SB406 Summary

• Expands health benefit plan coverage for Autism Spectrum Disorder treatment to all insureds (previously limited to children age 9 or under), subject to maximum annual benefits of $40,000 (ages 0-9), $30,000 (ages 10-13), $20,000 (ages 14-18), and $10,000 (age 19+) for applied behavior analysis.

• Requires treatment to be prescribed by a licensed physician or psychologist and includes behavioral health treatment, pharmacy care, psychiatric care, psychological care, and therapeutic care as covered services.

• Prohibits health benefit plans from denying coverage, refusing to issue policies, or terminating coverage based solely on an Autism Spectrum Disorder diagnosis.

• Allows health benefit plans to seek one-year exemptions from coverage requirements if actuarial analysis shows costs exceed 1% of premiums, subject to Department of Insurance approval.

• Requires Department of Insurance to file annual reports to the Legislature detailing costs of autism coverage, and mandates Alabama Medicaid and Children's Health Insurance Plan (ALL Kids) provide equivalent coverage.

• Takes effect October 1, 2017.