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You can give employees with preexisting conditions more $$$ in their HRA.

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What about sick employees?

While state-guaranteed personal health policies cost much more than private personal health policies in many states, the blended cost for a family is typically far less than employer group coverage. This is because you only purchase state-guaranteed coverage for one family member and get the rest of the family much less expensive personal policies from private carriers.


State-Guaranteed Coverage
Alabama 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Blue Cross Blue Shield $2,500 $312.00
35 Blue Cross Blue Shield $2,500 $442.00
45 Blue Cross Blue Shield $2,500 $594.00
55 Blue Cross Blue Shield $2,500 $791.00
  Average Group Plan $1,500 $371.63
More info about State-Guaranteed Coverage in Alabama
State-Guaranteed Coverage
Alaska 2010 (change state )
Age Carrier Deductible Monthly Premium
25 ACHIA $2,500 $447.00
35 ACHIA $2,500 $564.00
45 ACHIA $5,000 $562.00
55 ACHIA $5,000 $879.00
  Average Group Plan $1,500 $475.24
More info about State-Guaranteed Coverage in Alaska
State-Guaranteed Coverage
Arizona 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Blue Cross Blue Shield
$2,000
$417.00
35 Blue Cross Blue Shield $2,000 $$478.00
45 Blue Cross Blue Shield $2,000 $939.00
55 Blue Cross Blue Shield $2,000 $1535.00
  Average Group Plan $1,500 $378.36
More info about State-Guaranteed Coverage in Arizona
State-Guaranteed Coverage
Arkansas 2010 (change state )
Age Carrier Deductible Monthly Premium
25 ACHIP
$1,000 $122.27
35 ACHIP $1,000 $185.41
45 ACHIP $1,000 $293.47
55 ACHIP $1,000 $535.13
  Average Group Plan $1,500 $352.23
More info about State-Guaranteed Coverage in Arkansas
State-Guaranteed Coverage
California 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Kaiser Permanente
$500 $305.38
35 Kaiser Permanente $500 $387.48
45 Kaiser Permanente $500 $477.70
55 Kaiser Permanente $500 $631.49
  Average Group Plan $1,500 $384.29
More info about State-Guaranteed Coverage in California
State-Guaranteed Coverage
Colorado 2010 (change state )
Age Carrier Deductible Monthly Premium
25 CoverColorado $2,000 $169.58
35 CoverColorado $2,000 $229.80
45 CoverColorado $2,000 $353.96
55 CoverColorado $2,000 $604.51
  Average Group Plan $1,500 $386.35
More info about State-Guaranteed Coverage in Colorado
State-Guaranteed Coverage
Connecticut 2010 (change state )
Age Carrier Deductible Monthly Premium
25 United Healthcare
$1,500 $324.61
35 United Healthcare $1,500 $431.95
45 United Healthcare $1,500 $640.64
55 United Healthcare $1,500 $1104.84
  Average Group Plan $1,500 $425.59
More info about State-Guaranteed Coverage in Connecticut
State-Guaranteed Coverage
Delaware 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Blue Cross Blue Shield
$1,800 $685.00
35 Blue Cross Blue Shield
$1,800 $748.00
45 Blue Cross Blue Shield $1,800 $848.00
55 Blue Cross Blue Shield $1,800 $983.00
  Average Group Plan $1,500 $424.96
More info about State-Guaranteed Coverage in Delaware
State-Guaranteed Coverage
Florida 2010 (change state )
Age Carrier Deductible Monthly Premium*
25 Blue Cross Blue Shield
$2,000 $284.00
35
Blue Cross Blue Shield $2,000 $380.00
45 Blue Cross Blue Shield $2,000 $472.00
55 Blue Cross Blue Shield $2,000 $686.00
  Average Group Plan $1,500 $405.57
More info about State-Guaranteed Coverage in Florida
*Monthly Premiums are estimates
State-Guaranteed Coverage
Georgia 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Georgia Assignment $0 $175.84
35 Georgia Assignment
0 $233.00
45 Georgia Assignment
$0 $299.73
55 Georgia Assignment
$0 $444.27
  Average Group Plan $1,500 $373.51
More info about State-Guaranteed Coverage in Georgia
State-Guaranteed Coverage
Hawaii 2010 (change state )
Age Carrier Deductible Monthly Premium*
25 Blue Cross Blue Shield
$0 $273.25
35 Blue Cross Blue Shield $0 $273.25
45 Blue Cross Blue Shield $0 $273.25
55 Blue Cross Blue Shield $0 $273.25
