The Department of Insurance has regulatory authority over three Boards. Upcoming meetings, past agendas and minutes are made available below.
Title 41, Chapter 61, Idaho Code establishes the Idaho Health Insurance Exchange as an independent body corporate and politic. The exchange created by this chapter is not a state agency, and it is not subject to the purchasing statutes and rules of the state of Idaho or subdivisions of the state. It operates subject to the supervision and control of its board.
The board can adopt bylaws for the regulation of its affairs and the conduct of its business, subject to the review and approval by the Director of the Department of Insurance. The Director’s consent shall be required for any amendment to the bylaws.
Additional information about the Board is available from the Your Health Idaho Board of Directors webpage.
The Idaho Immunization Assessment Board was established by the Idaho State Legislature during the FY2010 legislative session. During the 2010 legislative session, the Idaho State Legislature adopted a chapter in the Idaho Code, Chapter 60, Title 41, entitled “Immunization Assessments.” The intent of the legislature was to provide funding for the Idaho Immunization Program to continue to provide vaccines for insured Idaho children. The chapter creates a dedicated vaccine fund and an independent board which is empowered to assess fees from all health carriers to fund vaccine purchases.
About the Board
The board of eleven members consists of:
- the Director of the Department of Insurance (ex officio member)
- one member of the Idaho Senate,
- one member of the Idaho House of Representatives
- three representatives of carriers (one of whom shall represent administrators or third party administrators)
- one primary care physician
- three representatives of the Idaho business community
- a representative appointed by the Director of the Department of Health and Welfare
- Dean Cameron, Director, Idaho Department of Insurance
- Dr. Christine Hahn, Department of Health and Welfare
- Senator Lee Heider
- Dr. Perry Brown, Primary Care Physician
- Norm Varin, carrier (TPA) representative
- Mark Ruszczyk, carrier representative
- Chase Ropelato, business community representative
- Susan Fudge, business community representative
- James Pelgram, business community representative
- House Bill 432 – Immunization Assessments
- House Bill 657 – Relating to Immunization Assessments
- House Bill 107 – Relating to Immunization Assessments
- House Bill 393 – Relating to Immunization Assessments
The Idaho Immunization program provides free vaccine to all participating providers, education for health care providers, nursing programs, and the general public, and maintains the statewide immunization registry (IRIS).
- Assessment Survey / Instructions
- List of vaccines available (Pediatric/VFC vaccine price list)
- Immunization Assessment Fund Update
- Glossary of Terms
- Plan of Operation
- Board Only
If you have questions, contact us by email or call 208-334-4300.
- 04/09/2018: Agenda, Minutes
- 07/09/2018: Agenda, Minutes
- 10/22/2018: Agenda, Minutes
- 12/10/2018: Agenda, Minutes
- 12/11/2017: Agenda, Minutes
- 09/25/2017: Agenda, Minutes
- 06/26/2017: Agenda, Minutes
- 04/06/2017: Agenda, Minutes
- 02/13/2017: Agenda, Minutes
- 12/05/2016: Agenda, Minutes
- 10/03/2016: Agenda, Minutes
- 07/25/2016: Agenda, Minutes
- 04/04/2016: Agenda, Minutes
- 02/22/2016: Agenda, Minutes
- 12/07/2015: Agenda, Minutes
- 10/05/2015: Agenda, Minutes
- 07/20/2015: Agenda, Minutes
- 05/21/2015: Agenda, Minutes
- 04/03/2015: Agenda, Minutes
- 02/09/2015: Agenda, Minutes
- 12/18/2014: Agenda, Minutes
- 12/01/2014: Agenda, Minutes
- 11/03/2014: Agenda, Minutes
- 07/14/2014: Agenda, Minutes
- 04/07/2014: Agenda, Minutes
- 02/06/2014: Agenda, Minutes
- 12/02/2013: Agenda, Minutes
- 07/15/2013: Agenda, Minutes
- 04/05/2013: Agenda, Minutes
- 01/28/2013: Agenda, Minutes
- 10/29/2012: Agenda, Minutes
- 08/06/2012: Agenda, Minutes
- 05/24/2012: Agenda, Minutes
- 04/11/2012: Agenda, Minutes
- 03/16/2012: Agenda, Minutes
- 09/12/2011: Agenda, Minutes
- 06/06/2011: Agenda, Minutes
- 03/21/2011: Agenda, Minutes
- 03/07/2011: Agenda, Minutes
- 01/14/2011: Agenda, Minutes
During the 2000 legislative session, the Idaho State Legislature adopted a new chapter in the Idaho Code (Chapter 55, Title 41), creating the Idaho Individual High Risk Reinsurance Pool. The purpose of the Pool was to ensure that Idaho residents without access to group health insurance coverage would be able to enroll in affordable individual health coverage regardless of health status. Prior to the legislation creating the Pool, Idahoans with chronic, costly health conditions could be refused coverage or charged exorbitant premium rates.
