Idaho HRP

The Idaho Individual High-Risk Reinsurance Pool [1] became operational in 2001 and currently has an enrollment of approximately 1,400 individuals. In the nongroup (individual) market, the state operates the Individual High-Risk Reinsurance Pool that reinsures fiveguaranteed issue products and sets premiums for the guaranteed issue products. The primary insurer is responsible for the first $5,000 in claims, 10 percent of the next $25,000. All claims exceeding $25,000 are covered by the reinsurance pool, up to the lifetime maximums of the guaranteed issue products.

The pool is funded through premiums, a portion of the state premium tax, and, if necessary, an assessment on insurers. The premiums for the guaranteed issue products are between 125 percent and 150 percent of the rates applicable to standard risks. The Idaho High-Risk Pool functions differently than most state high-risk pools. Under Idaho’s program, all carriers who offer individual health insurance must also offer the Idaho Individual High-Risk Reinsurance Pool plans, as well as notify persons applying for individual coverage of these high-risk pool plans.