  Average Group Plan $1,500 $343.97
More info about State-Guaranteed Coverage in Hawaii
*Final rates are subject to applicant's health condition at time of application
State-Guaranteed Coverage
Idaho 2010 (change state )
Age Carrier Deductible Monthly Premium
25 All Individual Market Carriers
$1,000 $272.00
35 All Individual Market Carriers $1,000 $357.00
45 All Individual Market Carriers $1,000 $495.00
55 All Individual Market Carriers $1,000 $830.00
  Average Group Plan $1,500 $368.49
More info about State-Guaranteed Coverage in Idaho
State-Guaranteed Coverage
Illinois 2010 (change state )
Age Carrier Deductible Monthly Premium
25 ICHIP $2,500 $161.00
35 ICHIP $2,500 $206.00
45 ICHIP $2,500 $324.00
55 ICHIP $2,500 $517.00
  Average Group Plan $1,500 $416.88
More info about State-Guaranteed Coverage in Illinois
State-Guaranteed Coverage
Indiana 2010 (change state )
Age Carrier Deductible Monthly Premium
25 ICHIA $1,000 260.61
35 ICHIA
$1,000 317.96
45 ICHIA $1,000 498.86
55 ICHIA $1,000 $780.79
  Average Group Plan $1,500 $403.59
More info about State-Guaranteed Coverage in Indiana
State-Guaranteed Coverage
Iowa 2010 (change state )
Age Carrier Deductible Monthly Premium
25 HIPIowa
$2,500 $212.63
35 HIPIowa $2,500 $275.24
45 HIPIowa $2,500 $404.36
55 HIPIowa $2,500 $635.58
  Average Group Plan $1,500 $372.26
More info about State-Guaranteed Coverage in Iowa
State-Guaranteed Coverage
Kansas 2010 (change state )
Age Carrier Deductible Monthly Premium
25 KHIA $2,500 $212.63
35 KHIA $2,500 $275.24
45 KHIA $2,500 $404.36
55 KHIA $2,500 $635.58
  Average Group Plan $1,500 $376.84
More info about State-Guaranteed Coverage in Kansas
State-Guaranteed Coverage
Kentucky 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Kentucky Access
$1,000 $222.90
35 Kentucky Access $1,000 $291.47
45 Kentucky Access $1,000 $363.79
55 Kentucky Access $1,000 $614.37
  Average Group Plan $1,500 $359.96
More info about State-Guaranteed Coverage in Kentucky
State-Guaranteed Coverage
Louisiana 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Louisiana Health Plan
$2,000 $219.32
35 Louisiana Health Plan $2,000 $313.29
45 Louisiana Health Plan $2,000 $802.78
55 Louisiana Health Plan $2,000 $1145.49
  Average Group Plan $1,500 $364.09
More info about State-Guaranteed Coverage in Louisiana
State-Guaranteed Coverage
Maine 2010 (change state )
Age Carrier Deductible Monthly Premium
25 MEGA Life and Health
$3,500 $205.51
35 MEGA Life and Health $3,500 $205.51
45 MEGA Life and Health $3,500 $205.51
55 MEGA Life and Health $3,500 $205.51
  Average Group Plan $1,500 $440.85
More info about State-Guaranteed Coverage in Maine
State-Guaranteed Coverage
Maryland 2010 (change state )
Age Carrier Deductible Monthly Premium
25 MHIP
$1,000 $195.00
35 MHIP $1,000 $268.00
45 MHIP $1,000 $342.00
55 MHIP $1,000 $414.00
  Average Group Plan $1,500 $391.47
More info about State-Guaranteed Coverage in Maryland
State-Guaranteed Coverage
Massachusetts 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Fallon Community
$2,000 $304.00
35 Fallon Community
$2,000 $322.00
45 Fallon Community $2,000 $412.00
55 Fallon Community $2,000 $608.00
  Average Group Plan $1,500 $434.21
More info about State-Guaranteed Coverage in Massachusetts
State-Guaranteed Coverage
Michigan 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Blue Cross Blue Shield
$2,500 $106.29
35 Blue Cross Blue Shield $2,500 $155.16
45 Blue Cross Blue Shield $2,500 $222.01
55 Blue Cross Blue Shield $2,500 $450.81
  Average Group Plan $1,500 $393.99
More info about State-Guaranteed Coverage in Michigan
State-Guaranteed Coverage
Minnesota 2010 (change state )
Age Carrier Deductible Monthly Premium
25 MCHA
$2,000 $208.15
35 MCHA $2,000 $245.81
45 MCHA $2,000 $337.46
55 MCHA $2,000 $546.05
  Average Group Plan $1,500 $397.94
More info about State-Guaranteed Coverage in Minnesota
State-Guaranteed Coverage
Mississippi 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Blue Cross Blue Shield
$2,000 $282.00
35 Blue Cross Blue Shield $2,000 $367.00
