Connecticut State-Regulated Insurance Coverage

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

Connecticut’s autism insurance bill, Substitute Senate Bill 301/Public Act 09-115, was enacted in 2009 and became effective January 1, 2010. Insurance bulletins HC-96 and HC-99 were published in 2014 and removed previous caps on coverage.

To which plan type does the STATE autism insurance law apply?

  • Individual Grandfathered Plans - NO
  • Individual Non-Grandfathered 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 the law?

  • Diagnosis
  • Behavioral therapy, including Applied Behavior Analysis
  • Prescription Drugs
  • Psychiatric care and psychological care
  • Speech Therapy, Occupational Therapy, Physical Therapy

For purposes of the law, “behavioral therapy" is defined as “any interactive behavioral therapies derived from evidence-based research, including, but not limited to, applied behavior analysis, cognitive behavioral therapy, or other therapies supported by empirical evidence of the effective treatment of individuals diagnosed with an autism spectrum disorder.”

Does Connecticut have caps on ABA coverage?

No. The dollar and age caps were removed by an order from the Connecticut Department of Insurance in 2014.

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

A copy of Substitute Senate Bill 301/ Public Act 09-115 as enrolled can be found here.

Insurance bulletins HC-96 and HC-99 are linked.

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

 

Last Updated: December 2019

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