Small Group Guaranteed Issue - Kaiser State Health Facts

Small Group Health Insurance Market Guaranteed Issue, 2009

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	Guaranteed Issue All Products	Definition of Small Group	Guaranteed Issue for Self-Employed Group of One?	Special Rules for Groups of One?	Special Rule

United States	NA	NA	NA	NA	NA

Alabama	Yes	2 to 50	No	No	NA
Alaska	Yes	2 to 50	No	No	NA
Arizona	Yes	2 to 50	No	No	NA
Arkansas	Yes	2 to 50	No	No	NA
California	Yes	2 to 50	No	No	NA
Colorado	Yes	1 to 50	Yes	Yes	Insurers are required to guaranteed issue the choice of either a standard or basic health plan to the self employed during a one month open enrollment period.
Connecticut	Yes	1 to 50	Yes	No	Insurers are required to guaranteed issue a standardized plan to the self employed.
Delaware	Yes	1 to 50	Yes	No	Insurers are required to guaranteed issue the choice of either a standard or basic health plan to the self employed.
District of Columbia	Yes	2 to 50	No	No	NA
Florida	Yes	1 to 50	Yes	Yes	Insurers are required to guarantee issue the choice of a basic health plan, a standard health plan or federally qualified HDHP to the self-employed during a one-month annual open enrollment period.
Georgia	Yes	2 to 50	No	No	NA
Hawaii	Yes	1 to 50	Yes	Yes	Insurers are required to guarantee issue small group plans to qualified self-employed during a 30 day enrollment period. In addition, for individuals experiencing certain qualifying events, insures are required to guarantee issue small group plans for the 30 day period following the qualifying event.
Idaho	Yes	2 to 50	No	No	NA
Illinois	Yes	2 to 50	No	No	NA
Indiana	Yes	2 to 50	No	No	NA
Iowa	Yes	2 to 50	No	No	NA
Kansas	Yes	2 to 50	No	No	NA
Kentucky	Yes	2 to 50	No	No	NA
Louisiana	Yes	2 to 50	No	No	NA
Maine	Yes	1 to 50	Yes	Yes	Insurers are required to guarantee issue either an individual health insurance policy or a small group plan to the self employed.
Maryland	Yes	2 to 50	No	No	NA
Massachusetts	Yes	1 to 50	Yes	No	NA
Michigan	Yes	2 to 50	Yes	Yes	BCBS is required to guarantee issue to the self-employed.
Minnesota	Yes	2 to 50	No	No	NA
Mississippi	Yes	1 to 50	Yes	Yes	Insurers are required to guarantee issue small group plans to the self-employed, except those covered by, or eligible for coverage under, a health benefit plan offered by an employer.
Missouri	Yes	2 to 50	No	No	NA
Montana	Yes	2 to 50	No	No	NA
Nebraska	Yes	2 to 50	No	No	NA
Nevada	Yes	2 to 50	No	No	NA
New Hampshire	Yes	1 to 50	Yes	Yes	Insured are required to guarantee issue small group plans to self-employed during bi-annual open enrollment periods.
New Jersey	Yes	2 to 50	No	No	NA
New Mexico	Yes	2 to 50	No	No	The New Mexico Health Insurance Alliance guarantee issues small group coverage to self-employed seeking family coverage (at least one dependent).
New York	Yes	2 to 50	No	No	NA
North Carolina	Yes	1 to 50	Yes	Yes	Insurers are required to guarantee issue a standard and basic health insurance plan to self-employed.
North Dakota	Yes	2 to 50	No	No	NA
Ohio	Yes	2 to 50	No	No
Oklahoma	Yes	2 to 50	No	No	Insurers participating in the Oklahoma Employer and Employee Partnership for Insurance Coverage Program (O-EPIC) are required to guarantee issue a program approved health plan to qualified self-employed.
Oregon	Yes	2 to 50	No	No	NA
Pennsylvania	Yes	2 to 50	No	No	NA
Rhode Island	Yes	1 to 50	Yes	No	Insurers are required to guarantee issue small group plans to the self-employed, except those covered by, or eligible for coverage under, a health benefit plan offered by an employer.
South Carolina	Yes	2 to 50	No	No	NA
South Dakota	Yes	2 to 50	No	No	NA
Tennessee	Yes	2 to 50	No	No	NA
Texas	Yes	2 to 50	No	No	NA
Utah	Yes	2 to 50	No	No	NA
Vermont	Yes	1 to 50	Yes	No	NA
Virginia	Yes	2 to 50	No	No	NA
Washington	Yes	2 to 50	No	No	NA
West Virginia	Yes	2 to 50	No	No	NA
Wisconsin	Yes	2 to 50	No	No	NA
Wyoming	Yes	2 to 50	No	No	NA

(show/hide notes)

Notes:	The rules presented in this chart are only applicable to small-group employer plans. Rules that apply to individuals are available at Individual Market Guaranteed Issue
Sources:	Data as of January 2009. Data compiled after review of federal and state law and interviews with government regulators. Data collection and analysis by researchers at the Health Policy Institute, Georgetown University.
Definitions:	NA: Not applicable. Guaranteed Issue: Federal law (and all states) requires all plans sold to small groups (employers with 2-50 employees) to be sold on a guaranteed issue basis. That means small employers cannot be turned down by an insurer based on the health status of their group. Small employers might be ineligible to buy coverage for other reasons, besides health status. For example, insurers might have requirements that small employers contribute a minimum percentage of the premium payment on behalf of employees, or that a minimum percentage of a small firms employees participate in the health plan. Federal law does not require guaranteed issue for the self-employed (sole proprietors with no other employees), however, states can, and in some cases do, apply broader guaranteed issue requirements. Group of One: Some states define the self employed as "groups of one" and require insurers to guarantee issue them coverage in the small group market.

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