OFFICE OF FISCAL ANALYSIS
Legislative Office Building, Room 5200
Hartford, CT 06106 ↓ (860) 240-0200
http: //www. cga. ct. gov/ofa
AN ACT EXPANDING HEALTH INSURANCE COVERAGE FOR OSTOMY SUPPLIES.
As Amended by House "A" (LCO 8312)
House Calendar No. : 85
Senate Calendar No. : 694
OFA Fiscal Note
State Impact: None in FY 10 & FY 11; Significant Cost in Out Years
Municipal Impact: Potential Significant Cost
The bill increases the annual limit related to mandated ostomy supply coverage from $1,000 to $5,000. This provision is not anticipated to impact costs to the state health plans since the state plans currently provide this coverage. The bill also adds mandated coverage for prosthetic limbs, hearing aids for children 18 years of age and under, wigs for hair loss associated with alopecia areata, and bone marrow testing. In addition, the bill prohibits copayments or other out-of-pocket expense for colonoscopies and requires wellness incentives to be provided to plan participants. These provisions of the bill are not anticipated to impact the state employee and retiree health plan until July 1, 2011 when the contract is renewed. It is anticipated the FY 12 cost of these mandates could be significant.
The bill's provisions may increase costs to fully-insured municipal plans which do not currently offer the coverage mandated. The coverage requirements may result in significant increased premium costs when municipalities enter into new health insurance contracts on or after January 1, 2010. Due to federal law, municipalities with self-insured health plans are exempt from state health insurance benefit mandates.
House Amendment “A” adds the provisions mandating coverage for prosthetic limbs, hearing aids for children 18 years of age and under, wigs for hair loss associated with alopecia areata, bone marrow testing, prohibits out-of-pocket expense for colonoscopies, requires wellness incentives to be provided to plan participants, and has the fiscal impact described above.
The Out Years
Sources: Municipal Employees Health Insurance Plan (MEHIP) Schedule of Benefits
Office of the State Comptroller
State Employee Health Plan Subscriber Agreement.