California State-Regulated Insurance Coverage

California requires meaningful coverage for autism under state-regulated plans.

California’s autism insurance bill, SB 946, was enacted in 2011 and became effective on July 1, 2012.

To which plan does the STATE autism insurance law apply?

  • Individual Plans - YES
  • Fully Insured Large Group Plans - YES
  • Fully Insured Small Group - YES

What services are covered by the law?

  • Behavioral health treatment (e.g. Applied Behavior Analysis)

For purposes of the law, “behavioral health treatment” is defined as “professional services and treatment programs, including ABA and evidence-based behavior intervention programs, that develop or restore, to the maximum extent practicable, the functioning of an individual.” Treatment must be prescribed by a licensed physician and provided by qualified autism service provider, qualified autism service professional or qualified autism service paraprofessional.

Does California have caps on ABA coverage?

No.

Where can I find more details about the California autism insurance law?

A copy of SB 946 as enrolled can be found here.

If you have additional questions, please email advocacy@autismspeaks.org.

 

Last Updated: December 2019