Short-term health plans in Connecticut
- Connecticut places strict regulations on short-term health plans, and none are for sale in the state as of 2020.
- Short-term plan duration is limited to six months in Connecticut.
- Short-term health insurance in Connecticut cannot be renewed.
- As of 2019, short-term health insurance in Connecticut was required to cover essential health benefits.
- Two insurers offered short-term plans in Connecticut in 2018, but none were offering coverage as of 2019, once the state’s essential health benefits requirements took effect.
Connecticut’s short-term health insurance regulations
As of October 2, 2018, the Trump administration relaxed the rules in terms of the allowable duration of short-term health insurance plans. But states can continue to impose more strict restrictions, and Connecticut does. As a result of the state’s regulations, including a requirement that short-term plans cover essential health benefits, there are no insurers offering short-term plans as of 2019.
Before the new federal rules took effect, Connecticut’s Insurance Commissioner, Katharine Wade, noted that “Connecticut already has the necessary statutory consumer protections in place to prohibit ‘junk plans.’ ”
After the Trump administration’s new regulations for short-term plans were finalized, the Connecticut Insurance Department issued a statement (Bulletin HC-121) to clarify the rules for short-term health insurance in Connecticut, which remained in effect after the federal rules were relaxed.
What is the allowable short-term plan duration in Connecticut?
Although there are no short-term medical plans for sale in Connecticut, the state does have laws in place to govern these plans in the event that an insurer chose to offer them.
Short-term health insurance in Connecticut cannot have a plan duration in excess of six months, and cannot be renewable.
Connecticut’s general statute 38a-476 requires health insurance plans to cover pre-existing conditions, unless the plan is “a short-term health insurance policy issued on a nonrenewable basis for six months or less.”
Short-term coverage virtually always excludes pre-existing conditions, so short-term plan duration is effectively limited to six months in duration. And it’s noteworthy that Connecticut’s law only allows them to exclude pre-existing conditions for which the patient received medical treatment/advice during the 24 months prior to the policy effective date.
Short-term plans are required to cover essential health benefits in Connecticut
As of January 1, 2019, short-term health insurance in Connecticut was required to cover essential health benefits (EHBs). In most states, short-term plans do not include coverage for all of the essential health benefits — maternity, prescription drug, and mental health coverage are most likely to be lacking.
So it was not surprising that as of 2019, Connecticut joined the list of states where there are no longer any short-term plans for sale. Avoiding coverage for some of the essential health benefits is one of the ways that short-term plans keep their costs down, and a state-level requirement to cover essential health benefits makes the market unattractive to short-term insurers.
Connecticut’s determination that short-term plans must cover EHBs was issued in a regulatory bulletin in 2018, but legislators considered a bill in 2019 that would have codified this requirement into state law. SB34 did not advance out of committee, but the state’s existing regulation is still in place. And as of 2020, there are still no insurers offering short-term plans in the state.
Which insurers offer short-term plans in Connecticut?
In late 2018, there were a few short-term plans available in Connecticut from National General and United States Fire Insurance Company. But by 2019, no insurers were offering short-term health insurance in Connecticut.
Who can get short-term health insurance in Connecticut, and when should I consider it?
Since short-term health plans are currently not available in Connecticut, we advise that you check your eligibility for a special enrollment period that would allow you to enroll in an ACA-compliant major medical plan.
A variety of qualifying life events will trigger a special enrollment period so you can buy a plan through the health insurance marketplace in Connecticut. These plans are purchased on a month-to-month basis, so you can enroll in a plan even if you only need coverage for a few months before another policy takes effect (and depending on your income, you might qualify for a premium subsidy to reduce the monthly cost of the coverage).
Depending on your income you may also qualify for health insurance in Connecticut under expanded Medicaid coverage. When the Affordable Care Act was enacted in 2010, Medicaid expansion was a cornerstone of lawmakers’ efforts to expand realistic access to healthcare to as many people as possible. If you have a household income up to 133 percent of poverty (138 percent with the 5 percent income disregard) you would likely be able to enroll in Medicaid in Connecticut.
Medicaid enrollment continues year-round, and eligibility is based on monthly (as opposed to annual) income. So even if your income was too high for Medicaid eligibility earlier in the year, or may again be too high later in the year, Medicaid might be available to you during the time your income is low.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.