Live In One State And Want To Sell Insurance In Another What You Need To Know About Non

If youre an insurance agent or customer service rep in the insurance industry, you probably know you need to be licensed to sell or even discuss insurance in the state where you live. But, what if you live in one state and work in another? This is a common scenario for people who live near a state border. In this case, youll need both a resident insurance license and a non-resident insurance license.

If you plan to work in another state, follow these steps to ensure you have covered all your bases.

Plans To Cover You When You’re Out Of State

Are you going on a trip soon? Check your health insurance before you go. Depending on what kind of health insurance plan you have, your benefits may be limited when you’re out of state.

Find out what out-of-state medical expenses may be covered under your health care plan. Plus, learn about multi-state health insurance plans, and what kind of health plan you should look at if you expect to travel often.

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Consumer Guide To Understanding Health Insurance

Many of the requirements discussed in this guide do not apply if your employer “self-funds” its health benefits plan. This Self-fund means that the employer pays your health claims from its own funds and does not pay premiums to an insurance company. The employer decides the plan coverage, including employee eligibility, covered benefits and exclusions, employee cost-sharing and policy limits. Federal law exempts these self-funded plans from state insurance laws, so these plans do not need to include state mandated benefits. You can ask your employer if your health plan is self-funded.

Do You Need Health Insurance If You’re Young And Healthy

Health insurance is essential for all, no matter your age or well-being. Accidents and illnesses can happen without warning, and expenses from medical emergencies can be overwhelming. Additionally, health plans can cover pregnancies, pre-existing conditions, lab work, rehab costs, mental health services, and more.

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How Will My Health Insurance Provider Network Change When I Move To A New State

Particularly in the individual market, health insurers have been moving towards HMOs and narrower networks. So its becoming rare for plans to offer network coverage in multiple states. Be prepared for the fact that you will almost certainly have a new provider network with your new plan.

Its also important to note that even if your health insurer is a big-name carrier that offers plans throughout the country, it will have different individual market plans in each state. So although you might have a Cigna plan already, and Cigna might also be available in the individual market in the state where youre moving, youll need to re-enroll in the new plan once you move.

And although Blue Cross Blue Shield is a household name in the health insurance market, their coverage varies from state to state. The Blue Cross Blue Shield name is licensed by 36 different health insurance carriers across the country a Blue Cross Blue Shield plan in one state is not the same as a Blue Cross Blue Shield plan in another state.

Do All Uc Plans Require That Members Agree To Binding Arbitration For Malpractice Claims Which If Any Do Not Have This Requirement

No, not all plans require arbitration. UC-sponsored plans with benefits provided by Optum Health do not require arbitration. However, California state HMO regulations mandate that an HMO medical plan disclose to enrollees that the plan requires resolution of disputes through binding arbitration. For more information about each plans provisions, please see the appropriate plan booklet or call the plan.

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How To Find Out If Your Health Plan Covers Out

Medical problems can arise at any time, even when youre traveling. Therefore, if you are planning a trip, its important to find out if your health insurance coverage will be effective in a state other than the one where it was purchased. Contact your health insurance company to find out the specifics of out-of-state coverage.

When speaking to your carrier, ask the following questions so you can gain a thorough understanding of your coverage:

Its always in your best interest to be fully aware of your healthcare coverage and what is included in your policy, both in the state where you purchased your policy, as well as other locations. The last thing you want is to assume that medical care that you required while you were traveling is covered and discover that it isnt.

Can You Have Two Health Insurance Plans

Yes, you can have two health plans.

The most common example of carrying two health insurance plans is Medicare recipients, who also have a supplemental health insurance policy, says David Mordo, former national legislative chair and current regional vice president for the National Association of Health Underwriters.

Its also possible that a married couple could have two health insurance plans, even if each spouse is covered through a health insurance plan at their workplace.

Theyre both covered under their own policies with their companies, but one of the spouses decides to jump on their spouses plan, Mordo says.

You also might have two health insurance plans if you have health insurance but also receive Medicaid coverage. Or, perhaps you are under the age of 26 and have group coverage both through an employer and your parents’ health insurance.

Other examples of when you might have two insurance plans include:

• An injured worker who qualifies for worker’s compensation but also has his or her own insurance coverage.
• A military veteran who is covered by both Veterans Administration benefits and his or her own health plan.
• An active member of the military who is covered both by military coverage and his or her own health insurance.

