Amends existing law to revise provisions regarding enhanced short-term plans

LEGISLATURE OF THE STATE OF IDAHO
Sixty-eighth Legislature Second Regular Session - 2026
IN THE HOUSE OF REPRESENTATIVES
HOUSE BILL NO. 844
BY HEALTH AND WELFARE COMMITTEE
AN ACT	1
RELATING TO HEALTH INSURANCE; AMENDING SECTION 41-5207, IDAHO CODE, TO	2
REVISE A PROVISION REGARDING RENEWAL OF ENHANCED SHORT-TERM PLANS;	3
AMENDING SECTION 41-5214, IDAHO CODE, TO REVISE PROVISIONS REGARDING	4
REQUIREMENTS FOR ENHANCED SHORT-TERM PLANS; AND DECLARING AN EMERGENCY	5
AND PROVIDING AN EFFECTIVE DATE.	6
Be It Enacted by the Legislature of the State of Idaho:	7
SECTION 1. That Section 41-5207, Idaho Code, be, and the same is hereby	8
amended to read as follows:	9
41-5207. RENEWABILITY OF COVERAGE. (1) A health benefit plan subject	10
to the provisions of this chapter shall be renewable with respect to the in-	11
dividual or dependents, at the option of the individual, except in any of the	12
following cases:	13
(a) Nonpayment of the required premiums;	14
(b) Fraud or intentional misrepresentation of material fact by the in-	15
dividual insured or his representatives. An individual whose coverage	16
is terminated for fraud or misrepresentation shall not be deemed to be	17
an "eligible individual" for a period of twelve (12) months from the ef-	18
fective date of the termination of the individual's coverage and shall	19
not be deemed to have "qualifying previous coverage" under chapter 22,	20
or 52, title 41, Idaho Code;	21
(c) The individual ceases to be an eligible individual as defined in	22
section 41-5203(10), Idaho Code;	23
(d) In the case of health benefit plans that are made available in the	24
individual market only through one (1) or more associations, as defined	25
in section 41-2202, Idaho Code, the membership of an individual in the	26
association, on the basis of which the coverage is provided ceases, but	27
only if the coverage is terminated under this paragraph uniformly with-	28
out regard to any health status-related factor relating to any covered	29
individual;	30
(e) The individual carrier elects, at the time of coverage renewal, to	31
discontinue offering a particular health benefit plan delivered or is-	32
sued for delivery to individuals in this state. Unless otherwise au-	33
thorized in advance by the department of insurance, a carrier may dis-	34
continue a product only after the product has been in use for at least	35
thirty-six (36) consecutive months, provided the carrier may not dis-	36
continue more than fifteen percent (15%) of its total number of individ-	37
uals and dependents in all lines of business regulated by this chapter	38
in a twelve (12) month period. The carrier shall:	39
(i) Provide advance written or electronic notice of its decision	40
under this paragraph to the director;	41

-- 1 of 3 --

2
(ii) Provide notice of the discontinuation to all affected indi-	1
viduals at least ninety (90) calendar days prior to the date the	2
particular health benefit plan will be discontinued by the car-	3
rier, provided that notice to the director under the provisions of	4
this paragraph shall be provided at least fourteen (14) calendar	5
days prior to the notice to the affected individuals;	6
(iii) Offer to each affected individual, on a guaranteed issue ba-	7
sis, the option to purchase all other health benefit plans cur-	8
rently being offered by the carrier to individuals in this state;	9
(iv) Act uniformly without regard to any health status-related	10
factor of an affected individual or dependent of an affected indi-	11
vidual who may become eligible for the coverage; and	12
(v) Offer the new products at rates that comply with section	13
41-5206(1)(b), Idaho Code.	14
(f) The individual carrier elects to nonrenew all of its health benefit	15
plans delivered or issued for delivery to individuals in this state. In	16
such a case the carrier shall:	17
(i) Provide advance notice of its decision under this paragraph	18
to the director; and	19
(ii) Provide notice of the decision not to renew coverage to all	20
affected individuals and to the director at least one hundred	21
eighty (180) calendar days prior to the nonrenewal of any health	22
benefit plans by the carrier. Notice to the director under the	23
provisions of this paragraph shall be provided at least three (3)	24
working days prior to the notice to the affected individuals;	25
(g) The director finds that the continuation of the coverage would:	26
(i) Not be in the best interests of the policyholders or certifi-	27
cate holders; or	28
(ii) Impair the carrier's ability to meet its contractual obliga-	29
tions.	30
In such instance, the director shall assist affected individuals in	31
finding replacement coverage; or	32
(h) The plan is an enhanced short-term plan that has reached the limit	33
of renewability established in rules issued by the director and the in-	34
dividual carrier offers the individual the opportunity to reapply for	35
coverage in accordance with the rules issued by the director, renewa-	36
bility for which is governed by the provisions of section 41-5214, Idaho	37
Code.	38
(2) An individual carrier that elects not to renew a health benefit plan	39
under the provisions of subsection (1)(f) of this section shall be prohib-	40
ited from writing new business in the individual market in this state for a	41
period of five (5) years from the date of notice to the director.	42
(3) In the case of an individual carrier doing business in one (1) es-	43
tablished geographic service area of the state, the rules set forth in this	44
section shall apply only to the carrier's operations in that service area.	45
SECTION 2. That Section 41-5214, Idaho Code, be, and the same is hereby	46
amended to read as follows:	47
41-5214. ENHANCED SHORT-TERM PLANS. (1) A carrier may allow enroll-	48
ment in enhanced short-term plans:	49

-- 2 of 3 --

3
(a) On a year-round basis, at any point in the calendar year;	1
(b) During an annual open enrollment period; or	2
(c) During a special enrollment period.	3
(2) The director shall adopt reasonable rules to establish specific	4
standards for enhanced short-term plans. The standards shall be in addi-	5
tion to and in accordance with applicable laws of this state, including this	6
chapter. The Notwithstanding any provision of law or federal waiver to the	7
contrary, the standards:	8
(1) Shall include requirements for renewability that are consistent	9
with federal law regarding short-term, limited duration insurance; and	10
(a) Shall not be more restrictive than the requirements established in	11
this section;	12
(b) Shall provide that the maximum duration of an enhanced short-term	13
plan shall be the greater of twelve (12) consecutive months or the maxi-	14
mum duration described in 45 CFR 144 or its succeeding regulation;	15
(c) Shall provide that enhanced short-term plans may be eligible for	16
renewal for a maximum total duration that is the greater of thirty-six	17
(36) months or the maximum duration described in 45 CFR 144 or its suc-	18
ceeding regulation; and	19
(2) (d) May include, but need not be limited to:	20
(a) (i) A scope of covered benefits, which may be as broad as the	21
scope of covered benefits required to be included in individual	22
health benefit plans that are not deemed short-term, limited dura-	23
tion insurance under federal law; provided, however, the director	24
may not establish minimum standards for covered benefits in en-	25
hanced short-term plans;	26
(b) (ii) Restrictions on premium rate increases when an enhanced	27
short-term plan ceases to be renewable and the individual policy-	28
holder reapplies for coverage from the same carrier; and	29
(c) (iii) Conversion of enhanced short-term plans into fully re-	30
newable coverage upon a finding by the director that the conver-	31
sion complies with law and is in the best interests of the public.	32
(3) Enhanced short-term plans shall not be subject to the rating re-	33
quirements established in section 41-5206, Idaho Code.	34
SECTION 3. An emergency existing therefor, which emergency is hereby	35
declared to exist, this act shall be in full force and effect on and after	36
July 1, 2026.	37

-- 3 of 3 --