANY TIME?

See also – Wrong or Incomplete Info.

 CAN I CANCEL MY HEALTH INSURANCE, AND WILL THERE BE A PENALTY OR ADVERSE CONSEQUENCE?

 IF I CANCEL DO I GET MY UNUSED PREMIUM BACK?

 ARE THERE DANGERS IN CANCELLING HEALTH INSURANCE?

 WHAT ARE TYPICAL PROBLEMS THAT ARISE IN GETTING HEALTH CARE BENEFITS PROVIDED OR PAID?

 WHAT IF THE INSURED LIED ABOUT A HEART ATTACK?

See also – Wrong or Incomplete Info.

 WHAT CAN, OR MUST, I DO WHEN A HEALTH INSURANCE COMPANY OR PLAN REFUSES TO PAY A CLAIM OR PROVIDE A BENEFIT OR SERVICE?

 WHAT IS THE APPEALS AND GRIEVANCE PROCESS LIKE?

 WHAT ARE MY LEGAL REMEDIES IF A HEALTH INSURANCE COMPANY OR PLAN REFUSES TO PAY A CLAIM FOR A BENEFIT OR SERVICE?

 WOULD I NEED A LAWYER TO HANDLE MY CASE?

Steve Shorr Insurance will do it’s best for it’s clients to get your claims paid – so you don’t have to wait or go to court In some circumstances we can help non-clients on a consultation basis

 I CURRENTLY AM ON WORKER’S COMPENSATION. CAN MY EMPLOYER MAKE ME PAY FOR MY OWN HEALTH INSURANCE WHILE I’M OFF?

 HOW LONG WILL MY MEDICAL INSURANCE ALLOW MY NEW BABY AND MYSELF REMAIN IN THE HOSPITAL FOLLOWING CHILDBIRTH?

 MY FATHER WHO HAS CONGESTIVE HEART FAILURE AND TYPE 2 DIABETES RECENTLY UNDERWENT A QUINTUPLE HEART BYPASS. HIS MEDICAL BILLS ARE STAGGERING AND HE HAS NO HEALTH INSURANCE. SHORT OF FILING BANKRUPTCY, WHAT ARE HIS OPTIONS IN GETTING THESE AMOUNTS REDUCED?

You might try Medi-Cal

Cancellation

 CAN A HEALTH INSURANCE COMPANY OR HEALTH SERVICE PLAN CANCEL MY POLICY FOR MEMBERSHIP FOR ANY REASON?

 CAN I CANCEL MY HEALTH INSURANCE, AND WILL THERE BE A PENALTY OR ADVERSE CONSEQUENCE?

 IF I CANCEL DO I GET MY UNUSED PREMIUM BACK?

 ARE THERE DANGERS IN CANCELLING HEALTH INSURANCE?

 I CURRENTLY AM ON WORKER’S COMPENSATION. CAN MY EMPLOYER MAKE ME PAY FOR MY OWN HEALTH INSURANCE WHILE I’M OFF?

Coverage
 WHAT ARE TYPICAL PROBLEMS THAT ARISE IN GETTING HEALTH CARE BENEFITS PROVIDED OR PAID?

 I CURRENTLY AM ON WORKER’S COMPENSATION. CAN MY EMPLOYER MAKE ME PAY FOR MY OWN HEALTH INSURANCE WHILE I’M OFF?

 WHAT IS PRIVATE INDEMNITY INSURANCE?

 HOW LONG WILL MY MEDICAL INSURANCE ALLOW MY NEW BABY AND MYSELF REMAIN IN THE HOSPITAL FOLLOWING CHILDBIRTH?

 MY FATHER WHO HAS CONGESTIVE HEART FAILURE AND TYPE 2 DIABETES RECENTLY UNDERWENT A QUINTUPLE HEART BYPASS. HIS MEDICAL BILLS ARE STAGGERING AND HE HAS NO HEALTH INSURANCE. SHORT OF FILING BANKRUPTCY, WHAT ARE HIS OPTIONS IN GETTING THESE AMOUNTS REDUCED?

You might try Medi-Cal

See Cobra Get quotes

Denial

 WHAT CAN, OR MUST, I DO WHEN A HEALTH INSURANCE COMPANY OR PLAN REFUSES TO PAY A CLAIM OR PROVIDE A BENEFIT OR SERVICE?

 WHAT IS THE APPEALS AND GRIEVANCE PROCESS LIKE?

See also Cal Broker Magazine 12/04 Article

View our Grievance Page

 WHAT IF THE INSURED LIED ABOUT A HEART ATTACK?

Divorce See also our (no longer supported) Family Law Page

Employer bankruptcy

Employer sponsored plans and benefits


 DO I AUTOMATICALLY LOSE MY HEALTH INSURANCE WHEN I LOSE MY JOB?  See Cobra

 WHAT IS PRIVATE INDEMNITY INSURANCE?

 I CURRENTLY AM ON WORKER’S COMPENSATION. CAN MY EMPLOYER MAKE ME PAY FOR MY OWN HEALTH INSURANCE WHILE I’M OFF?

Government regulation

 ARE THERE ANY GOVERNMENT AGENCIES THAT REGULATE HOW HEALTH INSURANCE COMPANIES OR PLANS OPERATE?

California Department of Insurance Department of Managed Health Care

Government sponsored plans

 ARE THERE GOVERNMENT SPONSORED PROGRAMS?

Check out this page

HMOs

 WHAT ARE HEALTH CARE MAINTENANCE ORGANIZATIONS?

Premiums

 ARE THERE ANY LIMITATIONS ON WHAT AN INSURANCE COMPANY CAN CHARGE FOR COVERAGE?

For group plans max. 20% variance see CIC 10700

 IF I CANCEL DO I GET MY UNUSED PREMIUM BACK?

Private indemnity policies

 WHAT IS PRIVATE INDEMNITY INSURANCE?

 HOW DO I OBTAIN HEALTH INSURANCE?

Call  310 519 1335  Get Quotes by clicking here

Purpose

 WHAT IS HEALTH INSURANCE?

Rates

For Group Plans 20% variance see CIC 10700

Self-employed

 HOW DO I OBTAIN HEALTH INSURANCE?

Call Steve Shorr  310.519.1335 or email him

Social Security recipients

 HOW DO I OBTAIN HEALTH INSURANCE?

See our page on   Medi Gap Policies

Spousal support payments

 

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