Health Status Rating

Varying premiums based on health status. Though Minnesota statutes do not currently require health plans to issue coverage in the individual market on a guarantee-issue basis, Minn. Stat. 62A.65 does limit the amount that premiums can vary in the individual market due to health status, claims experience and occupation to 1.67:1. Minnesota law does require guarantee-issue on small group plans and applies the same 1.67:1 ratio to the amount that small group plan premium can vary based on health status. Minnesota includes refraining from tobacco use and other actuarially valid lifestyle factors associated with good health as a health status factor. The ACA, once fully implemented in 2014, will prohibit health status rating except for rating based on tobacco use. The ACA will limit the maximum amount that premiums can vary for tobacco use to 1.5:1.