Ohio Certificate of Group Health Plan Coverage

State:
Multi-State
Control #:
US-332EM
Format:
Word; 
Rich Text
Instant download

Description

This certificate provides evidence of prior health insurance coverage.

How to fill out Certificate Of Group Health Plan Coverage?

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FAQ

Most Ohioans get health insurance coverage through their employers . It is important to understand, however, that employers offer insurance voluntarily ? no law requires it . The employer may offer insurance that covers you only, or may offer coverage to you and your dependents .

Attach copies of your proof of income, resources (such as cash, savings, checking, real property, stocks, bonds, etc.), proof of citizenship or alien status, pregnancy if applicable, and other insurance you may have.

The HIPAA certificate, also known as certificate of creditable coverage, documents the health coverage you had before you lost coverage. If you had less than 18 months of continuous coverage, the certificate includes the dates any waiting period began and when coverage began and ended.

Family Size Monthly Income* 1 $1,823 2 $2,465 3 $3,108 4 $3750 5 $4,393 6 $5,035 7 $5,678 8 $6,320 9 $6,963 10 $7,605 Families with monthly incomes higher than the amount in the first column, but lower than the amount in the second column MUST apply if they do not have private health insurance.

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Ohio Certificate of Group Health Plan Coverage