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Gender Rating in the Group Health Insurance Market

Many businesses obtain coverage for their employees in what is known as the group health insurance market. Though federal law prohibits employers from charging individual male and female employees different rates for coverage, insurance companies are allowed to consider the proportion of women a business employs when determining the group’s overall premium. As a result, businesses with predominately female workforces—such as child care centers, home health agencies, or non-profits—can end up paying significantly more for coverage.1

The Report Card examines whether states have enacted laws to prohibit or limit insurers from gender rating in the group health insurance market. States that limit gender rating use a “rate band” to set limits between the lowest and highest premium that a health insurer may charge based on gender.

Insurance companies operating both in and outside of the new "Health Insurance Exchanges" will no longer be allowed to charge businesses more for coverage because they have a predominantly-female workforce.

Does the state allow private insurance companies to consider gender when determining health insurance premiums for groups?

States receive a "meets policy" if they prohibit private insurers from considering gender when determining health insurance premiums for groups of all sizes. States that prohibit private insurers from considering gender when determining health insurance premiums for small groups only (i.e. businesses with up to 50 employees) receive a "limited policy." States receive a "weak policy" if they limit gender rating in in the group insurance market with a "rate band." States that do not prohibit or limit gender rating in the group health insurance market receive a "no policy.

This is a new indicator for the 2010 Report Card.

State Strength of Policy Change from 2007
Alabama No Policy N/A
Alaska No Policy N/A
Arizona No Policy N/A
Arkansas No Policy N/A
California Limited Policy N/A
Colorado Limited Policy N/A
Connecticut No Policy N/A
Delaware Weak Policy N/A
District of Columbia No Policy N/A
Florida No Policy N/A
Georgia No Policy N/A
Hawaii No Policy N/A
Idaho No Policy N/A
Illinois No Policy N/A
Indiana No Policy N/A
Iowa Limited Policy N/A
Kansas No Policy N/A
Kentucky No Policy N/A
Louisiana No Policy N/A
Maine Limited Policy N/A
Maryland Limited Policy N/A
Massachusetts Limited Policy N/A
Michigan Limited Policy N/A
Minnesota Limited Policy N/A
Mississippi No Policy N/A
Missouri No Policy N/A
Montana Meets Policy N/A
Nebraska No Policy N/A
Nevada No Policy N/A
New Hampshire Limited Policy N/A
New Jersey Weak Policy N/A
New Mexico 2 Limited Policy N/A
New York Limited Policy N/A
North Carolina No Policy N/A
North Dakota No Policy N/A
Ohio No Policy N/A
Oklahoma No Policy N/A
Oregon Limited Policy N/A
Pennsylvania No Policy N/A
Rhode Island No Policy N/A
South Carolina No Policy N/A
South Dakota No Policy N/A
Tennessee No Policy N/A
Texas No Policy N/A
Utah No Policy N/A
Vermont Weak Policy N/A
Virginia No Policy N/A
Washington Limited Policy N/A
West Virginia No Policy N/A
Wisconsin No Policy N/A
Wyoming No Policy N/A

Policy Indicator Counts
Meets Policy: 
1
Limited Policy: 
13
Weak Policy: 
3
No/Harmful Policy: 
34
Better: 
0
Same: 
0
Worse: 
0

Data Sources: Lisa Codispoti, et al., National Women's Law Center, "Nowhere to Turn: How the Individual Insurance Market Fails Women," 2008, available at http://www.nwlc.org/our-resources/reports_toolkits/nowhere-to-turn, accessed September 7, 2010; also, Unpublished Research conducted by the National Women's Law Center, 2009-2010.

Footnotes

1 Brigette Courtot and Julia Kaye, National Women’s Law Center, Still Nowhere to Turn: Insurance Companies Treat Women Like a Pre-Existing Condition, October 2009, available at http://www.nwlc.org/resource/still-nowhere-turn-insurance-companies-trea..., accessed August 26, 2010.

2 The New Mexico law prohibiting gender rating in the small group market takes effect in January 2014.  The ban is phased in over time so that from 2010-2013, gender rating is limited with an increasingly narrow "rate band." NMSA 1978, § 59A-18-13.1

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