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?
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 email@example.com.
Last Updated: December 2019