Hawaii (HI)
Individual Health Insurance Regulations

Learn more about Hawaii Individual Health Insurance

Individual health insurance policies in Hawaii are not standardized plans, but rather specifically designed by each of the private insurance carriers. Although each plan may differ with regard to the benefits offered therein, insurance laws in the State of Hawaii mandate that certain benefits be included in each plan. For a list of specific benefits which must be included please check with the Hawaii Insurance Division. In Hawaii, individual health insurance is medically underwritten and not guaranteed issue. Accordingly, your ability to purchase individual health insurance may depend on your past and present health status. Each insurance company has its own set of underwriting guidelines which will determine your eligibility. During the application process, the insurance company may decide to 1) decline your application based upon the information contained therein, 2) approve your application, placing restrictions and/or limitations on pre-existing conditions or 3) approve your application, offering full coverage. Under Hawaii insurance laws there is a 36-month exclusionary period limit for pre-existing conditions. Credit for prior coverage is not required.

Request Hawaii Individual Health Insurance Quotes from any of our multiple providers.

Hawaii (HI)
Small Group Health Insurance Regulations

The State of Hawaii offers no statute which definitively defines the size of the small group market; however, most insurance carriers define a small group as 1 -50 or 1-100 employees. Hawaii requires all employers, whose employees meet certain criteria, to offer those employees health insurance benefits. Employer sponsored health coverage must be through an approved prepaid group health insurance plan whose policy must include specific benefits. Employers are required to pay at least one-half of employee's health insurance premiums. The State of Hawaii requires that all group health insurance policies be guarantee issue; however, unlike many other states, all policies are medically underwritten. Rates for group policies are established as a result of the medical underwriter's determination, but must be reasonable for the coverage provided. All group rates must have prior approval by the Hawaii State Department of Insurance. Insurance carriers may exercise a 6 month look back and a 12 month exclusionary period for pre-existing conditions on all applicants who do not have prior creditable coverage. Credit for prior coverage is required under the state's insurance laws as long as there is no more than a 63 day break in coverage.

Small business owners can request quotes for Hawaii group health insurance from any of our listed providers.

Hawaii COBRA and Continuation Coverage

Hawaii does not have a state mini-COBRA regulation. Under Hawaiian law, continuation of health insurance coverage is regulated under federal COBRA laws. Under COBRA law, you may remain on your previous employers' group health plan and receive the same level of coverage for a period of 18 months. You will be responsible for paying the entire premium amount, plus a 2% administration fee. If the insurance company raises the premium on your employer's group plan, you will also be subject to those higher rates. Once you have exhausted your COBRA benefits, and if you are found to be ineligible for individual health insurance, you may apply for HIPAA coverage. Insurance companies selling individual health insurance in Hawaii must offer at least 2 of their standardized plans to HIPAA eligible applicants, regardless of their health status.