- The state of Colorado requires insurers in the state to offer the self-employed the choice of a standard or basic health plan during a 30-day open enrollment period. Individuals who do cannot obtain a health insurance policy from a private insurer can apply for the state's CoverColorado program. This program offers health insurance policies to applicants regardless of their health or pre-existing conditions.
- Insurers in the state are required to provide a guaranteed-issue health insurance policy to anyone who is self-employed. Insurers are not required to offer a guaranteed-issue policy to individual residents. As a result, individuals who cannot obtain heath coverage will need to use the state's high-risk pool, known as the Health Reinsurance Association or HRA. HRA guarantees access to health coverage regardless of pre-existing conditions.
- The state of Florida requires the guaranteed-issue of a basic or standard health insurance plan from an insurer to a self-employed individual. Insurers also can offer an additional choice of a high deductible health plan if federally qualified. Individuals can obtain a guaranteed-issue health insurance policy through the Cover Florida Health Care Program. The program is available to individuals who have been without insurance the previous six months and no pre-existing exclusions apply.
- The self-employed in Michigan are guaranteed to be issued a health insurance policy from BlueCross and BlueShield of Michigan or BCBS. BCBS is also the insurer of last resort in the state. All HMOs in the state including BCBS are required to guarantee issue a certain number of policies during one 30-day enrollment period each year.
- The state of Ohio has guaranteed-issue requirements for HMOs and non-HMOs that offer individual health insurance policies. Non-HMOs are required to guarantee issue a standardized policies to a pre-determined number of people set by the state. This needs to be done annually during a 30-day enrollment period. HMOs in the state need to guarantee issue health insurance policies every year until a state determined number has been reached.
