SB 1687 Summary

• Repeals and replaces Section 20-123 to require all health care insurers offering individual, short-term limited duration, or small employer group plans to cover essential health benefits with limited cost sharing.

• Mandates coverage of ten essential health benefit categories: ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health and substance abuse services, prescription drugs, rehabilitative services, laboratory services, preventive and wellness services, and pediatric services including dental and vision care.

• Prohibits health care insurers from declining coverage based on health status, imposing preexisting condition exclusions or limitations, canceling plans based on health status, using health status to set premiums, or imposing annual or lifetime dollar limits on essential health benefits.

• Requires dependent coverage for adult children to continue until age 26 and prohibits unfair discrimination in premium rates based on age or sex.

• Amends Section 20-1384 to require short-term limited duration insurance policies to display a federal disclosure notice in at least 14-point type and mandates insurers provide notice before policy expiration or non-renewal.