SB474 Summary

• Requires all health benefit plans executed or renewed in Alabama to offer coverage for breast reconstruction surgery after a mastectomy, including all stages of reconstruction and surgery on the contralateral breast to achieve symmetrical appearance.

• Defines health benefit plans broadly to include individual insurance policies, HMOs, PPOs, and other entities providing health care services to Alabama residents or processing claims for Alabama beneficiaries.

• Coverage may be subject to the same deductibles and reasonable copayments or coinsurance applicable to similar health care services under the plan.

• Requires written notice of coverage availability to be delivered to policyholders at enrollment and annually thereafter.

• Prohibits insurers from denying eligibility, providing incentives to accept less coverage, penalizing healthcare providers, or restricting hospital stays based on compliance with breast reconstruction coverage requirements; becomes effective three months after passage.