45 Blue Cross Blue Shield $2,000 $472.00
55 Blue Cross Blue Shield $2,000 $620.00
  Average Group Plan $1,500 $370.28
More info about State-Guaranteed Coverage in Mississippi
State-Guaranteed Coverage
Missouri 2010 (change state )
Age Carrier Deductible Monthly Premium
25 MHIP
$2,500 $244.00
35 MHIP $2,500 $312.00
45 MHIP $2,500 $536.00
55 MHIP $2,500 $846.72
  Average Group Plan $1,500 $370.28
More info about State-Guaranteed Coverage in Missouri
State-Guaranteed Coverage
Montana 2010 (change state )
Age Carrier Deductible Monthly Premium
25 MCHA $1,000 $365.00
35 MCHA $1,000 $442.00
45 MCHA $1,000 $605.00
55 MCHA $1,000 $859.00
  Average Group Plan $1,500 $391.02
More info about State-Guaranteed Coverage in Montana
State-Guaranteed Coverage
Nebraska 2010 (change state )
Age Carrier Deductible Monthly Premium
25 NECHIP
$2,000 $222.26
35 NECHIP $2,000 $285.11
45 NECHIP $2,000 $426.78
55 NECHIP $2,000 $724.30
  Average Group Plan $1,500 $394.34
More info about State-Guaranteed Coverage in Nebraska
State-Guaranteed Coverage
Nevada 2010 (change state )
Age Carrier Deductible Monthly Premium
25 All Individual Market Carriers
$1,000 $214.00
35 All Individual Market Carriers $1,000 $258.00
45 All Individual Market Carriers $1,000 $472.00
55 All Individual Market Carriers $1,000 $651.00
  Average Group Plan $1,500 $352.59
More info about State-Guaranteed Coverage in Nevada
State-Guaranteed Coverage
New Hampshire 2010 (change state )
Age Carrier Deductible Monthly Premium
25 NHHP $2,500 $210.00
35 NHHP $2,500 $247.00
45 NHHP $2,500 $422.00
55 NHHP $2,500 $702.00
  Average Group Plan $1,500 $471.11
More info about State-Guaranteed Coverage in New Hampshire
State-Guaranteed Coverage
New Jersey 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Blue Cross Blue Shield
$2,500 $304.89
35 Blue Cross Blue Shield $2,500 $387.07
45 Blue Cross Blue Shield $2,500 $410.84
55 Blue Cross Blue Shield $2,500 $532.03
  Average Group Plan $1,500 $430.80
More info about State-Guaranteed Coverage in New Jersey
State-Guaranteed Coverage
New Mexico 2010 (change state )
Age Carrier Deductible Monthly Premium
25 NMMIP $2,000 $148.00
35 NMMIP $2,000 $205.00
45 NMMIP $2,000 $286.00
55 NMMIP $2,000 $383.00
  Average Group Plan $1,500 $365.79
More info about State-Guaranteed Coverage in New Mexico
State-Guaranteed Coverage
New York 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Atlantis $0 $561.23
35 Atlantis $0 $561.23
45 Atlantis $0 $561.23
55 Atlantis $0 $561.23
  Average Group Plan $1,500 $416.43
More info about State-Guaranteed Coverage in New York
State-Guaranteed Coverage
North Carolina 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Inclusive Health $2,500 $213.00
35 Inclusive Health $2,500 $264.00
45 Inclusive Health $2,500 $380.00
55 Inclusive Health $2,500 $632.00
  Average Group Plan $1,500 $400.45
More info about State-Guaranteed Coverage in North Carolina
State-Guaranteed Coverage
North Dakota 2010 (change state )
Age Carrier Deductible Monthly Premium
25 CHAND
$1,000 $255.70
35 CHAND $1,000 $325.80
45 CHAND $1,000 $408.70
55 CHAND $1,000 $549.70
  Average Group Plan $1,500 $343.88
More info about State-Guaranteed Coverage in North Dakota
State-Guaranteed Coverage
Ohio 2010 (change state )
Age Carrier Deductible Monthly Premium
25 United Healthcare Golden Rule
$1,000 $247.75
35 United Healthcare Golden Rule $1,000 $321.42
45 United Healthcare Golden Rule $1,000 $482.13
55 United Healthcare Golden Rule $1,000 $754.43
  Average Group Plan $1,500 $367.14
More info about State-Guaranteed Coverage in Ohio
State-Guaranteed Coverage
Oklahoma 2010 (change state )
Age Carrier Deductible Monthly Premium
25 OHRP $1,000 $253.91
35 OHRP $1,000 $324.51
45 OHRP $1,000 $477.69
55 OHRP $1,000 $779.49
  Average Group Plan $1,500 $365.61
More info about State-Guaranteed Coverage in Oklahoma
State-Guaranteed Coverage
Oregon 2010 (change state )
Age Carrier Deductible Monthly Premium
25 OMIP $1,000 $309.00
35 OMIP $1,000 $359.00
45 OMIP $1,000 $491.00
55 OMIP $1,000 $646.00
  Average Group Plan $1,500 $393.63
