GUIDE TO CALIFORNIA HIGH RISK POOLS
IMPORTANT UPDATE: With the Affordable Care Act, most of the high risk pools are no longer available. You can quote the guaranteed issue plans here.
You can find lots of borderline legal discussion of HIPAA coverage online but we wanted to try and simplify the big words down to a simple explanation of how it works from which, you can always go to the deeper side of the pool with more detail.
Let’s take a look at HIPPA health insurance coverage in California and how it can provide a safety net for those people who are loosing group health insurance.
We’ll also discuss Health Reform’s impact and probably elimination of the need for HIPAA.
You can always run your Covered California quote here:
HIPAA Coverage
So what is HIPAA and when does it become important.
HIPAA actually refers to a federal law that governs many aspects health insurance portability (the congressional term for being able to continue health insurance) and privacy among other items.
We’ll focus on the portability side of things.
HIPAA coverage may be available to people on a guaranteed issue basis (regardless of health) if they meet certain requirements.
The primary scenario where HIPAA becomes an option is when a person exhausts Cobra coverage or involuntarily loses group health insurance (for example…the company closes or shuts down the group health plan).
A person (or dependents) generally have be on continuous coverage for 18 months most recently on a group health plan (regular employer sponsored health insurance or Cobra) and involuntarily lose the coverage.
For example, you can’t just stop paying your Cobra premium and cancel that coverage in order to get HIPAA and it likely wouldn’t be advisable anyway.
To take a step back, Cobra is continuation of California group health insurance where you (as the terminated employee) pay the premium.
You must exhaust Cobra to be eligible for HIPAA coverage and if you’re eligible for a Cal-Cobra extension of another 18 months, you must exhaust that as well.
HIPAA is designed a plan of last option and we really can’t have other options available to us.
A few key points about HIPAA coverage for California health insurance.
By law, a California health carrier must offer their two most popular individual health plans on a HIPAA basis.
You typically have 62 days to elect HIPAA from your last date of eligible group health coverage (including Cobra or Cal-Cobra) to elect HIPAA but the carrier have become more stringent on this in terms of potential effective dates.
It used to be that we could choose any effective retro-actively back to the last date of group health insurance but that doesn’t seem to be the case.
Although we’re not sure of what law changed to allow this scrutiny, the carriers are instituting effective date rules based on when they receive the application and required supporting information.
You generally have to submit either a HIPAA application or complete the HIPAA information.
The bottom line is that you want to get this information in as soon as possible if you need the HIPAA coverage.
Why would we get HIPAA coverage?
Basically, we can’t qualify for anything else.
When we exhaust Cobra/Cal-Cobra, we generally want to apply for California individual health insurance but that currently requires that we’re in good health.
If were declined coverage, HIPAA may be our only option and it’s generally richer than MRMIP through the State’s high risk pool.
PCIP, the Federal pre-existing condition plan requires that you have been uninsured for at least 6 months which does not work for people who are exhausting Cobra/Cal-Cobra and it’s hard to recommend going without coverage for 6 months even though the pricing for PCIP is better.
Each California health carrier will have their own HIPAA application, brochures, and rates and we don’t publish them since they change over time.
They are not quoted in our California health insurance quoting engine but they can be emailed you by request.
This is just a quick and hopefully understandable overview of HIPAA insurance plans in California so please feel free to run your situation by us.
Keep in mind that the need for HIPAA largely went away Jan 2014 when all individual health plans are guaranteed issue through the Exchange albeit at a higher expected monthly rate.
Call us at 800-320-6269 with any questions. Our services are free to you as licensed health agents.
Your Calhealth Advantage
Our online tools, free quotes and licensed agents are here to help you find a plan.

