Cost Sharing for Behavioral Services Prohibited and Healthcare Affordability Fund Introduced

On April 8, 2021, Gov. Grisham signed SB 317 into law. This statute prohibits cost sharing, including deductibles, for behavioral services covered by health plans issued in the state until January 1, 2027. It also created a fund that is to be used for reducing premiums for low-income citizens who enroll in the state’s exchange and assist small businesses in the state with healthcare costs. It will be financed by increasing the state’s surtax on insurance companies from 1% to 3.75%, replacing a federal fee that was recently phased out.

Employers with plans issued in the state should be aware of the prohibition against cost-sharing for behavioral services. Although the effect of the new fund on rates has not yet been determined, it may affect premiums that carriers in the state charge for health insurance.

SB 317 »