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What About State Licensing Exams

If you live in one state and work in another, you may or may not be required to pass a licensing exam in the state where you work, in addition to the state where you live. Contact the insurance licensing department in the state where you plan to work to find out whether you can obtain a non-resident insurance license without having to pass the state exam.

In either case, you will need to apply for a non-resident insurance license in the state where you work after obtaining your resident license from the state you are a resident of.

It can get even more complicated if you sell insurance in multiple states. For example, suppose youre a salesperson for a large insurance agency that sells insurance nationwide. If your company has you selling auto insurance and homeowners insurance policies in 26 states, youll be required to maintain active non-resident property and casualty insurance licenses in all 26 of those states, as well as the state where you work, plus a resident insurance license in the state where you live. Thats a lot of licenses to maintain!

The good news: Large agencies usually have a dedicated person or department that handles licensing for sales agents, customer service reps, and others who are required to be licensed.

Does My Health Insurance Cover Me When Im Out Of My Home State

To begin to understand how your health insurance might be impacted by a move, you first need to understand how various health plans work when youre not in your home state.

Health insurance plans and benefits vary across the U.S. because most plans are tied to a specific state. However, some plans mainly PPO and POS plans offer health insurance coverage for medical care outside of the insured persons home state. They do this through the use of out-of-network coverage. With these kinds of plans, if you see a provider for a non-emergency medical situation, you wont have to assume all the costs for that care yourself. Instead youll pay for a percentage of the total amount and your insurance plan will pay for the remaining amount. Thats why PPO or POS plans are a good option for people who travel a significant portion of the year.

Grab our quick guide to learn the differences between HMO, PPO, POS, and EPO health plans.

There are also multi-state plans, which offer in-network providers across a region or even nationally. However, this coverage depends on the specific plan a person is enrolled in. And not all multi-state plans have out-of-state coverage, despite their name.

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Please note: All information provided by Expat in Croatia is only for the purposes of guidance. It does not constitute legal advice in any form. For legal advice, you must consult with a licensed Croatian lawyer. We can recommend one if you contact us.

How Was The Uc Blue & Gold Hmo Network Developed

The university worked closely with Health Net to establish criteria for the Blue & Gold HMO network. Affordability was a key factor, but other factors included:

• Offering access in all 30 California counties.
• Incorporating the largest possible number of doctors currently caring for UC employees, non-Medicare retirees, and their families into the network.
• Having all the University of California medical groups and centers participate.

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Dental Family + Pediatric Insurance Plans

Dental Plans are insured by Cigna Health and Life Insurance Company with network management services provided by Cigna Dental Health, Inc. Rates vary based on age, family size, geographic location , and plan design. Dental rates are subject to change upon 30 days prior notice in AZ, CO & TN, and 45 days prior notice in FL.

This plan includes a combination of insurance coverage and discounted services. The insurance coverage shall be only for the classes of services referred to in The Schedule of a purchased plan.

Waiting periods do not apply to eligible children. Waiting periods may apply to adult family members for covered basic restorative and major restorative dental care services. Waiting periods do not apply to covered preventive/diagnostic dental care services.

Dental preferred provider insurance policies have exclusions, limitations, reduction of benefits and terms under which the policy may be continued in force or discontinued.

Form Series:

AZ: INDDENCOMB.AZ.1, CO: EOC_ENG_Cigna-49375CO0030002_20210101, FL: INDDENCOMB.FL.1, TN: INDDENCOMB.TN.1

10-DAY RIGHT TO RETURN POLICYIf you are not satisfied with your policy, for any reason, you may return it to us within 10 days of receipt. Cigna will then cancel your coverage as of the original effective date and promptly refund any premium you have paid.

Notice to Buyer: This policy provides dental coverage only. Review your policy carefully.

Can I Use My Health Insurance Out Of State

Whether you are traveling out or you are planning on having a medical procedure done in a different state, its important to find out if your health insurance will work outside of the state that you purchased it in.

In the event that an emergency arises while you are traveling and require medical care, you could be hit with an unexpected surprise and find out that your health insurance is not effective. The same is true if you are planning a procedure in a state that other than the one you purchased your policy from. As the cost of medical care in the United States continues to rise, knowing the details of health insurance coverage is crucial.

