Idaho Reinsurance

The state of Idaho operates reinsurance pools [1] for both the small group and the nongroup (individual) markets. In the small group market, the insurer is responsible for the first $13,000 worth of claims as well as 10 percent of the next $12,000 in the basic plan, $87,000 in the standard plan, and $130,000 in the catastrophic plan. Above those amounts, the pool pays claims up to maximums of $25,000 for the basic plan, $100,000 for the standard plan and $200,000 for the catastrophic plan. Carriers determine whether they want to reinsure individuals, dependents, or small groups but all carriers participating in the health insurance market are assessed to cover loses incurred by the pool so, in essence, all carriers participate.