Medical Conversion Program
Overview
Celtic Insurance Company has over 25 years of experience in offering its stand-alone guarantee-issue medical conversion program to self-funded employer groups, stop-loss and fully-insured group carriers, managed care plans, and HMO reinsurers. Celtic’s Medical Conversion Program is available in 49 states.
To groups covered under the Medical Conversion Program, coverage is made available on a guaranteed-issue basis to eligible employees who are no longer covered under their group plan. And there are no pre-existing condition limitations.
The Celtic Medical Conversion Program is trouble-free, comprehensive, and cost-effective. Celtic issues conversion policies on its own paper, assumes full financial risk, and performs all administration – all in exchange for a modest monthly per-employee or member fee.
Eligibility
Employees and dependents of employer groups participating in the Medical Conversion Program are eligible for conversion if they:
- Have been covered under the group plan for 3 consecutive months (or other statutory minimum) immediately prior to losing their eligibility under the plan
- Have completed the maximum period permitted under state continuation or COBRA (if the group is subject to these requirements)
- Are under age 65 and not covered by or eligible for Medicare or any other insurance program that would result in overinsurance as determined by Celtic. NOTE: Eligibility for coverage under HIPAA does not preclude eligibility for conversion.
Conversion for Self-Funded Employer Groups
Attention: Employer Groups, MGUs, Brokers and TPAs!!
Attention: Government Employees, School Districts, Union Groups!!
Attention: Stop Loss Carriers and ASO Providers!!
The Medical Conversion Program was originally designed just for you!!
Medical Conversion is usually only provided to groups covered under fully-insured programs. Celtic makes conversion available to self-funded groups as well. Conversion is available to self-funded groups in all states except Oregon. Conversion is available in New York through an arrangement with Union Labor Life Insurance Company
Just click on the links below to view full details of the program:
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Fully Insured Group Insurers
Celtic serves as the outsource solution for your medical conversion needs. Our Medical Conversion program can help you meet your state conversion obligations. Celtic issues conversion policies on its own paper and takes on the full financial responsibility for all your future convertees. Celtic assumes full responsibility for all administration – including statutory compliance, all form and rate filing – as well as all claims payment, billing and customer service.
The Celtic Medical Conversion Program frees up valuable resources – like actuaries and compliance personnel - for other tasks. Your conversion expenses are controllable – and budgetable. Your only cost is a modest monthly prospective per employee fee – based upon the size of your insured group population.
The Celtic Medical Conversion Program is currently available to fully-insured group carriers in all states except Oregon, Colorado, and Montana. Conversion is available in New York through an arrangement with Union Labor Life Insurance Company.
Celtic may also be able to assume the financial risk and administrative responsibility for your existing block of in-force convertees as well. Please contact Kevin Carney, Senior Sales Manager, at (312) 332-8561 or kcarney@celtic-net.com for further details.
Just click on the links below to view full details of the program:
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HMOs and HMO Reinsurers
HMOs have a unique medical conversion need: to provide a conversion option to covered employees and dependents who lose their HMO coverage because they move out of the plan’s own service area. Celtic’s Medical Conversion Plan provides the solution: making conversion coverage available to such individuals regardless of where they move.
Participation in the Celtic Program is available to HMOs either directly or through participating HMO reinsurers. Some HMOs face an additional conversion need: some states require conversion in the event of plan insolvency. Celtic may also provide the solution in these cases as well – subject to financial underwriting and approval.
HMO conversion expenses are controllable – and budgetable: a modest monthly prospective per member fee – based upon the size of the insured group population.
The Celtic Medical Conversion Program is currently available to HMOs and HMO reinsurers in all states except Oregon, Colorado, and Montana. Conversion is available in New York through an arrangement with Union Labor Life Insurance Company.
Just click on the links below to view full details of the program:
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Contact Special Health Sales Today
For further information regarding all of our medical conversion options, including timely quotes for your group or block of business, contact either Kevin Carney, Senior Sales Manager, at (312) 332-8561 or kcarney@celtic-net.com or Tom Frank, Vice President, at (312) 332-8570 or tfrank@celtic-net.com.
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