More info about State-Guaranteed Coverage in Oregon
State-Guaranteed Coverage
Pennsylvania 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Blue Cross Blue Shield
$1,500 $530.31
35 Blue Cross Blue Shield $1,500 $530.31
45 Blue Cross Blue Shield $1,500 $530.31
55 Blue Cross Blue Shield $1,500 $530.31
  Average Group Plan $1,500 $403.95
More info about State-Guaranteed Coverage in Pennsylvania
State-Guaranteed Coverage
Rhode Island 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Blue Cross Blue Shield $2,000 $487.37
35 Blue Cross Blue Shield $2,000 $487.37
45 Blue Cross Blue Shield $2,000 $514.29
55 Blue Cross Blue Shield $2,000 $541.21
  Average Group Plan $1,500 $442.65
More info about State-Guaranteed Coverage in Rhode Island
State-Guaranteed Coverage
South Carolina 2010 (change state )
Age Carrier Deductible Monthly Premium
25 SCHIP $1,500 $338.11
35 SCHIP $1,500 $458.94
45 SCHIP $1,500 $681.7
55 SCHIP $1,500 $1063.93
  Average Group Plan $1,500 $401.98
More info about State-Guaranteed Coverage in South Carolina
State-Guaranteed Coverage
South Dakota 2010 (change state )
Age Carrier Deductible Monthly Premium
25 SDRP $3,000 $212.37
35 SDRP $3,000 $296.21
45 SDRP $3,000 $447.04
55 SDRP $3,000 $714.77
  Average Group Plan $1,500 $380.07
More info about State-Guaranteed Coverage in South Dakota
State-Guaranteed Coverage
Tennessee 2010 (change state )
Age Carrier Deductible Monthly Premium
25 AccessTN
$1,000 $410.00
35 AccessTN $1,000 $477.00
45 AccessTN $1,000 $579.00
55 AccessTN $1,000 $688.00
  Average Group Plan $1,500 $383.93
More info about State-Guaranteed Coverage in Tennessee
State-Guaranteed Coverage
Texas 2010 (change state )
Age Carrier Deductible Monthly Premium
25 Blue Cross Blue Shield $2,500 $260.00
35 Blue Cross Blue Shield $2,500 $340.00
45 Blue Cross Blue Shield $2,500 $460.00
55 Blue Cross Blue Shield $2,500 $687.00
  Average Group Plan $1,500 $377.55
More info about State-Guaranteed Coverage in Texas
State-Guaranteed Coverage
Utah 2010 (change state )
Age Carrier Deductible Monthly Premium
25 HIPUtah $2,500 $315.00
35 HIPUtah $2,500 $429.00
45 HIPUtah $2,500 $477.00
55 HIPUtah $2,500 $629.00
  Average Group Plan $1,500 $376.84
More info about State-Guaranteed Coverage in Utah
State-Guaranteed Coverage
Vermont 2010 (change state )
Age Carrier Deductible Monthly Premium
25 MVP
$3,500 $211.72
35 MVP $3,500 $227.92
45 MVP $3,500 $257.70
55 MVP $3,500 $291.40
  Average Group Plan $1,500 $439.96
More info about State-Guaranteed Coverage in Vermont
State-Guaranteed Coverage
Virginia 2010 (change state )
Age Carrier Deductible Monthly Premium*
25 Blue Cross Blue Shield
$1,200 $112.00
35 Blue Cross Blue Shield $1,200 $141.00
45 Blue Cross Blue Shield $1,200 $199.00
55 Blue Cross Blue Shield $1,200 $311.00
  Average Group Plan $1,500 $377.28
More info about State-Guaranteed Coverage in Virginia
*Monthly Premiums are estimates
State-Guaranteed Coverage
Washington 2010 (change state )
Age Carrier Deductible Monthly Premium
25 WSHIP
$2,500 $193.00
35 WSHIP $2,500 $263.00
45 WSHIP $2,500 $388.00
55 WSHIP $2,500 $544.00
  Average Group Plan $1,500 $395.42
More info about State-Guaranteed Coverage in Washington
State-Guaranteed Coverage
West Virginia 2010 (change state )
Age Carrier Deductible Monthly Premium
25 AccessWV $2,000 $155.00
35 AccessWV $2,000 $198.00
45 AccessWV $2,000 $315.00
55 AccessWV $2,000 $562.00
  Average Group Plan $1,500 $439.24
More info about State-Guaranteed Coverage in West Virginia
State-Guaranteed Coverage
Wisconsin 2010 (change state )
Age Carrier Deductible Monthly Premium
25 HIRSP $2,500 $151.00
35 HIRSP $2,500 $156.00
45 HIRSP $2,500 $208.00
55 HIRSP $2,500 $316.00
  Average Group Plan $1,500 $428.91
More info about State-Guaranteed Coverage in Wisconsin
State-Guaranteed Coverage
Wyoming 2010 (change state )
Age Carrier Deductible Monthly Premium
25 WHIP $1,000 $378.20
35 WHIP $1,000 $507.40
45 WHIP $1,000 $758.80
55 WHIP $1,000 $1297.60
  Average Group Plan $1,500 $415.00
More info about State-Guaranteed Coverage in Wyoming

