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PCIP Coverage Ended April 30

Benefits coverage for enrollees in the federally-run Pre-Existing Condition Insurance Plan (PCIP) ended on April 30, 2014. PCIP benefits were not extended to May. This temporary program, created by the Affordable Care Act, was originally scheduled to end on December 31, 2013. We were able to extend benefits coverage to enrollees for an additional four months in 2014, to help ensure they did not experience a break in health coverage as they transitioned to other coverage through the Health Insurance Marketplace.

Updated: Timely Filing of Claims & Appeals

Claims for PCIP must be received no later than 3 months from the date of service, and all claims must be filed by July 31, 2014. The benefits administrator will not accept claims after that date.

The timeframe for an enrollee to appeal a claims benefit determination is 2 months from the date of our decision. Click here to view the Disputed Claims Process.

The Health Insurance Marketplace

The Affordable Care Act guarantees that all Americans – regardless of their health status or pre-existing conditions – finally have access to quality, affordable coverage. The next enrollment period for the Health Insurance Marketplace starts November 15, 2014, for the 2015 plan year.

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