Ohio individual health open enrollment

This product is only available from Everence to people who meet Everence's fraternal eligibility requirements. For details contact your local representative or the Everence home office.   

Open enrollment will begin on Jan. 1 of each year and will remain open until we have reached the statutory limit. If our required enrollment limit is full and we have a waiting list, we will notify you if you are placed on the waiting list within five days after you have submitted an application. To inquire about the status of our waiting list, and if necessary, add your name to the list, you may call (800) 348-7468, ext. 2460.

Federally Eligible Individual details

Ohio law requires us to accept a certain number of individuals for open enrollment coverage without regard to health status. If you qualify as a Federally Eligible Individual (FEI), your coverage will be effective immediately without any pre-existing condition exclusion periods. If you do not qualify as a FEI, you may apply for non-FEI open enrollment coverage.

You are a Federally Eligible Individual if you meet all of the following conditions:

1. You had health coverage for at least 18 months without a break in coverage greater than 63 days.

2. Your most recent health coverage was under a group health plan, governmental plan, or church plan.

3. You are not eligible for coverage under any of the following plans:

    a. A group health plan

    b. Medicare

    c. Medicaid

4. You do not have any other health coverage.

5. Your most recent health coverage was not terminated because of nonpayment of premiums or fraud.

6. If you had been offered the option to continue coverage under COBRA or a state continuation plan, you both elected and 
    exhausted the continuation coverage.

If we have not yet met our enrollment quota, we will offer you the Ohio health care Basic or Standard benefit plans for purchase. You may need to submit proof of previous creditable coverage.

You are a Non-Federally Eligible Individual if you meet the following conditions:

1. You are not applying for coverage as an employee of an employer, member of an association, or member of any other group.

2. You do not have any other health coverage and are not eligible to be covered under any private or public health benefit plans including the following:

    a. Medicare or Medicare supplement policy

    b. Medicaid

    c. Any COBRA or state continuation coverage plan

    d. Other health benefits arrangement

If we have not yet met our enrollment quota, and if you meet our fraternal eligibility requirements, we will offer you the Ohio health care Basic and Standard benefit plans for purchase. Federally eligible individuals will not have their health status evaluated or be assigned waiting periods on pre-existing conditions. Non-federally eligible individuals will not have their health status evaluated, but may have their requested effective date postponed 90 days and be assigned waiting periods on pre-existing conditions for up to 12 months. Pre-existing waiting period credit is given for prior creditable health coverage. 

Benefits, rates, and enrollment

The first payment will be due two weeks following receipt of the premium notice, or the certificate effective date, whichever is later.

Select for Ohio Department of Insurance

Select for Everence 2013 rates and calculations

Select for Ohio Basic Plan Certificate

Select for Ohio Standard Plan Certificate

Select for Ohio Basic and Standard Everence Medical Insurance Application