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Individual Conversion Plan

VHP offers an Individual Conversion Plan under HIPAA.  If you exhaust your COBRA (or Cal-COBRA) coverage, you may be eligible for this continuation coverage under the VHP Individual Conversion Benefit Plan. Covered Services are the same as your Group Benefit Plan. This Benefit Plan is described in the "VHP Individual Conversion Plan Membership Agreement and Evidence of Coverage and Disclosure Form".  If enrolled in the Individual Conversion Benefit Plan you will be responsible to pay your premiums directly to VHP. To enroll, contact VHP prior to or within 63 days of the termination of your COBRA coverage.

Eligibility rules for the Individual Conversion Plan are:

  • You cannot apply if you are eligible for other health insurance, even if the other coverage is less valuable;
  • You must contact VHP at least thirty (30) days prior to reaching your maximum COBRA eligibility period;
  • You must have been employed by your employer for at least three (3) months prior to termination or be the dependent of such a subscriber.

Coverage under this section will cease on the earliest of the following events:

  • You become eligible for other health insurance.
  • You fail to pay monthly premiums to VHP; or
  • For the reasons stated in the section entitled “Cancellation of Members for Cause;” or
  • Your employer Group Service Agreement terminates; or
  • You become entitled to Medicare; or
  • You enlist in the armed services.

If a Member converts to VHP Individual Conversion Plan coverage, that coverage is effective as of midnight following the date Coverage under this Agreement terminates.  Payment of individual conversion plan premiums is due from the date the Group Coverage ends. You cannot have a lapse of coverage in order for you to continue Plan Coverage. 

For more information, or the premium cost for the Individual Conversion Plan, call VHP Member Services at 408.885.4760 or 888.421.8444.


Attachments:
PDF DocumentValley Health Plan Individual Conversion Evidence of Coverage & Disclosure Form
 
PDF DocumentStandardized Template Conversion Coverage Product
Santa Clara County Final Matrix (Excel)
 
Get_Adobe_Acrobat

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