Short-term health insurance in Montana

Montana defers to the federal limits for short-term plan duration, but all of the available plans still have maximum terms of six months

Buying a short-term plan in Montana

Montana defaults to federal short-term rules

The Trump Administration’s new regulations allow short-term plans to have initial terms of up to 364 days, and total duration, including renewals, of up to 36 months (prior to October 2018, federal regulations limited short-term plans to three months in duration, and prohibited renewals).

Montana published guidance in 2018, clarifying that the state is deferring to federal rules for short-term health insurance plans. The state has also published a series of FAQs about short-term health insurance, including details about state-mandated benefits and state regulations that apply to short-term plans.

Although Montana is allowing short-term plans to have initial terms of up to 364 days, the three insurers that offer short-term plans in Montana all currently cap their plan terms at six months, and have have not started offering longer-term plans.

During the 2019 legislative session, Representative Tom Winter (D, Missoula) introduced H.B.503, which would have limited short-term plans to three months. But the legislation did not pass, and Montana continues to allow short-term plans to be issued with initial terms of up to 364 days.

Montana insurance regulators and short-term health insurance plans

From 2009 to 2016, Monica Lindeen was the Commissioner of Securities and Insurance in Montana. Lindeen, a Democrat, was term-limited in 2016 and could not seek re-election that year. Matt Rosendale, a Republican, won the election in 2016 and assumed office as the Commissioner at the start of 2017 (Rosendale also ran unsuccessfully to unseat Senator Jon Tester, a Democrat, in the 2018 election; Rosendale lost that race, so he continues to be Montana’s Insurance Commissioner).

The two Commissioners have differing approaches to health care reform, and to short-term health insurance plans. Lindeen’s office warned consumers early in 2016 about the potential shortcomings of short-term health insurance, while Rosendale has been much more open to the idea of short-term plans.

State secures restitution for people who were misled by short-term insurers

Lindeen’s office took action against several short-term health insurers and insurance producers in 2016, alleging that they had sold short-term plans to Montana residents without adequate licensing, and without communicating the fact that these plans didn’t cover pre-existing conditions, didn’t count as health insurance in terms of avoiding the individual mandate penalty (which applied from 2014 through 2018, and was assessed on people who were enrolled in short-term health plans) and could not be considered comprehensive coverage.

The issue was resolved with an agreement (finalized three days after Rosendale took over as Commissioner) that refunds would be offered to residents who had purchased the policies in question.

Rosendale’s office has since secured nearly $285,000 in restitution that can be paid to as many as 3,645 policyholders in Montana, although people will have to demonstrate that they were misled by one of the insurers or agents deceptively marketing short-term plans between 2012 and 2016. The primary insurer in the case is Health Insurance Innovations, but there are several other insurers and individuals who paid into the restitution fund, and Commissioner Rosendale has sent letters to the 3,645 people who were identified by his office as possibly having been misled by one of them. There is a form included with the letter that people must fill out in order to claim restitution funds, and it has to be returned to Rosendale’s office by November 9, 2019.

Although Rosendale has pursued restitution for people who were misled by deceptive marketing tactics used by some short-term insurers, his approach tends to be more welcoming of short-term health insurance than Lindeen’s (which is in line with his general opposition to the ACA). Although he has noted that it’s essential for consumers to be well-informed about what they’re purchasing, he’s in favor of expanding health insurance options “outside the scope of Obamacare regulations” (Rosendale has also championed health care sharing ministries as an alternative to ACA-compliant coverage).

Rosendale believes longer short-term plans will be purchased by people who have been uninsured, and thus isn’t concerned about the potential for short-term health insurance plans to destabilize the existing ACA-compliant market (there’s debate about this — it’s true that people who are uninsured may gravitate to the short-term market, but hundreds of thousands of people nationwide are expected to switch from individual market plans to short-term plans now that they’ve been expanded, in part due to the elimination of the individual mandate penalty).

Which insurers offer short-term plans in Montana?

  • Independence American Insurance Company
  • National General
  • UnitedHealthcare (Golden Rule)

As noted above, all of these insurers currently cap their plan terms at six months.

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 Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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