NAIC Lists Risk Pool Adopters

The new Affordable Care Act — the legislative package that includes the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act – will require health insurers to offer individual coverage on a guaranteed-issue basis, without adjusting the price of coverage to reflect the insured’s health status, in 2014.

Before then, states can apply for a share of $5 billion in federal funding allocated for risk pool programs, or other programs, that will cover uninsured people who cannot buy conventional coverage because they have health problems.

A state that already has a risk pool program can cover eligible uninsured, high-risk individuals by setting up a second risk pool program alongside the existing program, according to the NAIC.

The cost of the new risk pool coverage can be no more than 100% of the standard non-group rate, and the cost of coverage for the oldest insureds can be no more than 4 times the cost of the cost of coverage for younger insureds.