On this page:

• What does "pre-existing wait period" mean?
• What is a pre-existing condition?
• How do I get Evergreen to pay for my group plan premium at work?
• What is COBRA?
• What is the COBRA election period?
• What happens when my COBRA ends?
• What is WSHIP?
• I have WSHIP. What is my coverage?

What does "pre-existing wait period" mean?

• The pre-existing wait period is the time when you first enroll in insurance where pre-existing conditions are not covered. HIV-related costs would generally be considered pre-existing if you tested positive before enrolling in insurance. In Washington State, the pre-ex period can be up to 9 months. After this period, full coverage will begin.
• However, if you have had insurance within the last 63 days before enrolling in new insurance, the pre-ex period should be waived. This is called "continuous coverage."
• With WSHIP, the 63 days is calculated from the time your previous plan ends to the time you apply for individual insurance – it may be more than 63 days to the time you are actually enrolled in WSHIP.
• We recommend enrolling in new insurance as quickly as possible if your current insurance ends. That way, you will not experience a pre-existing wait period.
• Medicaid and Medicare qualify as continuous forms of coverage so there is usually no pre-existing wait period.

What is a pre-existing condition?

• A pre-existing condition is anything you have been diagnosed with (or treated for) prior to the start of the new plan.

How do I get Evergreen to pay for my group plan premium at work?

• You must be a client of EIP and Evergreen.
• You must make arrangements with your company’s department that handles medical benefit deductions. Usually, this will be the Human Resources (HR) or finance department. Ask these departments to stop deducting premiums from your paycheck and to begin accepting payment directly from Evergreen. Evergreen cannot reimburse you for this amount.
• We can pay only the premiums, or portion of premiums, for individuals enrolled in our program. We cannot pay for non-client spouses/partners or dependents.
• It is your responsibility to notify Evergreen of any changes in your coverage at work that may affect your premiums.
• Nothing on the checks or materials that Evergreen sends in making payments will disclose your HIV status. However, confidentiality regarding your condition may be jeopardized since anyone who visits the Evergreen website or does business with us over time will know that we are here for the support of people living with HIV.

What is COBRA?

• COBRA is the acronym for Continuation of Benefits Requirement Act.
• If you leave a job where you had health insurance, and your former employer had 20 or more employees, you are eligible for COBRA. You will be responsible for the premiums.

What is the COBRA election period?

• The COBRA election period is the time between when you leave your job and the last possible day you can sign up to continue your benefits. This includes the amount of time your employer has to send you the forms (45 days) and the time you have to fill them out and mail them back (60 days). This gives you time to sign up for EIP and Evergreen and have Evergreen pay your COBRA premiums without losing any coverage.

What happens when my COBRA ends?

• We will work with you as your COBRA is ending to help you enroll in other coverage available to you.

What is WSHIP?

• The Washington State Health Insurance Pool (WSHIP) is Washington State’s high-risk pool available for anyone who is denied coverage under other plans due to their health.

I have WSHIP. What is my coverage?

• WSHIP is a comprehensive health coverage which can vary somewhat depending on the plan you are enrolled in. You can go to the WSHIP website to find out answers to specific questions regarding your benefits and/or the medications that are covered.