SB 1292 Summary

• Requires all health care insurers offering individual plans, short-term limited duration insurance, or small employer group plans to cover ten essential health care benefit categories including ambulatory services, emergency services, hospitalization, maternity care, mental health services, prescription drugs, rehabilitative services, laboratory services, preventive care, and pediatric services.

• Mandates cost sharing limits for essential health benefits and requires coverage without cost sharing for preventive services recommended by the U.S. Preventive Services Task Force, CDC immunization advisory committee, and HHS Health Resources and Services Administration.

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

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

• Amends the short-term limited duration insurance definition to remove the exemption from state health coverage mandates, making these plans subject to section 20-125 requirements.