Comparison of State High-Risk Pools in 2002-2003

Prepared by Michelle A. Small, Esq.

Consumers for Affordable Health Care
Last updated on 6/1/03

State	Date	Monthly Premium Age 50	Participants	Deductible	Annual Out-of-Pocket Maximum	Lifetime Maximum Benefits	Waiting Period	Benefit Limitations	Maximum Premium
Alabama	1998	$335 M $352 F $1,000 deductible	3,545	$1,000 to $2,500	$2,500 to $4,000	$1 million	None	-only 30 days of inpatient mental health coverage w/ 20% co-pay -outpatient mental health coverage w/ 50% co-pay -no skilled nursing care, home health visits or hospice care -no physical, occupational or speech therapy	200% of average
Connecticut	1976	$869.43 M $835.13 F $500 deductible	2,318	$200 to $1,000	$200 to $5,000	$1 million	12 months	-25% coinsurance rate for special health care plan -limited outpatient mental health benefits ($2,000) -no pharmacy benefits for special health care plan -special health care plan only pays 75% of Medicare Reimbursement level; enrollees above 200% FPL subject to balance billing	150% of average

State	Date	Monthly Premium Age 50	Participants	Deductible	Annual Out-of-Pocket Maximum	Lifetime Maximum Benefits	Waiting Period	Benefit Limitations	Maximum Premium
Idaho	2001	$383 M $432 F non-smoker $460 M $518 F smoker $1,000 deductible	Information not compiled by state	$500 to $1,000	$10,000 to $20,000	$1 million	12 months	-50% coinsurance rate for $500 deductible plan; 30% coinsurance rate for $1,000 deductible plan -separate $5,000 maternity and $250 pharmacy deductibles -limited preventative care ($200), skilled nursing care (45 days), rehabilitation ($2,000), home health care ($5,000), hospice ($5,000) and mental health ($5,000) benefits	150% of average
Iowa	1987	$853.61 $1,000 deductible	178	$500 to $2,000	$1,500 to $3,000	$1 million	6 months	-limited mental health coverage -additional premiums for maternity coverage	150% of average
Kentucky	2001	$534.80 M $645.76 F $400 deductible	843	$400 to $1,500	$1,900 to $6,500	$2 million to unlimited	12 months	-limited mental health coverage -no skilled nursing care or speech or occupational therapy provided by least costly plan	175% of average
Minnesota*	1976	$235.24 $1,000 deductible	29,325	$500 to $2,000	$3,000	$2.8 million	6 months	-no preventative care	125% of average
Mississippi	1992	$344 M $356 F for $1,000 deductible	3,011	$1,000 or $2,000	None	$500,000	6 months	-separate $250/$500 pharmacy deductible -$20,000 lifetime cap on physical, occupational and speech therapy -limited mental health coverage	175% of average

*Minnesota’s Legislature appropriated $30 million in 1997 and $15 million in 2000 to keep the Minnesota Comprehensive Health Association solvent. In 2002, the Commissioner of Commerce approved a $70 million allocation to MCHA from the tobacco settlement awarded to Blue Cross Blue Shield of Minnesota.

State	Date	Monthly Premium Age 50	Participants	Deductible	Annual Out-of-Pocket Maximum	Lifetime Maximum Benefits	Waiting Period	Benefit Limitations	Maximum Premium
Montana	1987	$411	2,635	$1,000	$5,000	$1 million	12 months	-no occupational or speech therapy benefits -only severe mental illness covered -prescription drug coverage limited to $2,000 annually (with 20% co-pay for generic drugs and 30% co-pay for formulary brand name drugs)	200% of average
North Dakota**	1982	$306.80 for $1,000 deductible	1,407	$500 or $1,000	$3,000	$1 million	180 days; 270 days for maternity benefits	-additional premium for chiropractic coverage -no coverage of inpatient or outpatient rehabilitation -mental health benefits vary	135% of average
Oregon	1990	$661 in Area 1 $593 in Area 2 for $200 deductible	8,817	$200 to $1,000	$700 to $4,000	$1 million	6 months	-separate pharmacy deductible ($100 to $1,000) -no mental health benefits under $1,000 deductible plan -no physical, occupational or speech therapy under $1,000 deductible plan -no preventative care under $1,000 deductible plan	125% of average

**Participating companies pay losses in excess of premiums in the form of assessments. Companies are allowed a credit against the premium tax they would otherwise pay to the state in an amount equal to the assessment paid, costing the state millions in lost tax revenues.

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