ON THE BLOG
Featured Articles
California Individual Vision Insurance
California Health Reform Subsidy
California Health Insurance Resource List
California Health Insurance Rate Increases
California Health Insurance Office Copay
California Health Insurance Maternity and Individual
California Health Insurance Individual Versus Cobra
California Health Insurance Individual Underwriting
California Health Insurance Group Value Dental Vision
California Health Insurance Group Kaiser
California Health Insurance Definitions
California Health Insurance Coverage Rescission
California Health Insurance Continuing Education
California Health Care Rights
California Blue Shield Vital Shield
Best California Health Insurance Plan
Affordable California Health Insurance
Understand Senior California Health Insurance
Covered California for Small Business
Individual California Health Insurance If Declined
Individual California Health Insurance Application Questionnaire
Health Net California Application Center
GURU Which Plan Should I Go With
GURU Subsidy If Offered Group Coverage
Do HSA Funds Roll Over
Compare and Contrast Alieracare Health Sharing Plan Benefits
California Vision Insurance Group
California Individual Dental Insurance
California HSA Plans and Health Reform
California Health Insurance Simplified
California Health Insurance Hospital Plans
California Health Insurance College Plan
California Health Insurance Cancel Individual Group Insurance
California Health Exchange Platinum Plan
California Health Exchange and Non Exchange Plans
Bronze California Health Plan
Covered California Open Enrollment How To
Covered California Open Enrollment
Covered California Early Pre Enroll
Small Business Tax Credits Covered California
GURU What If I Miss Open Enrollment Period
Free Assistance Covered California Enrollment
Covered California Enrollment After Open Enrollment
Comparing Deductible and Out of Pocket
California PCIP Health Insurance
California Medi-cal
California Health Insurance Group How to Choose
Avoid Bad Health Insurance Plan
Anthem Blue Cross California Application Center
How to Quote United Health National Restaurant Association
Hold On to Grandfathered Health Plans
Health Insurance for Engineering Firms
GURU What Income Period Do They Look At
Carriers
California Health Subsidy Calculator
California Health Reform Penalty
California Health Insurance Group Guaranteed Issue
Are Health Care Sharing Ministry Plans Worth It
Travel Medical Insurance
Term Life Insurance in California
Health Reform Rebates California Health Insurance
GURU Do I Use Business or Personal Gross Income
Guide Continuation of Coverage
Federal Poverty Level and California Health Insurance
California Individual Family Delta Dental
California Health Insurance Exchange
California Health Insurance Discount Plans
California Health Insurance Coinsurance
California Health Insurance Agencies
California Family Health Insurance
Obamacare Health Insurance for Gig Economy
Complaints California Health Plan
California Health Insurance Copays
Anthem Blue Cross Covered California Plans Rates Networks
Short Term Health Insurance
Short Term Insurance
Kaiser Covered California Rates Plans
California Health Insurance Individual Split Policy
Blue Shield of California
HSA Versus PPO Health Plans California
GURU What Effective Date Can I Pick
California Individual Family VSP Vision
California HSA HRA Health Insurance
California Health Insurance Dental Networks
California Health Insurance Concept
Pros and Cons of Health Sharing Plans Like Alieracare
Health Sharing Plans for Short Term Health in California
Embedded Deductibles in California Health Plans
United Health Group Rates Save Employers
Sharp Health in Covered California Reviews Plans Rates
Senior Supplement Best Value
California Health Insurance Negotiated Rates
AlieraCare CarePlus Advantage Catastrophic Health Sharing Plan Review Quote Comparison
Kaiser Through Covered California
TrumpCare HSA and Obamacare Covered California
Guide High Risk Pools
Common Questions Pre-existing and Options
California Restaurant Association United Health Plan
California Health Insurance Payment Options
California Group Health Insurance Eligibility
Current Individual HSA Health Insurance Options
Critical Illness Insurance Review Rates Plans
California Special Enrollment Periods SEP
California Health Insurance Life Time Max
California Health Insurance Claims Processing
Understand Group California Health Insurance
Student Health Insurance California
GURU Whats Difference Between In Out Exchange Plans
Are Health Sharing Plan Payments Deductible
Small Business Penalty Paying Individual Plans
Small Business Penalty Paying Individual Plans
California Health Insurance Primary Care Physician
Moving to California Covered California
California Small Business
California Health Insurance Sick Rates Change
Aetna Leaves California Individual Health Market
Covered California Tax Penalty
What is Best Health Sharing Ministry Plan
United Health Insurance National Restaurant Association Employees
Pacificare of California
La Care Health Plan Review Rates Networks
Covered California Compare Bronze Silver Plans
California Medicare Supplement Center
Basic PPO Blue Cross California
Critical Illness Insurance California
California Small Group RAF
Health Net In Covered California Reviews Rates Plans
California Insurance and Alternative Health Care
What Is Health Sharing Ministry And Plan
Covered California Versus Short Term Health Insurance
California Health Emergency Urgent Care
Smart Sense Blue Cross California
Kaiser Short Term Health Insurance
California On Exchange Application Terms Conditions
Guide Group Health Insurance
Free Assistance Covered California Enrollment
By Major Insurance Company
Blue Shield California Plans Rates Reviews
California Health Insurance Group New Company
Covered California Tax Credit
Health Insurance by State
California Health Insurance Out of Network
Anthem Blue Cross Leaving California Market 2018
