On May 17, 2009 the New Jersey Senate health committees and Assembly Appropriations supported legislation that expands health-insurance coverage for autism and other developmental disorders. The bill would require health-insurance firms and state plans to cover physical, speech and occupational therapy as well as more expensive methods called behavioral intervention.

Supporters of the bill state that coverage for autism treatments is limited and in some cases not covered at all by insurance companies. Therapies for autistic children can cost upwards of $150 an hour.

Ten other states have passed similar measures, with the maximum coverage amount ranging between $36,000 and $50,000.

The full Assembly is expected to consider the bill while the Senate version advances to the Senate budget committee.

WHAT THIS MEANS TO YOU AS AN EMPLOYER?
Under the bill, carriers would have to cover up to $36,000 a year in behavioral intervention for people under 21 for state regulated policies under insured plans. The figure would be adjusted annually for inflation. The bill currently does not say how much coverage would be required for the other therapies. With respect to self-insured plans, the federal Employee Retirement Income Security Act of 1974, as amended (“ERISA”) preempts all state law mandates. As such, self-insured plans would be exempt from this proposed requirement.

WHAT SHOULD I DO NEXT?
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