If you or a member of your family are rejected or charged more for a personal health policy from a private insurance carrier because of a pre-existing medical condition, you typically become eligible for state-guaranteed personal health insurance.

A federal law passed in 1996 (HIPAA) requires all states beginning 2006 to offer state-guaranteed personal health policies (sometimes called "state risk pool coverage") to employees that lose their group coverage (called "HIPAA-eligibles"). Forty states go far beyond this federal mandate and offer state-guaranteed personal health policies to all of their residents with pre-existing medical conditions even if they never had an employer plan.

Click above for More info about State-Guaranteed Coverage in your state

Below are the most important general facts about state-guaranteed coverage.

  • There is virtually no difference between a state-guaranteed personal health insurance policy and a traditional private-carrier personal policy-except the price. In fact, state-guaranteed coverage is typically provided by the leading private carrier(s) such as Blue Cross in each state.
  • While the federal government suggests states charge 100%-200% more than personal policy coverage for state-guaranteed coverage, the cost of state-guaranteed coverage varies widely between states. State-guaranteed coverage has nothing to do with income. It is available equally to all residents of every state who have preexisting medical conditions regardless of whether they earn minimum wage or are a millionaire, although some states offer low income assistance with premiums.
  • Most states impose a waiting period of up to 12 months before covering preexisting medical conditions, however these waiting periods do not apply to HIPAA-eligibles. A HIPAA-eligible is typically a person formerly on an employer group plan who is no longer eligible for COBRA either because of time (18-36 months) or because COBRA was not offered.
  • If your company currently had a group plan, terminating the group plan often makes every employee "HIPAA-eligible" for a short period of time because there is no COBRA offered. Making an employee or dependent "HIPAA-eligible" can be a great gift to someone with a preexisting medical condition because it guarantees them, in all 50 states, acceptance into state-guaranteed coverage without a waiting period.

Personal health policies are superior to group coverage for all employees because they are permanent and portable, independent of their employment. This is especially true for employees with preexisting medical conditions in their family since these are the employees most likely not to be able to come to work due to illness.

Last year 1 million of the 2 million U.S. families filing for personal bankruptcy protection did so for medical reasons. 80% of these 1 million families had group employer coverage when they first became ill-coverage they lost when they were no longer healthy enough to come to work or were needed at home to take care of a family member with an illness.

In 45 states insurance carriers are allowed to reject or charge more to applicants for personal policies who have a preexisting medical condition. This is why it is so important for you to get a personal health insurance policy, now, for every member of your family that does not (yet) have a preexisting medical condition. Once insured, your premium cannot be increased based on your individual claims history and your policy can be renewed until age 65 (Medicare) regardless of your health. See What is a Personal policy?



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Copyright © 2012, Zane Benefits Inc.
Disclaimer: The information provided on this website is general in nature and does not apply to any specific U.S. state except where noted.
Health insurance regulations differ in each state. See a licensed agent for detailed information on your state. Zane Benefits, Inc. does not sell health insurance.


This website and related materials contain proprietary information, property of Zane Benefits, Inc., patent pending. Patents mentioned refer to patents or patent pending.
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