The original legislation required health insurance carriers offering health plans in the individual market to offer five standardized health plans to eligible individuals – those who were not eligible for group coverage or public programs such as Medicare or Medicaid. These individuals paid premiums not to exceed a limit set by the Pool’s Board of Directors to an individual health carrier in return for coverage for themselves (and dependents, if applicable). The health carrier, in turn, paid a reinsurance premium to the Pool for each ceded individual or household. Health claims for the ceded individuals/families were then paid out of Pool funds.
Similarly, in 1993, the Idaho Small Employer Health Insurance Availability Act (Chapter 47, Title 41) was adopted by the legislature to ensure the affordability and availability of small employer health insurance coverage regardless of health or claims experience. The Act created the Idaho Small Employer Health Reinsurance Program, a safety net for carriers in the form of a risk program and reinsurance mechanism.
Beginning January 1, 2014, federal law required that carriers in the individual and small group health insurance market set premium rates without regard to health status or claims experience; nor can carriers deny coverage due to these factors. Therefore, there were no new entrants into the Individual High Risk Reinsurance Pool’s standardized health plans in 2014 or later years; nor were there any new entrants into the Small Employer Health Reinsurance Program.
In 2017, Idaho legislation was passed which amended Chapter 55, Title 41 in order to create an “invisible” reinsurance program, allowing for reinsurance of individuals and dependents already enrolled in individual health insurance. Eligibility for reinsurance is based on a diagnosis of one or more serious health conditions, as determined by the Board. By ceding these high-risk individuals to the Pool and paying a reinsurance premium, carriers are able to mitigate the effects of extremely high health claims on the individual risk pool, as the Pool pays a percentage of the claims once the claims reach an annual threshold. This helps to stabilize the individual health insurance market, resulting in lower premiums than would otherwise occur. A small number of individuals have chosen to remain in one of the five standardized Pool plans, whose existence was grandfathered by the 2017 legislation.
- House Bill 750 (2000) – Establishes the Idaho Individual High Risk Reinsurance Pool for individual insurance carriers
- House Bill 306 (2003) – Clarifies all health carriers subject to reporting requirements relating to annual assessments
- House Bill 812 (2004) – Amends definition of eligible individual and incorporates federal law concerning pre-existing conditions
- Senate Bill 1150 (2017) – Allows for individuals with high risk medical conditions to be reinsured through the Pool, while grandfathering coverage for those enrolled in standardized Pool plans.
Public Hearing to Update Individual High Risk Reinsurance Pool Plan of Operations – November 18, 2021
- Idaho Individual High Risk Reinsurance Pool Plan of Operation
- Draft Idaho Individual High Risk Reinsurance Pool Plan of Operation Update
- Idaho Small Employer Health Reinsurance Program Plan of Operation
- Individual High Risk Pool Plan Comparison Table
- Individual High Risk Pool Plan Designs (Sample Policy of Insurance)
Rates for Pool Plans Issued Prior to 1/1/2014
About the Board
The Idaho Small Employer Reinsurance Program and Individual High Risk Reinsurance Pool Board of Directors was established by the Idaho State Legislature during the FY2000 legislative session. The Board of 11 members consists of:
- The Director of the Department of Insurance (ex officio member)
- One member of the Idaho Senate – appointed by Present Pro Tempore
- One member of the Idaho House of Representatives – appointed by Speaker of the House
- Two representatives of Idaho consumers – appointed by Director
- Four representatives of Idaho health insurance carriers – appointed by Director
- Two representatives of Idaho health insurance agents – appointed by Director
On an annual basis, the Board members elect a Chair, Vice-Chair and Secretary from among the members.
- Director, Idaho Department of Insurance – Dean Cameron
- Idaho Senate – Senator Jim Guthrie, Idaho Senate
- Idaho House of Representatives – Vacant
- Consumer representative – Janice Fulkerson (Secretary)
- Consumer representative – Chris Pickford
- Carrier representative – Trent Nate
- Carrier representative – Dave Pankey
- Carrier representative – Mike Reynoldson
- Carrier representative – Norm Varin (Vice-Chair)
- Agent representative – Hyatt Erstad (Chair)
- Agent representative – Vacant