Short-Term Plans – Enacted Laws


Arizona

  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan is not required to comply with the Affordable Care Act.¹

1: https://www.azleg.gov/viewdocument/?docName=https://www.azleg.gov/ars/20/01384.htm


California

  • Prohibits the sale of short-term plans.¹

1: https://law.justia.com/codes/california/2018/code-ins/division-2/part-2/chapter-1/article-1/section-10123.61/


Colorado

  • Requires short-term plans to provide coverage for essential health benefits mandated by Colorado law.¹
  • Requires short-term plans to vary rates based only on plan type (individual vs. family coverage), geographic rating area, age, tobacco use, and plan benefits.¹
  • Prohibits short-term plans from charging enrollees more based on pre-existing conditions.¹
  • Requires short-term plans to be guaranteed-issue.¹
  • Requires short-term plans to be maintain a medical loss ratio of 80 percent.¹

1: https://casetext.com/regulation/colorado-administrative-code/department-700-department-of-regulatory-agencies/division-702-division-of-insurance/rule-3-ccr-702-4-life-accident-and-health/section-3-ccr-702-4-2-life-accident-and-health-series-4-2/regulation-3-ccr-702-4-2-59-concerning-premium-rate-setting-for-short-term-limited-duration-health-insurance-policies


Connecticut

  • Excludes short-term plans from the state’s definition of “health insurance plan.”¹

1: https://law.justia.com/codes/connecticut/2013/title-38a/chapter-700c/section-38a-476/


Delaware

  • Prohibits short-term plans from being issued to an enrollee more than once per year.¹
  • Requires short-term plans to maintain a medical loss ratio of at least 60 percent.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee of the plan’s benefits, any limitations or exclusions on coverage, the plan’s non-renewability provisions, and a description of the coverage and benefits provided by the plan.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan is not required to comply with the Affordable Care Act.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan does not qualify as minimum essential coverage and that the plan’s expiration does not qualify the enrollee for a special enrollment period.¹

1: http://regulations.delaware.gov/AdminCode/title18/1300/1320.shtml


District of Columbia

  • Prohibits short-term plans from excluding prospective enrollees from coverage based on pre-existing conditions.¹
  • Prohibits short-term plans from providing coverage for more than 3 months.¹
  • Prohibits short-term plans from being renewed.¹
  • Prohibits short-term plans from being issued to an enrollee that was covered by a short-term plan during the previous 9 months.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan does not qualify as minimum essential coverage.¹

1: https://code.dccouncil.us/dc/council/code/sections/31-3303.13d.html


Florida

  • Prohibits short-term plans from lasting for more than 36 months, taking into account renewals and extensions.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan is not required to comply with the Affordable Care Act.¹

1: http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0600-0699/0627/Sections/0627.6426.html


Hawaii

  • Prohibits short-term plans from being issued to an enrollee who was eligible to obtain coverage during through the health insurance marketplace during the previous year’s open enrollment period.¹

1: https://casetext.com/statute/hawaii-revised-statutes/division-2-business/title-24-insurance/chapter-431-insurance-code/article-10a-accident-and-health-or-sickness-insurance-contracts/part-vi-miscellaneous-provisions/section-43110a-605-short-term-limited-duration-health-insurance


Idaho

  • Defines “enhanced short-term plan.”¹
  • Includes enhanced short-term plans in the definition of “health benefit plan.”¹

1: https://legislature.idaho.gov/statutesrules/idstat/title41/t41ch52/sect41-5203/


Illinois

  • Prohibits short-term plans from lasting longer than 181 days.¹
  • Prohibits short-term plans from being renewed or extended within a year of the plan’s expiration.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan is not required to comply with the Affordable Care Act.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan does not qualify as minimum essential coverage and that the plan’s expiration does not qualify the enrollee for a special enrollment period.¹

1: http://www.ilga.gov/LEGISLATION/ILCS/ilcs3.asp?ActID=3917&ChapterID=22


Indiana

  • Excludes short-term plans from the definition of “health plan.”¹
  • Allows issuers of short-term plans to require applicants to declare how many times they will renew the plan.¹
  • Prohibits issuers of short-term plans to require underwriting of the plan until the enrollee has exhausted the plan renewals that they initially declared, and the plan is subsequently renewed.¹
  • Requires short-term plans to cover ambulatory patient services, hospitalization, emergency services, and laboratory services.¹
  • Requires short-term plans to include essential community providers in its provider network.
  • Requires short-term plans to meet network adequacy requirements.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan is not required to comply with the Affordable Care Act.¹

1: https://casetext.com/statute/indiana-code/title-27-insurance/article-8-life-accident-and-health/chapter-59-short-term-insurance-plan


