O F F I C E O F L E G I S L A T I V E R E S E A R C H
P U B L I C A C T S U M M A R Y
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PA 23-148—sHB 6643
Committee on Children
Human Services Committee
AN ACT CONCERNING IN SURANCE COVERAGE FOR THE
PROVISION OF MENTAL HEALTH WELLNESS EXAMINATIONS
SUMMARY: This act eliminates the requirement that commercial health insurance
policies cover mental health wellness examinations by a primary care provider. It
maintains existing law’s requirement that the policies cover the examinations when
done by a licensed mental health professional.
EFFECTIVE DATE: Upon passage
INSURANCE COVERAGE F OR MENTAL HEALTH WEL LNESS
EXAMINATIONS
By law, certain individual and group health insurance policies must cover two
mental health wellness examinations per year. Under prior law, the examinations
could be done by a licensed mental health professional or primary care provider
and had to be covered without preauthorization or patient cost sharing. The act
eliminates the option for a primary care provider to do the examinations.
The act applies to individual and group health insurance policies delivered,
issued, renewed, amended, or continued in Connecticut that cover (1) basic hospital
expenses; (2) basic medical-surgical expenses; (3) major medical expenses; or (4)
hospital or medical services, including those provided under an HMO plan. Because
of the federal Employee Retirement Income Security Act (ERISA), state insurance
benefit mandates do not apply to self-insured benefit plans. (Although the state
employee health insurance plan is self-insured, in practice, it adopts enacted benefit
requirements.)