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This page lists some of the action toward parity compliance undertaken by Idaho regulatory agencies since 2008.

Are we missing any actions taken by state regulatory agencies? Let us know at info@paritytrack.org.

Actions in the Regulatory Arena

4/2018

Primary Focus: Parity-General
Agency: Idaho Department of Insurance
Title/Description: Transitional Health Insurance Plans to be Extended
Citation: Idaho Department of Insurance News Release
Summary:  The news release announces that non-grandfathered transitional plans (also known as “grandmothered” plans) will be extended through December 31, 2019. A renewal for these plans must be offered by carriers for the 12 month period beginning on January 1, 2019. Transitional policies must continue to comply with ACA provisions with respect to essential health benefits, pre-existing condition exclusions, waiting periods, and mental health parity rules.
Effective Date: April 27, 2018
Notes: N/A

Primary Focus: Parity-General
Agency: Idaho Department of Insurance
Title/Description: Extension of Transitional Plans through December 31, 2019
Citation: BULLETIN NO. 18-03
Summary:  This bulletin to carriers in the employer and individual health insurance markets provides guidance regarding the extension of non-grandfathered transitional plans (also known as “grandmothered” plans) through December 31, 2019. The transitional plans must continue to comply with the mental health parity rules (individual plans upon renewal July 1, 2014 or later; not applicable to small group plans).
Effective Date: April 19, 2018
Notes: N/A

Primary Focus: Parity-General, Access to Services
Agency: Idaho Department of Insurance
Title/Description: Clarification Regarding Coverage of Treatments for Autism Spectrum Disorder
Citation: BULLETIN NO. 18-02
Summary: Treatments for autism spectrum disorder by Idaho health plans cannot be excluded from coverage if rehabilitative or habilitative services are covered. All health benefit plans that are subject to the Mental Health Parity and Addiction Equity Act of 2008 must follow the guidance in this bulletin for plan years starting on or after January 1, 2019. If a group health plan or health insurance coverage includes medical/surgical benefits and mental health/substance use disorder benefits, under the MHPAEA an applicable health plan cannot impose limitations on a numerical basis, e.g. financial, visit limits or day limits (quantitative); or other basis, e.g., medical management, (non-quantitative); unless, under the terms of the plan any such limitation of MH/SUD benefits such as treatments for autism is comparable to, and is applied no more stringently than, the standards and factors used in applying the limitation with respect to medical surgical/benefits under the plan. Exclusion of treatments for autism spectrum disorder are discriminatory and prohibited when a plan includes coverage of rehabilitative or habilitative services, such as coverage of occupational therapy or speech therapy. Treatments for autism spectrum disorder are to be considered part of Idaho’s Essential Health Benefits (EHB) package under mental health services including behavioral health treatment; and therefore the coverage of such treatments must be: consistent with other mental health services (including applicable deductibles, copayments, or coinsurance), not subject to any separate dollar limits or visit limits, and in parity with medical and surgical benefits.
Effective Date: April 2, 2018
Notes: N/A

1/2018

Primary Focus: Parity-General
Agency: Idaho Department of Insurance
Title/Description: Provisions for Health Carriers Submitting State-Based Health Benefit Plans
Citation: BULLETIN NO. 18-01
Summary:  Outlines the provisions that will be required for new health products to comply with Idaho Code, Title 41, Chapter 52. The “state-based health benefit plans” or “state-based plans” will not be subject to the federal restrictions applied to “grandfathered” or “transitional” plans. The plans must be in accordance with mental health and substance use disorder parity rules.
Effective Date: January 24, 2018
Notes: N/A

8/2017

Primary Focus: Parity-General
Agency: Idaho Department of Insurance
Title/Description: Extension of Transitional Plans through December 31, 2018
Citation: BULLETIN NO. 17-01
Summary:  This bulletin to carriers in the employer and individual health insurance markets provides guidance regarding the extension of non-grandfathered transitional plans (also known as “grandmothered” plans) through December 31, 2018. The grandmothered plans (not applicable to small group plans) must continue to comply with mental health parity rules.
Effective Date: March 8, 2017
Notes: N/A

5/2014

The Idaho Department of Insurance issued a bulletin (pdf | Get Adobe® Reader®) to some insurance plans throughout the state. This bulletin was nearly identical to the bulletin issued in December of 2013 (listed below), and extended the deadline for applicable plans to October 1, 2016. It applied to some small employer plans and individual plans. It explained that these plans would be exempted from certain parts of the Affordable Care Act . However, the bulletin stated that these plans would have to comply with the Federal Parity Law.

12/2013

The Idaho Department of Insurance issued a bulletin (pdf | Get Adobe® Reader®) to some insurance plans about compliance with the Affordable Care Act (ACA). The plans in question were small employer plans and individual plans . The bulletin explained that some of these plans might qualify for exemptions from certain parts of the ACA. However, the bulletin was very clear that these plans would still have to comply with the Federal Parity Law.

9/2009

The Idaho Department of Insurance issued a bulletin (pdf | Get Adobe® Reader®) to insurance plans throughout the state. The bulletin was very short and simply reminded insurance plans that they had to comply with the Federal Parity Law. The bulletin had a brief explanation of the Federal Parity Law and how it only applies to large employer plans. The information in this bulletin is no longer accurate.

Idaho Parity Law

Idaho’s parity law is found in Title 67 Chapter 57 Section 61A of the state’s laws about State Government and State Affairs. This is not a comprehensive parity law because it only applies to certain behavioral health conditions. The law also only applies to state government employees and their spouses and children. This means that it does not apply to the vast majority of people in Idaho.

These are the behavioral health conditions covered by the law:

  1. Schizophrenia
  2. Paranoia and other psychotic disorders
  3. Bipolar disorder
  4. Major depressive disorders
  5. Schizoaffective disorder
  6. Panic disorder
  7. Obsessive compulsive disorders

Insurance plans for state government employees must provide coverage for these conditions “in a manner that is equitable and commensurate” to other medical conditions.

The law also requires plans for state government employees to provide coverage for children with “serious emotional disturbances.” This coverage must be “no more restrictive” than coverage for other medical care. Serious emotional disturbances are defined as: “emotional or behavioral disorder, or a neuropsychiatric condition which results in a serious disability, and which requires sustained treatment interventions, and causes the child’s functioning to be impaired in thought, perception, affect or behavior.” This section of the law also makes it clear that substance use disorders do not count as serious emotional disorders, according to Idaho state law.

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Idaho Insurance Division

Common Violations

In seeking care or services, be aware of the common ways parity rights can be violated.

Common Violations

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