Losing Health Insurance After Divorce
Cobra
California Health Insurance Max Out Of Pocket
United Health versus Anthem Blue Cross California
Short Term Health Insurance Between Jobs
Cheap California Health Insurance
California Health Insurance Group Size
California Health Insurance Broker Agent
Anthem Blue Cross Covered California
California Health Insurance Group Premium Only Plan POP
California Health Insurance Deductibles
Alternative to Obamacare Health Insurance
Health Sharing Versus Covered California
Current Catastrophic Health Insurance Options
California Health Insurance Rates Based On
Covered California Open Enrollment Changes
California Health Carrier Comparison
Missed Health Insurance Open Enrollment Deadline
What are Medicare Excess Charges
How to Apply for Aliera Care Health Sharing Plans
Medicare Supplement versus Medicare Advantage Comparison
Major Medical California Insurance
Immediate Health Insurance In California
Individual Health Insurance Between States
How to Pay Covered California Premium
Already Pregnant California Health Insurance
Health Insurance for High Earners California
Obamacare Health Insurance Versus Health Sharing Comparison
California On Exchange Application
Is Western Health Advantage PPO or HMO
Health Insurance Between Retirement And Medicare
California Retirement Health Insurance Options
California Health Insurance Group 1099
California Health Insurance Blue Card
California Health Insurance Acupuncture
Are Health Sharing Plans Like Alieracare Tax Deductible
Guide California Health Doctor Network
Health Savings Account
GURU What If I Move To California
Blue Cross Blue Shield Short Term Health Insurance
Calcobra Extension
Oscar California Health Insurance Review Rates Plans
Losing Health Insurance at Age 26
California PPO POS Health Insurance
California Health Reform 400 Poverty Level
Covered California Login Issues
California Health Insurance High Deductible Plan
GURU Medi Cal for Children
California Health Pre Existing Condition
Obamacare Income Guidelines in California
How to Designate Covered California Agent
How to Quote AlieraCare for Short Term Coverage
California Health Insurance Full Time Student
Do Health Insurance Plans Cover CBD
Catastrophic Health Insurance California
California Health Insurance Out Of State Employees
Covered California Marketplace Tax Credit
Health Insurance For Larger Family Of 4 5 6 Or More
Common Questions Individual Contract
Can You Have HSA Account With Health Sharing Plans
Blue Cross Senior Smart Choice
GURU What If My Income Changes
California Health Insurance Carrier Comparison
Self Employed Health Insurance California
Health Insurance for 1-2-3 Months
How to Apply for Covered California
Kaiser Versus Western Health Advantage Comparison
California Health Insurance Chiropractic
Covered California Versus Cobra Comparison
California Los Angeles Medi Medi Anthem Mediblue Health Plan
How to Quote Aliera Care Health Sharing Rates
California Health Insurance Dependent Children
GURU Tax Filing Status and Covered California
California Health Insurance HMO Versus PPO
GURU Difference Between EPO And PPO
California Health Insurance Group Part Time
Comparing Covered California Plans
Covered California Self Employment Income
Health Net Versus Anthem Blue Cross Comparison
Common Questions Time to Process Application
GURU What Type Of Income
Kaiser Versus Sharp Health Plan Review Comparison
How To Pick Best Covered California Health Plan
Do HSA Funds Roll Over
Anthem Blue Cross Versus United Health Comparison
Kaiser Versus PPO
Aliera Care Health Sharing Plan Review Rates Plans
Health Care Sharing Ministry Comparison Review
Emergency Health Insurance California
Secular Non Religious Health Sharing Plan
Blue Shield California Versus United Health Comparison
Kaiser Versus Health Net Comparison Reviews
Health Net Versus Blue Shield California
Blue Shield Versus Anthem Blue Cross California
Blue Shield California Individual Rate Increase
Does A Company Have To Offer Health Insurance California
Kaiser Versus United Health Comparison Reviews
Kaiser Versus Anthem California
Blue Shield California Versus Kaiser Comparison Review
Blue Shield California Individual Rate Increase
Holiday
California Health Insurance Law
Blue Cross Smart Sense Individual
Blue Cross May Focal Renewal Group
Blue Cross Group Rates
Blue Cross California Individual Rate Increase
Blue Cross California Individual Rate Increase
Blue Cross Anthem Name Change
SCHIP Status
Immunizations
HSA Guideline Update
Blue Shield HIPAA Approach
Blue Cross Urgent Care Network
Blue Cross Small Group Rate Increase
Blue Cross Rate Increase Individual
Blue Cross Rate Increase Client
Blue Cross New Consumer Driven Plan
Blue Cross Healthy Living
Antibiotic Power
Holiday
California Mental Health Parity Bill
California Mental Health Parity
Blue Shield Rate Increase Individual
Blue Shield of California
Blue Cross Transfer To Colorado Nevada
Blue Cross Lawsuit
Blue Cross Billing Fee
Blue Shield New Individual Plans
Blue Cross Core 5000
Two Decades Of Helping Californians Find Affordable Health Insurance
Kaiser Versus Blue Shield Of California
See All Reviews on the Blog
See All Reviews on the Blog
- Over 500,000 Quotes
- 10’s of 1000’s Enrolled
- Guaranteed Best Rates
- Referenced for finding affordable
- California Health Inurance

20 years of experience in the California health insurance market has taught us one thing… Competent and experienced guidance is INVALUABLE
We are licensed Covered Ca agents with in-depth knowledge of their plans, process, and tax credits.
This website is owned and operated by Goodacre Insurance Services, which is solely responsible for its content. This site is not maintained by or associated with Covered California, and Covered California bears no responsibility for its content. The email address and phone numbers that appear throughout the site belong to Goodacre Insurance Services, and cannot be used to contact Covered California.