SB2440 Summary

• Requires insurers offering group or individual health insurance policies and qualified health plans to ensure financial requirements and treatment limitations for mental health and substance use disorder benefits are no more restrictive than those for medical/surgical benefits, with no separate cost-sharing applicable only to mental health or addiction treatment.

• Prohibits aggregate lifetime limits or annual limits on mental health and substance use disorder benefits unless the same limits apply to all hospital and medical benefits without distinction.

• Mandates insurers use formulary policies for substance abuse treatment drugs that are no less favorable than policies for other drugs and follow expedited coverage determination requirements.

• Requires insurers to submit comprehensive annual reports to the Department of Insurance (or Department of Healthcare and Family Services for medical assistance) by March 1 containing detailed data on benefit limits, claim denials, out-of-network usage, provider availability, pharmacy management, and compliance with federal parity regulations.

• Prevents the Director of Insurance from certifying any policy if the insurer fails to submit all required reporting information.