Nebraska Health Insurance (NE)

Nebraska (NE)
Individual Health Insurance Regulations

Learn more about Nebraska Individual Health Insurance

Nebraska law permits health insurance carriers to medically underwrite individual health insurance policies. This process provides the insurance carrier an opportunity to evaluate the applicant's past and present health history and determine whether or not coverage will be declined, offered under the terms of the individual health plan or amended so as to exclude coverage of specific pre-existing conditions. There is no limitation as to the look back and/or exclusionary periods for pre-existing conditions. Nebraska does not require health insurance carriers to offer credit for prior creditable coverage towards exclusionary periods. Compared to most other states, Nebraska has few laws that regulate the individual health insurance market, including no rate caps on health plan monthly premiums.

Nebraska (NE)
Small Group Health Insurance Regulations

Nebraska defines a small group as 2-50 employees. Companies who fall under this classification are entitled to obtain health insurance coverage on a guarantee issue basis and may not be declined coverage due to the health status of the group or any individual employee wishing to obtain coverage under that group health plan. Nebraska health insurance carriers require verification of employment on all employees and may request copies of State Wage and Tax Reports for this purpose. Once an employee has been determined eligible to join the health plan, issuance of health insurance coverage is guaranteed and may not be denied or altered due to health status or history. For all applicants joining a group health plan, Nebraska allows health insurance carriers to utilize a 6 month look back period and 12 month exclusionary period for pre-existing medical conditions. Under Nebraska law, credit for prior coverage is required as long as there is no more than a 63 day break in coverage. Newborns, children placed for adoption and adopted children are automatically covered under the group health plan for the first 31 days. Premiums for small business health insurance plans can be altered based on medical underwriting with a rate adjustment factor of 1.25.

Nebraska COBRA and Continuation Coverage

Federal COBRA regulations, as in all states, apply to Nebraska employers that offer group health insurance and have 20 or more employees. Nebraska has a state mandated mini-COBRA program which applies to groups of less than 20 employees. Under the state regulated COBRA program, employees suffering a qualifying event may elect, at their sole expense, to continue their health insurance coverage under their group health plan. Under state regulations, continuation coverage provides for an additional 6 months of coverage. Individuals who are transferring out of a group health plan may also seek coverage under an individual conversion plan. For exhausting their COBRA coverage, the state high-risk pool guarantees them the right to purchase a permanent issue individual health plan without being subjected to medical underwriting.

Additional Nebraska Resources

• Nebraska Comprehensive Health Insurance Pool
  A guaranteed issue health plan offered to uninsurable residents of Nebraska, as well as providing coverage to persons that have exhausted their COBRA option.
• Nebraska Kids Connection
  Administered by the Nebraska Health and Human Services System, Nebraska's Kid Connection is a state sponsored health insurance program for low income, uninsured children across the State of Nebraska.
• Nebraska Health and Human Services System
  Manages the Nebraska state Medicare program that provides health care benefits to families that are unable to afford basic medical services.
• Nebraska Senior Health Insurance Information Program
  Provides assistance to senior Nebraska residents in understanding their health insurance rights and benefits that are provided to them under the Medicare program and Medicare Part D Prescription Drug program.

NE Medical Insurance Statistics

Total Population: 1,766,000
With Health Insurance: 1,588,000 / 88.2%
Without Health Insurance: 208,000 / 11.8%
*According to 2005 CPS Reports / U.S. Census Bureau

Note: The percentage of Nebraska residents without health insurance has increase by .4% since 2004.

Nebraska Department of Insurance
Phone: 402-471-2201
The Nebraska Department of Insurance regulates and examines all insurance companies doing business in the state.

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