SB 1111 Summary

• Requires health insurers to make dependent coverage available until age 26 and prohibits denial of coverage based on marital status, tax return status, or residency of dependent children.

• Prohibits lifetime and annual dollar limits on essential health benefits coverage, with exceptions for grandfathered plans, retiree-only coverage, and short-term policies of 6 months or less.

• Mandates coverage of ten essential health benefit categories including ambulatory services, emergency care, hospitalization, mental health services, prescription drugs, preventive and wellness services, and pediatric oral and vision care in individual and small group markets.

• Eliminates preexisting condition exclusions for health insurance coverage, with exceptions for limited benefit policies, supplemental coverage, disability income, dental/vision plans, and retiree-only coverage.

• Excludes retiree-only health insurance coverage, short-term limited duration policies, and certain transitional health plans from compliance requirements.