The ACA lets insurers charge tobacco users up to 50 percent more in premium, though several states limit or ban the surcharge. Many plans waive it for enrollees who complete a cessation program.
Eight jurisdictions ban tobacco rating entirely: California, Connecticut, the District of Columbia, Massachusetts, New Jersey, New York, Rhode Island, and Vermont. Elsewhere insurers may add up to a 1.5x surcharge.
Yes, where a surcharge applies. ACA rules require the plan to offer a tobacco-cessation program and to waive or refund the surcharge for members who complete it. In states that ban tobacco rating, there’s no surcharge to begin with.
Generally yes. Federal rules let a small-group insurer charge tobacco users up to 50% more (a 1.5:1 ratio), and Texas is not among the states that ban tobacco rating. Any surcharge a carrier uses must be applied uniformly, so check the carrier’s filed rates.