Conversion Plans

When an insured person terminates coverage under a group health plan, the group health plan must provide the insured person the opportunity to convert coverage to an individual health insurance plan. The insured person must meet the eligibility requirements for conversion under the group health plan in order to convert coverage to an individual plan.

Idaho Code § 41-2210D requires any group carrier doing business in Idaho that does not have individual health plans available in Idaho to provide an individual plan specifically for insureds who convert from group health coverage. The benefits offered must be at least equal to the Small Employer Standard Plan (under § 41-4712, as described in Rule IDAPA 18.01.70). The premium charged for such plans may not exceed 125% of the index rate for groups.

Conversion requirements apply to policies issued under Idaho Code, Title 41, Chapter 22 (Group and Blanket Disability Insurance) and Chapter 47 (Small Employer Health Insurance Availability Act).