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GA SB1

Bill

Status

Engrossed

1/29/2015

Primary Sponsor

Charlie Bethel

Click for details

Origin

Senate

2015-2016 Regular Session

AI Summary

  • Requires accident and sickness insurance policies to cover autism spectrum disorder diagnosis and treatment for individuals age six and under, including assessments, evaluations, counseling, therapy services, and applied behavior analysis (ABA)
  • Caps coverage for applied behavior analysis at $35,000 per year, with no limits on the number of visits, and requires treatment to be deemed medically necessary by a licensed physician or psychologist with annual re-evaluation
  • Exempts employers with ten or fewer employees and excludes limited benefit insurance policies (e.g., dental, vision, disability, long-term care) from the coverage mandate
  • Allows insurers an exemption from the behavioral health treatment coverage requirement if an actuary certifies to the Insurance Commissioner that the associated costs exceed 1% of premiums, with the exemption lasting one year before coverage must resume
  • Requires the Department of Insurance to submit an annual report to the General Assembly beginning January 15, 2017, detailing the number of insured individuals diagnosed, total claims paid, cost per insured per month, and average cost of ABA coverage

Legislative Description

Insurance; provide for certain insurance coverage for autism spectrum disorders

Last Action

House Passed/Adopted By Substitute

3/22/2016

Full Bill Text

No bill text available