Sunday, May 17, 2009

Texas Department of Insurance

The Texas Department of Insurance is responsible for regulating all types of insurance sold in the state of Texas, including health insurance policies.

If you are looking for health insurance coverage, the Department of Insurance has a list of insurance companies licensed to sell individual policies in Texas.

U.S. Department of Labor

If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees. For example, your employer cannot single out an individual employee to exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.

If you have concerns about your employer's practices in administering your job-based health coverage (for example, if you think you should have been offered COBRA continuation coverage, but were not, or if you feel that you were wrongly terminated from your health plan) contact your regional EBSA office.

Buying Individual Policies in Texas

As a general rule, insurers in Texas are allowed to reject your application for coverage based on your health status. However, you may qualify for coverage as a "HIPAA-eligible" individual if you:

* had at least 18 months of continuous creditable coverage, the last day of which was under a group plan
AND
* you have exhausted all COBRA continuation coverage which was available to you

People who are HIPAA-eligible are guaranteed the right to buy an individual policy from a private insurer. You can also buy insurance through Texas Health Insurance Risk Pool (described below). If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the Texas Department of Insurance can help you find out.

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