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Small Business Employee Benefits and HR Blog

Guaranteed Issue Individual Health Insurance - A State-by-State Guide

August 13, 2009
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In my previous post, I wrote about the 1996 HIPAA legislation and its requirement that states offer guaranteed-issue health insurance to all of its HIPAA-eligible residents.  I also mentioned that 40 states go far and above what HIPAA mandates.  These states offer forms of guaranteed issue individual health insurance (e.g. risk pools) to their medically uninsurable residents, regardless of the HIPAA requirements.state by state guide to individual health insurance
 

Health insurance sold on a guaranteed issue basis cannot reject applicants based on health or risk status. In a few states (e.g. New Jersey) all individual market insurers must guarantee issue all individual plans. In others states guaranteed issue requirements are much less restrictive.

If you have questions, please comment.

 

State > HIPAA? Risk Pool Notes
Alabama No AHIP  
Alaska Yes ACHIA  
Arizona No N/A  
Arkansas Yes CHIP  
California Yes MRMIP  
Colorado Yes CoverColorado  
Connecticut Yes HRACT  
Delaware No N/A  
D.C. No N/A  
Florida Yes N/A Eligible individuals, who are uninsured for 6 months, can buy a guaranteed issue limited benefit policy through the Cover Florida Health Care Program
Georgia No N/A  
Hawaii No N/A  
Idaho Yes N/A Individual market insurers must guarantee issue standardized policies to the medically uninsurable.  These policies are called High Risk Pool Policies.
Illinois Yes ICHIP  
Indiana Yes ICHIA  
Iowa Yes HIPIOWA  
Kansas Yes KHIA  
Kentucky Yes Kentucky Access  
Louisiana Yes LHP  
Maine Yes N/A All Insurers must Guaranteed Issue all products
Maryland Yes MHIP  
Massachusetts Yes N/A All Insurers must Guaranteed Issue all products
Michigan Yes N/A BCBS of Michigan is Insurer of last resort
Minnesota Yes MCHA  
Mississippi Yes MCHIRPA  
Missouri Yes MHIP  
Montana Yes MCHA  
Nebraska Yes NECHIP  
Nevada No N/A  
New Hampshire Yes NHHP  
New Jersey Yes N/A All Insurers must Guaranteed Issue all products
New Mexico Yes NMMIP  
New York Yes N/A All Insurers must Guaranteed Issue all products
North Carolina Yes Inclusive Health  
North Dakota Yes CHAND  
Ohio Yes N/A Individual Market Insurers must guarantee issue standardized policies on a periodic basis.
Oklahoma Yes OKHRP  
Oregon Yes OMIP Individual Market Insurers must guaranteed issue portability policies to individuals with 6 months creditable coverage
Pennsylvania No N/A  
Rhode Island Yes N/A Individual market insurers must guarantee issue all products with 12 months of creditable coverage, provided that the applicant is not eligible for alternative group coverage, Medicare or any other state insurance plan
South Carolina Yes SCHIP  
South Dakota Yes SDRP  
Tennessee Yes AccessTN  
Texas Yes TXHIP  
Utah Yes HIPUtah  
Vermont Yes N/A All Insurers must Guaranteed Issue all products
Virginia No N/A  
Washington Yes WSHIP  
West Virginia Yes AccessWV  
Wisconsin Yes HIRSP  
Wyoming Yes WHIP  
  

SRC:  State Health Facts Website

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