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Arkansas Comprehensive Health Insurance Pool (CHIP)
The Comprehensive Health Insurance Pool (CHIP) was created by legislation passed
by the Arkansas General Assembly in 1995. It serves as a health insurance plan for
individuals who:
- Do not qualify for any other insurance;
- Are covered by an individual policy with lesser benefits;
- Are covered by an individual policy with rates greater than 50 percent of those
offered by CHIP.
Why CHIP Was Created
The plan was created to provide coverage for high-risk health insurance consumers.
CHIP is funded 72 percent by premiums collected from policyholders and 28 percent from assessments
to insurance carriers. The plan will not deny any applicant simply because of health
status.
Benefits
CHIP is an individual, comprehensive major medical policy with deductibles of $1,000,
$1,250, $5,000 and $10,000, which may be elected. Corresponding stop losses are $5,000, $10,000,
$25,000 and $50,000. A pre-existing condition rider may be purchased
at extra cost by qualifying applicants.
Eligibility
CHIP is available to three classifications of eligible members:
Federal-eligible is for uninsured Arkansas residents who have
had 18 months of previous health insurance coverage (creditable
coverage) without a break in coverage of 63 days or more. The most
recent coverage must have been group or COBRA coverage.
A federally eligible individual cannot be currently eligible for
group coverage through an employer (including COBRA), Medicare, or
Medicaid.
A person applying as federally eligible has 62 days from the group
or COBRA termination date
to apply for CHIP. There is no waiting period for pre-existing conditions
for federally eligible individuals.
Resident-eligible is for Arkansas residents (1) with no current health
insurance coverage and who have been rejected for individual coverage because
of a medical condition, (2) who have individual coverage with substantially
lesser benefits, (3) who have individual coverage with rates greater than 50
percent of CHIP’s rates at the most similar deductible, or (4) whose current
individual policy is being non-renewed (the insurance carrier is no
longer writing policies in Arkansas).
(5) New residents of Arkansas whose most recent coverage was from
another state’s risk pool may also qualify as Resident Eligible.
Such persons must have been an Arkansas resident for 30 days and
apply for coverage within 63 days after coverage ended in the other
risk pool.
A six-month waiting period applies before claims will be paid for
any pre-existing condition(s) for which an individual has been
treated or diagnosed within six months prior to the inception of
the policy. For qualifying applicants, however, a conditional
waiver of pre-existing condition exclusion may be applied for and
purchased at additional cost.
The pre-existing waiver may be purchased if the applicant has 6
months of individual coverage ending through no fault of their own,
and if application is made to CHIP within 30 days of the other
coverage ending.
Health Coverage Tax Credit (HCTC) Eligible Persons are
certain residents of Arkansas whom the government has certified
to have lost their job because of global trade (for example, a
company moves its manufacturing plant overseas). HCTC Eligible
Persons will receive a letter from the federal government which
must be submitted with their CHIP application.
If an HCTC Eligible Person lost his or her coverage less than 63
days ago and had creditable coverage for at least three months
without a break in coverage of 63 days or more, the HCTC Eligible
Person will not be subject to pre-existing condition exclusions.
Other HCTC Eligible Persons will be subject to the six-month
pre-existing condition exclusion, unless they are eligible for
and purchase a waiver. Family members of HCTC Eligible Persons
may be eligible for individual coverage under CHIP as well.
For more information, click on the CHIP links below, e-mail
Customer Service, or call Customer Service at 1-800-285-6477.
CHIP Application Information
Federal/Resident Eligible:
Health Coverage Tax Credit (HCTC) Eligible:
Additional CHIP Forms and Information
Additional Resource
CHIP Website — http://www.chiparkansas.org
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