Small Group Health Insurance Market Pre-Existing Condition Exclusion Rules
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2013
| Location | Federal Standard / Exceeds Federal Standard | Maximum Look-Back Period (months) | Maximum Exclusion Period (months) | Credit for Prior Coverage Required? | Maximum Lapse Period Allowed (days)? |
|---|---|---|---|---|---|
| United States | N/A | N/A | N/A | N/A | N/A |
| Alabama | Federal Standard | 6 | 12 | Yes | 63 |
| Alaska | Exceeds Federal Standard | 6 | 12 | Yes | 90 |
| Arizona | Federal Standard | 6 | 12 | Yes | 63 |
| Arkansas | Federal Standard | 6 | 12 | Yes | 63 |
| California | Exceeds Federal Standard | 6 | 6 | Yes | 62; 180 if loss of coverage due to unemployment |
| Colorado | Exceeds Federal Standard | 6 | 6 | Yes | 90 |
| Connecticut | Exceeds Federal Standard | 6 | 12 | Yes | 120 most; 150 some |
| Delaware | Federal Standard | 6 | 12 | Yes | 63 |
| District of Columbia | Federal Standard | 6 | 12 | Yes | 63 |
| Florida | Federal Standard | 6 | 12 | Yes | 63 |
| Georgia | Exceeds Federal Standard | 6 | 12 | Yes | 90 |
| Hawaii | Exceeds Federal Standard | 0 | 0 | N/A | N/A |
| Idaho | Federal Standard | 6 | 12 | Yes | 63 |
| Illinois | Federal Standard | 6 | 12 | Yes | 63 |
| Indiana | Exceeds Federal Standard | 6 | 9 | Yes | 63 |
| Iowa | Federal Standard | 6 | 12 | Yes | 63 |
| Kansas | Exceeds Federal Standard | 6 | 3 | Yes | 63 |
| Kentucky | Federal Standard | 6 | 12 | Yes | 63 |
| Louisiana | Federal Standard | 6 | 12 | Yes | 63 |
| Maine | Exceeds Federal Standard | 6 | 12 | Yes | 90; 180 if loss of coverage is due to unemployment |
| Maryland | Federal Standard | 6 | 12 | Yes | 63 |
| Massachusetts | Exceeds Federal Standard | 6 | 6 | Yes | 63 |
| Michigan | Exceeds Federal Standard | 0 | 0 | N/A | N/A |
| Minnesota | Federal Standard | 6 | 12 | Yes | 63 |
| Mississippi | Federal Standard | 6 | 12 | Yes | 63 |
| Missouri | Federal Standard | 6 | 12 | Yes | 63 |
| Montana | Federal Standard | 6 | 12 | Yes | 63 |
| Nebraska | Federal Standard | 6 | 12 | Yes | 63 |
| Nevada | Federal Standard | 6 | 12 | Yes | 63 |
| New Hampshire | Exceeds Federal Standard | 3 | 9 | Yes | 63 |
| New Jersey | Exceeds Federal Standard | 6 | 6 | Yes | 63 |
| New Mexico | Exceeds Federal Standard | 6 | 6 | Yes | 63 |
| New York | Federal Standard | 6 | 12 | Yes | 63 |
| North Carolina | Federal Standard | 6 | 12 | Yes | 63 |
| North Dakota | Federal Standard | 6 | 12 | Yes | 63 |
| Ohio | Federal Standard | 6 | 12 | Yes | 63 |
| Oklahoma | Federal Standard | 6 | 12 | Yes | 63 |
| Oregon | Exceeds Federal Standard | 6 | 6 | Yes | 63 |
| Pennsylvania | Federal Standard | 6 | 12 | Yes | 63 |
| Rhode Island | Exceeds Federal Standard | 6 | 6 | Yes | 90 |
| South Carolina | Federal Standard | 6 | 12 | Yes | 63 |
| South Dakota | Federal Standard | 6 | 12 | Yes | 63 |
| Tennessee | Federal Standard | 6 | 12 | Yes | 63 |
| Texas | Exceeds Federal Standard | 6 | 12 | Yes | 63 |
| Utah | Federal Standard | 6 | 12 | Yes | 63 |
| Vermont | Exceeds Federal Standard | 6 | 12 | Yes | 90 |
| Virginia | Federal Standard | 6 | 12 | Yes | 63 |
| Washington | Exceeds Federal Standard | 6 | 9 | Yes | 90 |
| West Virginia | Federal Standard | 6 | 12 | Yes | 63 |
| Wisconsin | Federal Standard | 6 | 12 | Yes | 63 |
| Wyoming | Exceeds Federal Standard | 6 | 12 | Yes | 90 |