Agency: Insurance

Line Item: Comprehensive Health Insurance Pool

Function

Created in 1991, the Utah Comprehensive Health Insurance Pool (CHIP, now called HIPUtah to avoid confusion with the Health Department's Children's Health Insurance Program CHIP) provides access to health insurance coverage to people who are considered uninsurable. The Pool is funded by appropriations from the Legislature, premiums by those insured and by employers, and interest and dividends.

The Health Insurance Portability & Accountability Act of 1996 (HIPPA) is a federal law that guarantees health insurance for groups 2-50 people in the private market. Individuals losing coverage because their conditions are uninsurable are guaranteed coverage by the law. S.B. 60, 1997 General Session, Open Enrollment Amendments, mandates access to individual coverage for Utah Residents who are not eligible for public programs or private group insurance. Coverage comes through HIPUtah for individuals with uninsurable medical conditions. These people would otherwise seek coverage from private insurance companies which might cause companies to discontinue offering individual insurance coverage. To avoid this, the Legislature agreed to increase HIPUtah funding and provide coverage for individuals with an average medical risk of 200% or higher.

The HIPUtah board will cap funding rather than allow the fund to go insolvent. If the board caps enrollment, private individual insurers would then be forced to guarantee coverage to those with uninsurable medical conditions. These private insurers may then face the option of going out of the individual coverage business or becoming unprofitable. A decision to get out of the business would leave thousands uninsured.

Health Insurance Program Utah (HIPUtah) is funded as a separate line item.

Funding Detail