Group conversion coverage
Group conversion coverage happens when a Priority Health member covered by a group plan loses that coverage and applies for coverage under an individual health care coverage agreement. Priority Health provides group conversion coverage under a
PriorityHMO
SM plan.
Requirements
- Member must live in the Priority Health service area.
- COBRA coverage has expired or the employee and/or dependent aren't enrolled in COBRA.
- Employee must apply within 31 days of group coverage termination.
Who's eligible
Members who are losing group health coverage due to:
- Employment termination
- Loss of eligibility (whether member no longer meets employer's requirements for health coverage or a dependent no longer qualifies as a dependent)
- Group health coverage termination
- Death of a covered employee (coverage for surviving dependents)
Who's not eligible
A member who:
- Has not been enrolled in your group plan for three continuous months
- Is enrolled in or eligible for other coverage that provides similar benefits (whether through an employer group, Medicare or COBRA)
- Is losing coverage from a self-funded group plan
Applying for coverage
- Employee sends a completed and signed application to Priority Health within 31 days after the termination of group coverage.
- PriorityHMO coverage begins the day after group coverage is terminated.
- Premium payments are deducted from the member's bank account via Electronic Funds Transfer (EFT).
Get more information and an application by contacting Customer Service.
