OFFICE OF FISCAL ANALYSIS
Legislative Office Building, Room 5200
Hartford, CT 06106 ↓ (860) 240-0200
June 1, 2017
To Fiscal Note on LCO No. 7749
sSB-586, File No. 242
AN ACT EXPANDING MANDATED HEALTH BENEFITS FOR WOMEN, CHILDREN AND ADOLESCENTS.
The original fiscal note on the amendment did not correctly state the fiscal impact to all fully insured municipalities. It limited the scope of the impact to certain fully-insured grandfathered health plans as the amendment was interpreted to imply the special enrollment period would apply to those without access to certain plans. The impact to fully-insured municipal plans is described below.
The amendment will result in a cost to fully-insured municipalities for including pregnancy as a qualifying event for special enrollment. The cost to the plan will depend on the (1) number of pregnant individuals who enroll under the special enrollment terms established in the amendment who otherwise would not be covered by the plan until they were eligible to enroll under the current plan terms, (2) when the individual enrolls, and (3) the plan the individual enrolls in, including the level of coverage (i.e. employee only coverage, etc.).
The coverage requirements will result in increased premium costs when municipalities enter into new health insurance contracts after January 1, 2018. In addition, many municipal health plans are recognized as “grandfathered” health plans under the ACA.1 It is unclear what effect the adoption of certain health mandates will have on the grandfathered status of certain municipal plans under ACA. Pursuant to federal law, self-insured health plans are exempt from state health mandates.
The preceding Fiscal Impact statement is prepared for the benefit of the members of the General Assembly, solely for the purposes of information, summarization and explanation and does not represent the intent of the General Assembly or either chamber thereof for any purpose. In general, fiscal impacts are based upon a variety of informational sources, including the analyst's professional knowledge. Whenever applicable, agency data is consulted as part of the analysis, however final products do not necessarily reflect an assessment from any specific department.
1 Grandfathered plans include most group insurance plans and some individual health plans created or purchased on or before March 23, 2010.