Family Members To
Be Insured
You can insure any one
of the following combinations of family members:
• Single adult
• Couple - you and your spouse
• Family - you, your spouse and one or more children
• Single parent household - parent and one or more children
• Single child
• More than one child
The gender and age of each person is also required.
When enrolling a child and/or children only, enter the ages in
the child boxes. Enter any additional children in the appropriate
child blocks. Rate computations for child/children only plans
vary by carrier. Some insurance companies have specific rates
for youth plans and other insurance companies base rates for children
on the age of either the youngest or oldest child.
Age - The age for each family member that is to
be insured.
Tobacco Usage - For each adult that is to be insured,
please check the box if they are a tobacco user. By default, all
adults are assumed to Not be tobacco users.

Medical Plan Types
Medical, standard
long-term coverage
Most people select this form of coverage. This type of coverage
is renewable for multiple years and can provide continuous claims
coverage over a long period of time. Most plans of this type cover
both major medical expenses (e.g., hospitalization and surgeries)
and routine medical expenses (e.g., office visits and annual exams),
subject to deductibles and co-payments or co-insurance.
Short-term, up to 12 months temporary coverage
Short-term health insurance is a temporary health insurance plan
(typically 1 to 12 months) and should NOT be used as a substitute
for standard, long-term health insurance.
If you are:
• Between jobs
• Waiting for coverage from another health plan to start
• Laid off
• On strike
• A recent college graduate
• A seasonal employee
Then short-term health insurance may be right for you. But, please
keep in mind the following:
•Short-term medical
or dental plans are intended as interim or "gap"
coverage, i.e., for people who know, with certainty, that
they will have standard, long-term coverage (or coverage through
an employer) at a future date.
•Short-term dental
or medical plans are designed to provide protection from unforeseen
illness or injury; they are not meant to cover routine exams,
preventive care, dental or eye care, or immunizations.
•Short-term dental
or medical plans are exempt from HIPAA legislation. This means
that when issuing a Short-term medical policy, insurance carriers
do not have to: guarantee renewal, guarantee issue, or waive
the pre-existing condition limitation for federally eligible
individuals.
•Most importantly,
short-term dental or medical plans provide coverage
for a limited time frame only. Once this time frame ends,
you may or may not be able to buy additional health insurance,
depending on your health at that point in time.
If You Are Unsure That You Will Have Standard, Long-Term
Health Insurance(Or Insurance Through An Employer) Within
12 Months, We Strongly Recommend That You View Plans For Standard,
Long-Term Health Coverage Now, Before There Is An Adverse
Change In Your Health Condition.
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