Buying short-term health plans in Florida
- Short-term plans in Florida can have initial terms of up to 364 days, and total duration, including renewals, of up to 36 months.
- But plans that are renewable or last longer than six months are limited in how they can exclude pre-existing conditions.
- At least seven insurers offer short-term plans in Florida.
Florida allows short-term plans to follow new federal duration rules, but limits pre-existing condition exclusions for longer plans
Until October 2, 2018, federal regulations limited short-term health insurance plans to no more than three months in duration, and prohibited renewals. The Trump Administration is now allowing for much longer short-term plans unless a state imposes its own restrictions.
Florida does not limit the duration of short-term plans beyond the federal rules, but the state does have a statute that limits pre-existing condition exclusions on plans with terms of longer than six months. Florida Statute 627.6045 states that health plans cannot exclude pre-existing conditions for more than 24 months, and cannot look back more than 24 months to determine whether an applicant has pre-existing conditions. The law also says that a person who has prior continuous coverage (that’s at least as robust as the new coverage) during the 24 previous months is not subject to pre-existing condition exclusions. But it specifically exempts nonrenewable short-term plans with terms of no more than six months.
So if a short-term plan is nonrenewable and lasts no more than six months, the insurer can set its own rules regarding pre-existing conditions. But if the plan is renewable and/or has a term of more than six months, the insurer can only look at up to 24 months of medical history to determine whether pre-existing condition exclusions will apply, and cannot impose pre-existing condition exclusions at all if the person has had continuous creditable coverage during that time.
With that said, however, the majority of the short-term insurers in Florida are offering plans with initial terms in excess of six months. As of November 2018, United Healthcare (Golden Rule) appeared to be the only one that was limiting short-term plans to six months. At least six other insurers were offering plans with initial terms of up to 12 months, and some were allowing total duration, including renewals, of up to three years. A closer look at plan brochures for some of those insurers indicated that pre-existing condition lookback periods of up to five years were being used, so it’s unclear how well insurers are complying with Florida’s rules regarding pre-existing conditions and longer short-term plans.
Florida Statute 627.6045 also notes that non-renewable short-term plans with terms of six months or less are not considered qualifying continuous coverage in terms of allowing a person to avoid pre-existing condition exclusions when they purchase other coverage at a later date.
How long can short-term plans last in Florida?
Florida does not have state-specific limits on the allowable duration of short-term health insurance plans, so the state defaults to the federal regulations. Florida does not consider short-term health plans to be individual health insurance, which is the same as the federal approach. (This is why short-term plans are exempt from ACA regulation.)
Because Florida does not limit short-term plans, the Trump Administration’s new regulations apply in the state. Insurers can offer short-term plans with initial terms up to 364 days and the option to renew for a total duration of up to 36 months.
Insurers are allowed to cap their short-term plans at shorter durations, however, and prohibit renewal if they choose to do so. As noted above, insurers in Florida are restricted in their handling of pre-existing conditions if the policy is renewable or lasts more than six months.
Which insurers offer short-term plans in Florida?
- Companion Life
- Everest Prime
- Independence American Life
- National General
- Standard Life
- UnitedHealthcare (Golden Rule) — plans are capped at six months in duration
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.