November 08, 2000

 

2000-R-1049

SMALL BUSINESS HEALTH INSURANCE

 

By: Jerome Harleston, Senior Attorney

You want details about measures cited in OLR Report 2000-R-0907 and implemented by Northeast states to assist small businesses obtain health insurance for their employees and a contact person in each state.

In the small employer health insurance market, most state governments have adopted measures to ensure that (1) employees who want health insurance coverage are accepted and renewed by insurers; (2) waiting periods for preexisting conditions are short, occur only once, and are based only on recent medical history; (3) coverage is continuous and portable, even when the employee changes jobs or the employer changes insurers; and (4) extremes in premium costs are narrowed.

Specific health insurance reforms adopted in Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, and Vermont are shown in Table 1.

TABLE 1: Small Employer Health Insurance Reforms

STATE

NUMBER OF EMPLOYEES

GUARANTEED ISSUE

GUARANTEED RENEWAL

PREEXISTING CONDITION LIMIT

RATING BANDS

MODIFIED COMMUNITY RATING

Connecticut

1-50

yes

yes

12/6

no

yes

Maine

2-50

HIPAA*

yes

12/6

no

yes

Massachusetts

1-50

yes

HIPAA

6/6

no

yes

New Hampshire

1-100

yes

yes

9/3

no

yes

New Jersey

2-50

yes

yes

6/6

no

yes

New York

2-50

yes

yes

12/6

no

community rating

Rhode Island

1-50

yes

yes

0/0

yes

no

Vermont

1-50

yes

yes

12/6

no

yes

* Federal Health Insurance Portability and Accountability Act of 1996

A number of small businesses obtain health insurance coverage through trade or other association plans. Vermont and New Hampshire allow association plans to use their own community rate. Connecticut requires association plans to comply with the state's small employer law.

The insurance commissioners of the various states are responsible for making sure that insurers in the small employer health insurance market comply with state and federal laws. Their names and addresses are listed bellow.

JH:ro

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