Kansas (KS)
Individual Health Insurance Regulations

Learn more about Kansas Individual Health Insurance

Health insurance is important when it comes to safeguarding your family against unexpected situations of illness or injury. Evaluation of your family’s basic healthcare needs and your financial assets is essential before choosing a particular health plan. If you reside in Kansas, you have the option to choose from various health insurance alternatives. The Kansas Insurance Department regulates the legislature under which the Kansas health insurers can sell private health insurance to individuals and families.

Kansas does not require individual health insurance policies to be issued on a guarantee-issued basis. Insurance laws in Kansas provide for individual health insurance policies to be medically underwritten by health insurance carriers. This provision allows the health insurance carrier to decline the application for pre-existing medical conditions or past health history. During the application process, the insurance carrier may deny coverage based health history and status; offer to provide health insurance with certain limitations on pre-existing health conditions and/or elimination riders; or approve the application for full coverage as submitted. There is a 24 month exclusionary period allowable for pre-existing conditions. However, the state has not mandated the look-back period limit for the determination of pre-existing conditions. Credit for prior coverage is not required under Kansas state law and elimination riders are permitted.

Kansas (KS)
Small Group Health Insurance Regulations

In Kansas, a small group employer is defined as any company with 2-50 employees. Small group health insurance is guaranteed issue in the state of Kansas. Upon commencement of employment, the employer may impose a waiting period before you become eligible to join the employer sponsored health insurance plan. Once determined eligible to join the plan, issuance of health insurance coverage is guaranteed and may not be denied or altered in any way due to your health status. Insurance companies offering group health insurance in Kansas are permitted to utilize a 3 month look back and a 3 month exclusionary period for pre-existing conditions on all applicants who do not have prior creditable coverage. Under Kansas law, credit for prior coverage is required as long as there is no more than a 63 day break in coverage. Group health insurance rates are medically underwritten and may vary by plus or minus 25 percent of the indexed rate based on the health status of the group.

Kansas COBRA and Continuation Coverage

In Kansas, groups of more than 20 insured employees must follow federal COBRA guidelines which allow any employee to remain on the group health plan for 18 months or 36 months after leaving employment with the company, regardless of the reason they are leaving. In some special cases, widows, dependent children etc. may be eligible to remain on COBRA for 36 months. This includes person that meet disability guidelines. The premium amount, plus a 2% administration fee will be charged directly to the insured.

Kansas has a state mandated mini-COBRA program which applies to groups of less than 20 employees. Under the state regulated COBRA program an employee suffering a qualifying event may opt, at their sole expense, to continue their health insurance coverage through their employer-sponsored group health plan. Kansas Continuation Law, K.S.A 40-2209 under state regulations provides for an additional 18 months of coverage, regardless of the reason why the group coverage was terminated. However, the burden of continuation of health coverage is placed on the insurance com¬pany. Secondly, the Kansas mini-cobra applies to terminated group policies as well as exempts new carriers when the employer switches insurance plans. The premium rates are limited to 100% of the amount charged to the employer and are paid directly to the insurance company.

Once state COBRA benefits have been exhausted, the applicant has 31 days in which to apply for an individual conversion plan. For those that have exhausted their COBRA option, and meet federal HIPAA eligibility, the state risk pool provides another avenue for obtaining permanent guaranteed issue coverage.