Montana Health Insurance Coverage...
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If you are searching for ways to lower your health insurance costs and you live in the State of Montana...We, here at HealthInsureCoverage.com, work hard to supply you with the information you need to make an informed decision regarding your health insurance needs and requirements.

• Your Protections as a Small Business owner or Self-employed individual.
     Federal law extends certain protections to employers seeking to buy health insurance for themselves and their workers. Montana has enacted reforms to expand some of these protections. Generally, small employers are those that employ 2-50 employees. Please note, however, that the definitions of small employer and employee are somewhat different under federal and state law. Check with the Montana Department of Insurance to be sure that you know which protections apply to your group.
• With few exceptions, small employers cannot be turned down.
     This is called guaranteed issue. If you employ at least 2 but not more than 50 people eligible for health benefits, health insurance companies must sell you any small group health plan they sell to small employers. To determine the number of eligible employees, you pick a minimum standard of between 20 and 40 hours per week. Any of your employees who meet that weekly work standard must be counted as eligible employees by the insurer.
     Insurers can require that a minimum percentage of your eligible employees sign up for coverage. They can also require you to pay a minimum share of your workers’ premiums. If you are buying a large group health plan for 51 or more eligible employees, your group can be turned down.
• Your insurance cannot be canceled because someone in your group becomes seriously ill.
     This is called guaranteed renewability and it applies to group plans of all sizes. Insurers can impose other conditions, however. They can require you to meet minimum participation and contribution rates in order to renew your coverage. Additionally, they can refuse to renew your coverage for nonpayment of premiums or if you commit fraud, or if they are discontinuing that insurance product. In the latter case, they must give you a chance to buy other plans the sell to groups of your size.
• Within limits, you can be charged higher premiums based on the health, risk, and demographic characteristics of your group.
     For small employers, Montana limits the difference in premiums and the annual increase that can be charged.
• For groups with more than 50 eligible employees, Montana does not limit premium variation or increases.
• If you have questions about your group health insurance premiums, contact the Montana Department of Insurance.
• Insurance companies that sell small group health plans in Montana must offer a standard plan and a basic plan. Insurers can offer other health plans as well.
• The standard plan must meet coverage requirements set by law. A standard plan deductible cannot exceed $500 per person ($1,000 per family).
     Copayments cannot exceed 25%. The out-of-pocket limit on covered expenses cannot exceed $2,000 per person annually ($4,000 per family).
• Coverage under basic plans must be less than under standard plans.
     Basic plans must cover at least the benefits covered under MCHA traditional coverage, plus coverage for mammograms and treatment for chemical dependency and mental health. The insurance company will vary deductibles and copayments to give the basic plan benefits a lower value than the standard plan.
• If you are self-employed with no other workers, you are not eligible to buy a group health plan on your own (though you may be able to join another group health plan through a family member).
     Therefore, the laws that protect employers’ access to group health plans do not apply to you. Your access to health insurance is protected by the laws that apply to individuals.
• If you are self-employed and buy your own health insurance, you are eligible to deduct an increasing percentage of the cost of your premium from your federal income tax.
     This deduction is 60% for 2000 and 2001, 70% for 2002, and 100% in 2003 and thereafter.
• Some small employers, self-employed people, and other individuals buy health insurance through professional or trade associations.
     The laws applying to association health coverage can be different than those for other health plans. Check with the Montana Department of Insurance about your protections in association health plans.

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