Idaho (ID)
Individual Health Insurance Regulations

Learn more about Idaho Individual Health Insurance

Health insurance sold to individuals or families in Idaho may be medically underwritten to determine eligibility. Applicants that do not meet the medical guidelines of the insurance company with whom they are applying may be denied coverage. Underwriting guidelines may vary from one insurance company to another. The insurance company, if they elect to insure you, may impose an elimination rider(s) that excludes paying benefits on any pre-existing medical condition disclosed in this rider. Insurance laws in the State of Idaho provide for a 12 month exclusionary period limit for pre-existing conditions, but credit for prior creditable coverage is required. Premium rates vary and are based upon plan type, age and gender and tobacco usage. An insurance company has the right to offer you a higher rate if they feel the risk of insuring you is higher than their standard risk. The maximum allowable rate increase on a new individual health plan member is 50% above the standard rate.

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

Idaho (ID)
Small Group Health Insurance Regulations

A small group in Idaho is any employer with 2-50 employees. Any person qualified to enroll in a group health plan in Idaho is protect by non-discrimination laws that prohibit the health insurance company from rejecting an employee based on health status. Newborns and newly adopted children are automatically covered under the parent's group health plan for a period of 60 days. Group health insurance coverage in Idaho is guaranteed-issue. This means that the group application for coverage may not be declined coverage due to the health status of its employees. For pre-existing medical conditions, if the employee does not have creditable coverage, the insurance company can place a 12 month waiting period on treatment of that condition. An employer may elect to have a waiting period for new hires before they become eligible for coverage under the group plan, but this waiting period must be the same for all new employees. There are also laws in Idaho that require a minimum participation and minimum employer contribution of premium. Although a small group may not be denied coverage, the insurance companies can charge up to 50% higher for groups with an excessive claims history.

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

Idaho COBRA and Continuation Coverage

Groups with 20 or more employees must abide by federal COBRA regulations. Idaho does not have mini-COBRA laws that apply to groups with less than 20 employees. Some insurance companies may offer a conversion option that will allow persons under a group plan to transfer their coverage to an individual policy. Any insurance company offering individual health insurance in Idaho must offer at least 3 of their plans to all applicants, regardless of health status, if they are HIPAA eligible. This is done through the high-risk reinsurance pool (more information below).