July 24, 2013 – Large Group Insured Medical Plans Must Cover Autism
NEWS FLASH!
Last session, the Minnesota Legislature added to Minnesota’s already long list of mandated medical benefits. Large group medical insurance policies issued, renewed, etc. on and after January 1, 2014, must cover “autism spectrum disorders” (referred to as the “Autism Mandate”). [Requirement will appear in Minn. Stat. Section 62A.3094.]
Most public sector employers in Minnesota (e.g., cities, counties, school districts, etc.) that self-insure the medical coverage they offer to their employees must also include the Autism Mandate. Minnesota Statutes Section 471.617 authorizes certain public sector employers to self-insure. Among other things, that authority specifically requires the self-insured plan to “provide all benefits which are required by law to be provided by group health insurance policies.” In other words, a Minnesota public sector employer subject to Minnesota Statutes Section 471.617 that self-insures its medical coverage must provide the same benefits as would be provided if the employer purchased group insurance to provide the benefits.
As part of the passage of the Autism Mandate, the effective date for the State Employee Group Insurance Programs, governed by Minnesota Statutes Chapter 43A (a/k/a SEGIP), is delayed until January 1, 2016, or the date an earlier collective bargaining agreement requires such changes. No similar delay is provided for public sector entities subject to Minnesota Statutes Section 471.617. In addition, no change was made to Minnesota Statutes Section 471.617 itself. Other than SEGIP, public sector self-insured medical plans must comply with the Autism Mandate for plan years beginning on or after January 1, 2014. For plans operated on a calendar year, the Autism Mandate begins with the January 1, 2014 plan year.
If you have any questions, please contact us.
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The information contained in this ALERT is intended for general information purposes only and does not constitute legal advice relative to a specific situation.