IN HB1236

Requires state employee health plans, accident and sickness insurance policies, and health maintenance organization contracts to cover inpatient and outpatient dental, orthodontic, and prosthodontic services (including dentures, implants, and crowns) for treatment of ectodermal dysplasia, a congenital genetic disorder characterized by malformed or absent teeth.

Coverage must be for services determined medically necessary by a physician to restore or maintain the patient's ability to perform daily living activities and prescribed by the treating physician, including repair and replacement.

Prohibits coverage from being subject to annual dollar limits, deductibles, copayments, or coinsurance provisions less favorable than those applied to physical illness generally, and prohibits lifetime dollar limits, coinsurance, or deductibles.

Applies to state employee health plans, insurance policies, and health maintenance organization contracts established, entered into, amended, or renewed after June 30, 2018.

Effective July 1, 2018, with the implementation and application provisions expiring July 30, 2021.