The Kentucky Department of Insurance has given insurers more information about how it wants them to interpret a November 2010 order governing sales of child-only health insurance.
An insurer should apply group health market rules for “qualifying events” when deciding whether a child can buy individual child-only coverage using special enrollment period rules, Kentucky Insurance Commissioner Sharon Clark says in a child-only coverage advisory opinion.
Children who have state or federal “risk pool” coverage — coverage for people with health problems — can buy child-only coverage during special enrollment periods on a guaranteed-issue basis, Clark says.
Children with other types of health coverage, or access to other types of coverage, cannot buy child-only health coverage during special enrollment periods, Clark says.
The child-only coverage rules do not limit the price of the child-only coverage, Clark adds.
“Nothing in this order shall prohibit an insurer from setting a premium rate for individuals based upon medical underwriting so long as such rate is in compliance with the applicable product’s rate filing on record with the Department of Insurance,” Clark says.