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

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

Action in the Regulatory Arena

01/2017

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.

2016

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.

10/2016

Primary Focus:  Access to Services
Agency:  Division of mental health and addiction
Title/Description: Determining need for a new opioid treatment program
Citation: 440 Ind. Admin. Code 10-2-3
Summary: Outlines the requirements and factors needed in order to propose a new opioid treatment program in a geographic location. Some factors include emergency room reports including opioid misuse; death reports including opioid misuse, and the presence of pain clinics in the area.
Effective Date:  Oct 12, 2016
Notes: N/A

3/2016

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.

5/2015

Primary Focus:  Parity
Agency:  Office of the Secretary of Family and Social Services
Title/Description: Mental Health Parity
Citation: 405 Ind. Admin. Code 10-7-5
Summary: Coverage of mental health care services are subject to the same treatment limitations or financial requirements as coverage of services for physical illness.
Effective Date:  May 18, 2015
Notes: N/A

4/2015

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.

3/2014

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.

4/2010

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.

4/2003

Primary Focus:  Parity
Agency:  Department of Insurance
Title/Description: Coverage Requirements
Citation: 760 Ind. Admin. Code 1-68-4
Summary: Requires Multiple Employer Welfare Arrangements (professional employer organization) to comply with the federal Mental Health Parity Act.
Effective Date: Original effective date April 15, 2003
Notes: Readopted filed November 20, 2015.

Indiana Parity Law

Behavioral Health

The sections of state law relevant to parity requires that if plans offer behavioral health coverage, they cannot use treatment limitations and financial requirements if similar treatment limitations and financial requirements are not used for other medical coverage.

These sections of the law apply to large employer fully-insured plans, individual plans, and state employee plans.

Here are the relevant sections of the law: It is not possible to provide direct links to the specific subsections. You must scroll manually to the proper subsection once the link takes you to the appropriate title, article, and chapter. The specific subsections are listed next to each link.

Section for HMOs (scroll to 27-13-7-14.8)

Section for other commercial plans (scroll to 27-8-5-15.6)

Section for state employee plans (scroll to 5-10-8-9)

Autism

The sections of state law about autism coverage require large employer fully-insured plans, small employer fully-insured plans, and state employee plans to cover autism services. Individual plans must offer optional coverage for autism that can be rejected by the individual.

All plans that provide autism coverage cannot have annual maximums, lifetime maximums, deductibles, or coinsurance for autism services that are less favorable than those used with for other medical services.

Here are the relevant sections of the law:

Except for the section about commercial plans, It is not possible to provide direct links to the specific subsections. You must scroll manually to the proper subsection once the link takes you to the appropriate title, article, and chapter. The specific subsections are listed next to each link.

Section for commercial plans (this link goes directly to the proper location)

Section for HMOs (scroll to 27-13-7-14.7)

Section for state employee plans (scroll to 5-10-8-7.1)

Get Support

Indiana Insurance Division

Common Violations

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

Common Violations

Definition

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