What is a Certificate of Creditable Coverage form and how does it affect coverage for pre-existing conditions?
The Health Insurance Portability and Accountability Act of 1996, placed limits on the extent to which your group coverage can exclude or limit coverage for pre-existing conditions. It excludes coverage for the treatment of conditions which existed within 6 months prior to your enrollment date. This exclusion complies with state and federal laws and will not exceed a period of 12 months from your enrollment date or 18 months from your enrollment date if you are a late enrollee. Pre-existing conditions do not include pregnancy, pre- or post-natal care, or any complications with pregnancy. Refer to your certificate for more detailed information regarding the pre-existing condition limitation. For example, if you were covered by “creditable” health insurance for 12 straight months, with no lapse in coverage of 63 days or more, prior to your enrollment date with BPA (not a late enrollment), the pre-existing conditions exclusion of your coverage will not apply to you. If you had less than 12
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