First Regular Session 113th General Assembly (2003)
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HOUSE ENROLLED ACT No. 1135
AN ACT to amend the Indiana Code concerning insurance.
Be it enacted by the General Assembly of the State of Indiana:
SOURCE: IC 27-8-5-15.6; (03)HE1135.1.1. -->
SECTION 1. IC 27-8-5-15.6, AS AMENDED BY P.L.81-1999,
SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2003]: Sec. 15.6. (a) As used in this section, "coverage of
services for a mental illness" includes the services defined under the
policy of accident and sickness insurance.
(as defined in IC 27-8-5-1).
However, the term does not include services for the treatment of
substance abuse or chemical dependency.
(b) This section applies to a policy of accident and sickness
insurance
(as defined in IC 27-8-5-1) that:
(1) is issued on an individual basis or a group basis;
(2) is issued, entered into, or renewed after December 31, 1999;
and
(3) is issued to an employer that employs more than fifty (50)
full-time employees.
(c) This section does not apply to the following:
(1) An insurance policy listed under IC 27-8-15-9(b).
(2) A legal business entity that has obtained an exemption under
IC 27-8-5-15.7. section 15.7 of this chapter.
(d) A group or individual insurance policy or agreement may not
permit treatment limitations or financial requirements on the coverage
of services for a mental illness if similar limitations or requirements are
not imposed on the coverage of services for other medical or surgical
conditions.
(e) An insurer that issues a policy of accident and sickness
insurance that provides coverage of services for the treatment of
substance abuse and chemical dependency when the services are
required in the treatment of a mental illness shall offer to provide
the coverage without treatment limitations or financial
requirements if similar limitations or requirements are not
imposed on the coverage of services for other medical or surgical
conditions.
(f) This section does not require a group or individual insurance
policy or agreement to offer mental health benefits.
(f) (g) The benefits delivered under this section may be delivered
under a managed care system.
SOURCE: IC 27-13-7-14.8; (03)HE1135.1.2. -->
SECTION 2. IC 27-13-7-14.8, AS AMENDED BY P.L.81-1999,
SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2003]: Sec. 14.8. (a) As used in this section, "coverage of
services for a mental illness" includes the services defined under the
contract with the health maintenance organization. However, the term
does not include services for the treatment of substance abuse or
chemical dependency.
(b) This section applies to a group or individual contract with a
health maintenance organization that:
(1) is issued, entered into, or renewed after December 31, 1999;
and
(2) is issued to an employer that employs more than fifty (50)
full-time employees.
(c) This section does not apply to a legal business entity that has
obtained an exemption under IC 27-8-5-15.7.
(d) A group or individual contract with a health maintenance
organization may not permit treatment limitations or financial
requirements on the coverage of services for a mental illness if similar
limitations or requirements are not imposed on the coverage of services
for other medical or surgical conditions.
(e)
A health maintenance organization that enters into an
individual contract or a group contract that provides coverage of
services for the treatment of substance abuse and chemical
dependency when the services are required in the treatment of a
mental illness shall offer to provide the coverage without treatment
limitations or financial requirements if similar limitations or
requirements are not imposed on the coverage of services for other
medical or surgical conditions.
(f) This section does not require a group or individual contract with
a health maintenance organization to offer mental health benefits.
SOURCE: ; (03)HE1135.1.3. -->
SECTION 3. [EFFECTIVE JULY 1, 2003]
(a) IC 27-8-5-15.6, as
amended by this act, applies to a policy of accident and sickness
insurance that is issued, delivered, amended, or renewed after June
30, 2003.
(b) IC 27-13-7-14.8, as amended by this act, applies to a group
or an individual contract with a health maintenance organization
that is entered into, delivered, amended, or renewed after June 30,
2003.
HEA 1135 _ Concur
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