Idaho Administrative Code
Title IDAPA 18 - Insurance, Department of
Rule 18.04.15 - RULES GOVERNING SHORT-TERM HEALTH INSURANCE COVERAGE
Section 18.04.15.010 - DEFINITIONS

Universal Citation: ID Admin Code 18.04.15.010

Current through August 31, 2023

In addition to the applicable definitions in Chapters 21, 42, and 52, Idaho Code, the following definitions apply: (3-31-22)

01. Benchmark Medical Plan. The health benefit plan identified by the U.S. Department of Health and Human Services to be applicable in establishing minimum benefit coverages by Qualified Health Plans within Idaho, excluding any supplements for pediatric dental or vision. (3-31-22)

02. Exchange. Has the meaning set forth in Section 41-6103, Idaho Code. (3-31-22)

03. Nonrenewable Short-term Coverage. Short-term, limited-duration insurance that is not renewable, has a duration of six (6) months or less in total, and is not an Enhanced Short-term Plan under Section 41-5203(11), Idaho Code, and this rule. (3-31-22)

04. Preexisting Condition. (3-31-22)

a. A condition for which an ordinarily prudent person would seek medical advice, diagnosis, care or treatment during the six (6) months immediately preceding the effective date of coverage; (3-31-22)

b. A condition for which medical advice, diagnosis, care or treatment was recommended or received during the six (6) months immediately preceding the effective date of coverage; or (3-31-22)

c. A pregnancy existing on the effective date of coverage. (3-31-22)

05. Qualified Health Plan or QHP. A health plan certified as such by the Exchange. (3-31-22)

06. Reissuance or Replace. The practice of issuing a short-term, limited-duration insurance policy covering at least one individual having short-term, limited-duration insurance coverage within sixty-three (63) days of the policy ' s effective date. (3-31-22)

07. Short-term, Limited-duration Insurance. Health insurance coverage pursuant to a contract that has a specified expiration date less than twelve (12) months after the original effective date of the contract and, including renewals or extensions, has a total duration of no longer than thirty-six (36) months. (3-31-22)

Disclaimer: These regulations may not be the most recent version. Idaho may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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