HI SB306

Requires all individual and group health insurance policies issued or renewed in Hawaii after December 31, 2015, to cover medically necessary orthodontic treatment for orofacial anomalies (such as cleft lip or cleft palate) for individuals under 26 years of age.

Sets maximum benefit of $5,500 per treatment phase with no limits on number of orthodontist visits; insurance commissioner shall adjust maximum benefit annually for inflation starting December 31, 2016.

Requires insurers to provide written notice to policyholders about the coverage by December 31, 2016, prominently positioned in literature or correspondence.

Coverage is subject to standard copayments, deductibles, and coinsurance provisions no less favorable than other medical services; cannot be denied because treatment is habilitative or non-restorative.

Exempts qualified health plans offered through Hawaii health insurance exchange from mandate if coverage exceeds essential health benefits under the Affordable Care Act, but requirement applies to all other plans.