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Dental Pediatric Insurance Plans

Dental Plans are insured by Cigna Health and Life Insurance Company with network management services provided by Cigna Dental Health, Inc. Rates vary based on age, number of enrolled dependents, geographic location , and plan design.

Rates are subject to change upon 30 days prior notice in Arizona, Colorado, Illinois, Missouri, and Tennessee, and 45 days prior notice in Florida. In Virginia, rates are subject to change upon 60 days prior notice. In North Carolina, dental rates are guaranteed for a 12-month period. Some covered services are determined by age, including space maintainers.

Waiting periods do not apply.

Dental preferred provider insurance policies (have exclusions, limitations, reduction of benefits and terms under which the policy may be continued in force or discontinued.

Form Series:Arizona, Florida, Missouri, North Carolina, and Tennessee: INDDENPEDI.AZ.1, INDDENPEDI.FL.1, INDDENPEDI.MO.1, INDDENPEDI.NC 1, INDDENPEDI.TN.1

Colorado: EOC_ENG_Cigna_49375CO0030001_20210101

Illinois: INDDENPEDI.IL.2

10-DAY RIGHT TO RETURN POLICY If you are not satisfied with your policy, for any reason, you may return it to us within 10 days of receipt. Cigna will then cancel your coverage as of the original effective date and promptly refund any premium you have paid.

Notice to Buyer: This policy provides dental coverage only. Review your policy carefully.

Is It True That There Is No Cobra Extension For Uc Care And If So How Does Uc Care Meet What I Believe Is A Federal Obligation To Provide Such Coverage

No, this is not true. Federal COBRA for UC Care allows coverage to be continued for up to 18, 29 or 36 months, depending on the qualifying event however, UC Care enrollees are not able to extend enrollment up to 36 months under CalCOBRA because CalCOBRA is not available for self-insured plans, including the CORE plan.

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Requirements For Adding Your Children As Dependents

If you have children, theyre probably the first people that come to mind when talking about dependents. Generally speaking, you can include any child who fits the following criteria:

• Age: Your child has to be under the age of 26.
• Relationship to You: For a child to qualify as your dependent, he or she needs to be your biological child, your stepchild, your adopted child, or a foster child you are taking care of. If your child has other sisters, brothers, half sisters, half brothers, or children of their own, you can also include them on your health insurance plan.
• Length of Residency: A child only qualifies as your dependent if they have lived with you for at least six months.
• Income Contribution: Although your child can be your tax dependent while working and contributing to their own expenses, they cannot be their own primary source of support. This means a childs income must be less than half of the cost of their support expenses to qualify as your dependent.
• Tax Filing: A child cannot be your dependent if they file a joint tax return that year.
• Other Claims: A child cannot be claimed as a dependent by more than one household. So, regardless of your relationship, if someone else claims your child as a dependent, you cannot.

How Do I Use My Health Plan

Once you have enrolled in a health plan, be sure you understand your plan and the cost implications of various procedures and services. For example, going to an out-of-network doctor versus in-network traditionally costs a consumer much more for the same type of service.

When you enroll you will be given a certificate or evidence of coverage. The insurance company may mail a copy to you or they might give you the access to it on a website. If you have a health plan through your employer, the employer will have information on your plan. Read your certificate and keep it handy to look at when you use health services.

Know Your Benefits and Exclusions

Be sure you know exactly what your plan covers. Not all health plans cover the same services in the same way. Your certificate will list all of the services that are covered under your plan. It will also tell you if any services have limitations . And it should tell what services are not covered at all . Do your homework, research all the options available and review your insurance policy before making any decisions.

How to Access Services

The plan certificate will tell you if you need to use network providers to be covered. It should tell you if you need to have the health plan authorize care before you see a provider. It should also tell you:

• If you need to have the plan authorize care before you see a provider
• What to do in case of an emergency
• What to do if you are hospitalized

Internal Grievance Protections

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Transferring Medicare Part D

Like Medicare Advantage, Medicare Part D prescription drug plans are optional and are sold through private insurance companies. The available plan options and costs will vary based on where you live.

If you currently have a stand-alone Part D plan, follow the same steps as listed above for Medicare Advantage to make sure you can transfer your coverage to your new area of residence.