What Is a State Risk Pool?
A state risk pool, also called a high-risk pool, is typically a nonprofit entity that pays for the losses experienced by insurance carriers who provide individual/family health insurance to unhealthy individuals who qualify. (See Appendix A for specific information on the state risk pool in your state.) State risk pools lose hundreds of millions of dollars every year. States subsidize their state risk pools (or equivalents) by charging insurance carriers a premium-based fee on health insurance policies sold in their state, through tobacco and other revenue taxes, and by using federal grants and matching federal funds. Eligibility for State-Guaranteed Coverage To qualify for state-guaranteed coverage, you cannot be eligible to participate in an employer’s health benefits plan, cannot be eligible to receive COBRA benefits, and must satisfy at least one of the following three conditions: • You have been denied coverage by a private health insurance carrier for health reasons. • You have b
