Colorado State-Regulated Insurance Coverage

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

Colorado’s autism insurance bill, SB 09-244, was enacted in 2009 and became effective on July 1, 2010. Coverage was amended in 2015 under SB 15-015 and became effective on January 1, 2017.

To which plan does the STATE autism insurance law apply?

  • Individual Grand-Fathered Plans - NO
  • Individual Non- Grand- Fathered Plans - YES
  • Fully Insured Large Group Plans - YES
  • Fully Insured Small Group Grandfathered Plans - YES
  • Fully Insured Small Group Non-Grandfathered Plans - YES

What services are covered by law?

  • Diagnosis
  • Behavior Training, Behavior Management and Applied Behavior Analysis
  • Habilitative or rehabilitative care (e.g. Speech Therapy, Occupational Therapy, Physical Therapy)
  • Pharmacy care
  • Psychiatric care
  • Psychological care, including family counseling

Does Colorado have caps on ABA coverage?

No. The 2015 legislation removed all age and dollar caps on coverage.

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits.  This includes quantitative treatment limits like age and dollar caps.  Learn more here.

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

A copy of the 2009 law (SB 09-244) can be found here.

A copy of the 2015 law (SB 15-015) can be found here.

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

 

Last Updated: December 2019

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