Under Health Reform and the Affordable Care Act, the Federal Risk Pool is being introduced to expand on the work of Inclusive Health - Federal Option's state risk pool. Like the state pool, it will provide affordable health insurance to people who are uninsured because of having a pre-existing medical condition. There are also differences in who is eligible, in coverage and premium. The Federal Risk Pool will be available until January 1, 2025 when risk pool members will be eligible for the Health Insurance Exchanges provided for in the Affordable Care Act.

An individual must meet the following criteria:

• Be a US Citizen of the United States or a lawfully admitted resident of the United States
• Have not been covered with creditable coverage (please see the below explanation definition of creditable coverage) for the previous six months before applying for coverage
• Have a pre-existing medical condition

• The premiums will be based on the standard premiums for individual policies in NC
• The premiums will not exceed 100 percent of the standard non-group rate
• Premiums will not vary by age by more than a 4 to 1 ratio
• Premiums will not vary based on gender

The premiums for the Federal Risk Pool are currently being developed and will be available in mid to late June. The Federal Risk Pool will be ready for enrollment by July 1st for an August 1st effective date.

The federal government will provide $5 billion for the Federal Risk Pool. Each state will be allocated a portion of this based on the nonelderly population, nonelderly uninsured and geographic cost in each state.

In North Carolina, Governor Perdue in conjunction with Insurance Commissioner Goodwin has designated the North Carolina Health Insurance Risk Pool, Inc. also known as Inclusive Health - Federal Option to implement the Federal Risk Pool.

The target date for implementing enrollment in the Federal Risk Pool in North Carolina is July 1, 2010.

No. There will not be a waiting period for coverage of pre-existing medical conditions under the Federal Risk Pool.

Yes. You must have a pre-existing medical condition to qualify for coverage under the Federal Risk Pool.

Yes. Under the Federal Risk Pool, one of the requirements is that you have not had creditable coverage for at least six (6) months prior to applying for coverage.

No. If you meet the qualifications under the Federal Risk Pool, you cannot be turned down for coverage based on any pre-existing medical condition. The coverage is guaranteed issue.

Under the Federal Risk Pool, there will be several plan options with varying deductible options. Plan will have coverage for inpatient and outpatient care, doctor's visits, emergency care, prescriptions, etc. We will provide more information on the specific benefits as soon as it becomes available.