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Life Health > Health Insurance > Health Insurance

GEHA to Explain Federal PCIP Changes

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The Government Employees Health Association (GEHA) will be offering Pre-existing Condition Insurance Plan (PCIP) coverage for lower rates starting July 1.

GEHA, Lee’s Summit, Mo., expects to leave PCIP rates alone in about 6 states and jurisdictions with PCIP rates that are comparable to private-market rates but lower prices in about two dozen other states, officials say.

GEHA will hold an online chat to review the changes, which are set to take effect July 1, at 1 p.m. EDT June 28, at

The host of the chat will be Richard Popper, director of insurance programs at the Center for Consumer Information & Insurance Oversight (CCIIO).

The CCIIO is the arm of the Centers for Medicare and Medicaid Services (CMS) that administers many of the programs created by the Patient Protection and Affordable Care Act of 2010 (PPACA).


The PCIP provisions of PPACA were supposed to provide immediate relief for uninsured people with health problems, to help fill the gap between the date PPACA was signed in March 2010 until the date when insurers started selling subsidized coverage on a guaranteed issue, mostly community-rated basis in 2014.

PCIP provides comprehensive health coverage for people who have a hard time qualifying to buy ordinary individual commercial health coverage.

Eligibility is not based on income, and the risk pools cannot charge higher rates for people with more severe health problems.

Congress let states choose between running PCIP risk pools themselves or letting HHS provide PCIP risk pool services for their residents.

HHS now provides PCIP services in the District of Columbia and 24 states: Alabama, Arizona, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Kentucky, Louisiana, Massachusetts, Minnesota, Mississippi, North Dakota, Nebraska, Nevada, South Carolina, Tennessee, Texas, Vermont, Virginia, Washington, West Virginia, and Wyoming.

Program critics originally predicted that millions of uninsured Americans with health problems would rush to enroll in the program and quickly use up federal PCIP funding.

The National Conference of State Legislatures (NCSL), Denver, has reported that the program had a total of only about 18,000 enrollees nationwide in March.

The federal PCIP program ended March with about 5,000 enrollees, according to the NCSL.

PCIP administrators announced plans in May to address low enrollment by lowering premiums in some parts of the country and letting PCIP programs pay insurance agents and brokers to help consumers with PCIP applications.


A part of PPACA that has no direct connection with the PCIP component is supposed to create a family Consumer Operated and Oriented Plan Program (CO-OP) nonprofit, member-owned health plans.

The CO-OP plans are supposed to be an alternative to for-profit health insurers and government health programs.

GEHA, the administrator of the federal PCIP program, is a self-insured, not-for-profit association that provides health and dental coverage for about 1 million federal employees, federal retirees, and dependents of federal employees and retirees.

GEHA was one of the first insurers included in the Federal Employees Health Benefits program.

Other PCIP coverage from National Underwriter Life & Health:


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