146th
GENERAL ASSEMBLY
FISCAL
NOTE
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DESCRIPTION: AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO
AUTISM SPECTRUM DISORDERS COVERAGE.
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ASSUMPTIONS:
1. Effective 120 days after enactment.
2. This legislation requires all individual and group
health insurance policies provide coverage for individuals under the age of 21
with a medical diagnosis for the treatment of autism spectrum disorders. Coverage for applied behavior analysis
services will be subject to a maximum benefit of $36,000 annually.
3. The estimated cost for State compliance with the
provisions of the Bill in the self-insured group health plans is based on
forecasted current enrollee utilization by plan administrators.
4. Plan Administrators anticipate 20% utilization in the first year. Costs for Fiscal Year 2013 reflect six month
funding to allow time for the development of regulations and for providers to
become qualified and join insurance plans.
Plan administrators anticipate it may take up to three years for
services to the reach the entire eligible population.
5. The Fiscal Year 2013 rates for the state employee health plan have already been established, therefore should the State Employee Benefits Committee vote to implement this legislation upon passage, the State Employee Benefits Plan would incur the entire cost for Fiscal Year 2013.
6. The cost estimates for Fiscal Years 2014 and 2015
represent the state share (68%) of the estimated basic health insurance policy
cost for Fiscal Year 2013 plus a 5% to cover inflation in medical costs.
7. Future year cost projections may be affected by the
implementation of the Affordable Care Act on January 1, 2014 which may remove
the maximum benefit established in the legislation.
Fiscal Year 2013 (6 months) $ 443,657
Fiscal Year 2014 $ 914,774
Fiscal Year 2015 $1,394,400
Office of
Controller General (Amounts
are shown in whole dollars)
April 18,
2012
LNC:kea
0311460027