Maine

  • Excludes short-term plans from the definition of “individual health plan.”¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan is not required to comply with the Affordable Care Act.¹
  • Requires short-term plans to include a notice with the plan materials that compares the features of the plan with a qualified health plan.¹
  • Prohibits short-term plans from lasting for more than 24 months, taking into account renewals and extensions.¹
  • Requires short-term plans to be sold through an in-person encounter.¹
  • Requires short-term plan issuers to provide prospective enrollees an estimate of what it would cost for them to enroll in qualified health coverage through the health insurance exchange, which must account for their eligibility for cost-sharing reductions and tax credits.¹
  • Requires short-term plan issuers to, upon expiration of the policy, provide a notice to the enrollee that the plan does not qualify as minimum essential coverage, that the plan’s expiration does not qualify the enrollee for a special enrollment period, and the dates of the next open enrollment period.¹

1: https://www.mainelegislature.org/legis/statutes/24-A/title24-Asec2736-C.html


Maryland

  • Excludes short-term plans from the definition of “minimum essential coverage.”¹

1: https://casetext.com/statute/code-of-maryland/article-insurance/subtitle-2-maryland-easy-enrollment-health-insurance-program


New Mexico

  • Prohibits short-term plans from lasting for more than 24 months, taking into account renewals and extensions.¹
  • Prohibits consumers from enrolling in a short-term plan if they have been enrolled in the same or similar type of coverage during the three months preceding enrollment.¹
  • Requires issuers of short-term plans to provide notice to prospective enrollees that they may not enroll in the health plan if they were enrolled in a short-term plan during the previous 12 month period.¹
  • Excludes short-term plans from the definition of “individual health insurance coverage.”²

1: https://casetext.com/statute/new-mexico-statutes-1978/chapter-59a-insurance-code/article-23g-short-term-health-plan-and-excepted-benefit-act
2: https://casetext.com/statute/new-mexico-statutes-1978/chapter-59a-insurance-code/article-23e-health-insurance-portability/section-59a-23e-2-definitions


Oklahoma

  • Prohibits short-term plans from lasting for more than 36 months, taking into account renewals and extensions.¹
  • Exempts short-term plans from continuation provisions of HIPAA and medical loss ratio calculations.¹
  • Excludes short-term plans from the definition of “group accident and health insurance.”¹
  • Exempts short-term plans from the mandated benefits required by Title 36 of the Oklahoma Statutes.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan is not required to provide benefits mandated by Oklahoma law.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee of the essential health benefits that the plan covers.¹

1: http://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=485745


Rhode Island

  • Includes short-term plans in the definition of “health insurance coverage.”¹

1: http://webserver.rilin.state.ri.us/Statutes/TITLE27/27-18.5/27-18.5-2.HTM


Texas

  • Requires short-term plans to include a notice with the plan materials that informs the enrollee of the plan’s duration of coverage, the number of times that the policy may be renewed, that the plan’s expiration does not qualify the enrollee for a special enrollment period, that the policy may expire outside of the open enrollment period, the dates of upcoming open enrollment periods, the plan’s limitations or exclusions based on pre-existing conditions, the maximum dollar amount payable under the policy, the plan’s deductibles, and the health care services that the plan covers.¹

1: https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1509.htm


Utah

  • Excludes short-term plans from the definition of “health insurance.”¹
  • Prohibits short-term plans from lasting for more than 36 months, taking into account renewals and extensions.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee of any pre-existing condition exclusions.¹

1: https://codes.findlaw.com/ut/title-31a-insurance-code/ut-code-sect-31a-1-301.html
2: https://codes.findlaw.com/ut/title-31a-insurance-code/ut-code-sect-31a-22-605-1.html


Vermont

  • Prohibits short-term plans from excluding prospective enrollees from coverage or limiting benefits based on pre-existing conditions.¹
  • Requires short-term plans to cover essential health benefits and other benefits mandated by Vermont law.¹
  • Prohibits short-term plans from being renewed.¹
  • Prohibits an enrollee from being covered by a short-term plan for longer than 3 months in any 12 month period.¹
  • Prohibits short-term plans from subjecting enrollees to a waiting period.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan does not qualify as minimum essential coverage and that they may be eligible to purchase more affordable and comprehensive health coverage through the state’s health insurance exchange.¹

1: https://dfr.vermont.gov/reg-bul-ord/short-term-limited-duration-health-insurance


Washington

  • Requires short-term plans to provide hospital, surgical, and medical expense coverage.¹
  • Requires short-term plans to provide maximum coverage greater than $1 million.¹
  • Prohibits short-term plans from charging coinsurance rates greater than 50 percent.¹
  • Limits short-term plans’ lookback period for pre-existing coverage exclusions to 24 months.¹
  • Prohibits short-term plans from providing coverage for longer than 3 months.¹
  • Prohibits short-term plans from being renewed.¹
  • Prohibits an enrollee from being covered by a short-term plan for longer than 3 months in any 12 month period.¹
  • Prohibits short-term plans from being issued during open enrollment.¹
  • Requires short-term plans to include a notice with the plan materials that informs the enrollee that the plan is not required to comply with the Affordable Care Act.¹

1: https://www.insurance.wa.gov/sites/default/files/2018-10/cr-103_for_r_2018-01_0.pdf


Wisconsin

  • Requires short-term plans to comply with state law regarding coverage of pre-existing conditions and prohibitions on lifetime and annual benefit limits.¹

1: Statutory citation not yet available