Isn't there a gov't mandate that coverage cannot be denied when health insurance is through an employer group?

Question

or is that just part of the group agreement for a typical employer group health plan. Does this vary by state?

Answer 1

It's a federal mandate called HIPPA

http://www.dol.gov/dol/topic/health-plan...

Answer 2

Sort of.  The law says, as long as you are moving from one insurance policy to another group policy,  you've had 12 months of prior continuous coverage with 63 day gap in coverage or less, they are not allowed to exclude coverage for pre-existing conditions.

HOWEVER, if you're joining a group plan, and you haven't had any health insurance for the past six months, or year, or you've had a gap longer than 63 days, they ARE allowed to exclude coverage for pre-existing conditions.  

It does not vary by state.

Answer 3

Coverage cannot be denied because of HIPAA. However, the employer can pick and choose the plans and not all plans cover everything. So if your plan doesn't cover what you want covered there is no coverage. Also, plans are allowed to place a waiting period for coverage so what you want covered may be covered later.

Answer 4

With an individual plan, you have to provide documentation of your medical conditions, and an insurer can deny you a policy entirely if you don't pass through the underwriting process.

With a group plan, you don't have to "pass" medical underwriting like you would with an individual policy.  You are entitled to the policy as long as you are an eligible employee of the group.

However, the group plan can still have a pre-existing condition clause.  If you've had continuous insurance coverage prior to the group plan beginning, then the pre-existing clause wouldn't apply to you.  If you did not have continuous health insurance coverage prior to enrolling in the group plan, coverage for a pre-existing condition can be excluded for a specified time period.

You may need to provide more details to your situation, so that we can assist you better.  Have you had continuous insurance coverage?  Are you being denied a policy entirely, or are you just being denied coverage for a pre-existing condition?