Indiana Regulations

The Indiana Department of Insurance (IDOI)released a training resource manual for Indiana navigators. Among other things, the manual has a table that demonstrates which plans must comply with state parity laws.

To access this document, please contact info@paritytrack.org.

The IDOI requires all plans under their jurisdiction to submit forms that indicate whether they comply with state parity requirements. Here is an example (pdf | Get Adobe® Reader®) of the form used for non-grandfathered individual plans and an example (pdf | Get Adobe® Reader®) of the form used for small employer fully-insured plans (scroll to the top of page 7). IDOI also requires multiple employer welfare arrangements (MEWA) complete a form (pdf | Get Adobe® Reader®) to indicate that they comply with the Federal Parity Law.

The IDOI also has a list of state required benefits. This includes a section on mental health benefits. The document details which plans have to comply with the mandate and the associated statutory citations.

The IDOI held a webinar (pdf | Get Adobe® Reader®) called the Federal Parity Law , Student Health Plans, & Renewal Letters. Slides 7 – 9 address parity . The webinar outlined the main requirements of the Federal Parity Law and defined which plans are subject to it. The webinar also discussed how IDOI checks for compliance with the law.

The IDOI released an FAQs (pdf | Get Adobe® Reader®) on company compliance with the Affordable Care Act rate and form filing. Questions 54 and 55 relate to parity. The first addresses if health plans can offer separate visit limits for outpatient rehabilitation and habilitation services. The second questions addresses if health plans can have visit limits for applied behavior analysis to treat autism.

The IDOI created an FAQ document about essential health benefits required by the Affordable Care Act. This document explains that small employer fully-insured plans and individual plans must comply with the Federal Parity Law regarding outpatient visit limits, inpatient day limits, lifetime limits, annual maximums, and lifetime maximums.

The document also explains that any treatment limitations in place for physical, occupational, or speech therapy do not apply to applied behavior analysis.

The IDOI issued a bulletin (pdf | Get Adobe® Reader®) about the sections of state law about autism coverage. It clarified that a psychologist or physician specializing in pervasive developmental disorder services may sign the treatment plan for a child with autism spectrum disorder; it does not have to be the child’s primary care practitioner.