Resolving Individual Policy Effective Dates with COBRA and HIPAA

[Guest Michael L. Round]

HIPAA affords guaranteed availability to group members seeking individual coverage if certain conditions are met.

One of these conditions is the exhaustion of continuation coverage.

Suppose the COBRA benefit period begins 1/15/2000, and the benefit period is 18-months. The person is very sick, and would be a "decline" in the standard individual underwriting process.

Access to the guarantee-issue rates is appropriate, but at what effective date IF the individual policy effective date are approved by the State Insurance Department as the first of the month following approval?

7/1/2001

7/15/2001

8/1/2001

some other date

If 7/1/2001, benefits have not been exhausted.

If 8/1/2001, the person loses two weeks of coverage.

If 7/15/2001, the effective date is not allowed by the approved state insurance department document.

Thoughts?

Michael L. Round