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SHOP and Elimination of Pre-existing Condition Exclusions

Health insurance issuers can no longer refuse to offer coverage to a person with pre-existing health conditions or charge that individual more because of a pre-existing condition.

Health insurance issuers are also required to re-issue a health plan to any applicant without medical underwriting, which means that health insurance issuers cannot increase premiums at renewal for existing customers because they incurred claims, or experienced worsening health during a policy year. Health insurance issuers may terminate coverage for enrollees who knowingly submitted false information on their applications and those who have not paid premiums before the end of the payment grace period.

 

Next Topic: Premium Rate Variations

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