Hawaii Health Insurance

Hawaii (HI)

Individual Health Insurance Regulations

When it comes to protecting your family against unforeseen events, the presence of suitable health coverage is extremely important. Before zeroing on a particular medical insurance policy, a thorough evaluation of your family's healthcare needs and your financial assets is required. If you are a resident of Hawaii, you can choose from various product options. The Hawaii Insurance Division of Department of Commerce and Consumer Affairs controls the regulations under which the Hawaiian health insurers can sell private health insurance to individuals and families.
Individual health plan policies in Hawaii are not standardized plans, but rather specifically designed by each of the private insurance carriers. Although each plan may differ with regard to the benefits offered therein, insurance laws in the State of Hawaii mandate that certain benefits be included in each plan. These benefits include mammograms, diabetic care, etc. In Hawaii, individual healthcare insurance is medically underwritten and not guaranteed issue. Accordingly, your ability to purchase a policy may depend on your past and present health status. Each insurance company has its own set of underwriting guidelines which will determine your eligibility. During the application process, the insurance company may decide to decline your application based upon the information contained therein, either approve your application, placing restrictions and/or limitations on pre-existing conditions or approve your application, offering full coverage. Under Hawaii insurance laws there is a 36-month exclusionary period limit for pre-existing conditions. However, since there no limit on the look-back period, the health insurers can review your health history for any length of period. Credit for prior coverage is not required.
Search for plans and the costs associated with them using the search box above. We provide individual, family, group and student health plan quotes for you to compare on all states and zip codes. Remember that having coverage leads to a healthier lifestyle as you are able to get regular doctor checkups and therefore a low-cost premium.

Hawaii (HI)

Small Group Health Insurance Regulations

The State of Hawaii offers no statute which definitively defines the size of the small group market; however, most insurance carriers define a small group as 1 -50 or 1-100 employees. Hawaii requires all employers, whose employees work 20 hours per week, to offer those employees health plan benefits. Employer sponsored health coverage must be through an approved prepaid group insurance plan whose policy must include specific benefits. Employers are required to pay at least one-half of employee's medical insurance premiums. The State of Hawaii requires that all group medical insurance policies be guarantee issue; however, unlike many other states, all policies are medically underwritten. Rates for group policies are established as a result of the medical underwriter's determination but must be reasonable for the coverage provided. All group rates must have prior approval by the Hawaii State Department of Insurance. Insurance carriers may exercise a 6 month look back and a 12-month exclusionary period for pre-existing conditions on all applicants who do not have prior creditable coverage. Credit for prior coverage is required under the state's insurance laws as long as there is no more than a 63-day break in coverage.

Hawaii COBRA and Continuation Coverage

Hawaii does not have a state mini-COBRA regulation. Under Hawaiian law, continuation of coverage is regulated under federal COBRA laws. Under COBRA law, you may remain on your previous employers' group health plan and receive the same level of coverage for a period of 18 months. You will be responsible for paying the entire premium amount, plus a 2% administration fee. If the insurance company raises the premium on your employer's group plan, you will also be subject to those higher rates. Once you have exhausted your COBRA benefits, and if you are found to be ineligible for individual health insurance, you may apply for HIPAA coverage. Insurance companies selling individual health insurance in Hawaii must offer at least 2 of their standardized plans to HIPAA eligible applicants, regardless of their health status.