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Limitation Waived or Reduced

The 18-month limitation period will be waived if the person being enrolled had 18 or more months of prior health coverage under another group health plan, HMO, individual health insurance, Medicaid, or Medicare and as long as the gap in coverage between the other health coverage and the effective enrollment date of the CHP is less than 63 days. In order to avoid the limitation period and begin coverage for ALL benefits effective 1/1/06, a new enrollee must provide a Health Insurance Portability and Accountability Act (HIPAA) certificate of creditable coverage to document his/her prior health coverage.

 
The 18-month limitation period can also be reduced depending upon the number of months the person being enrolled had other health plan coverage. For example: if a worker was previously enrolled in other health plan coverage for 12 months immediately prior to CHP enrollment, then 12 of those 18 months of limitation have already been satisfied, and so the ongoing limitation period will only be for an additional 6 months for the pre-existing condition. Once again, a HIPAA certificate of creditable coverage must be provided to document that prior health coverage.
 
Please Note: The 18-month limitation does not apply to newly hired workers or newly eligible
dependents (e.g., newborn babies or newly adopted children) who enroll or are enrolled when they first become eligible for CHP coverage.

 
 
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