Some states require that we notify members or prospective members of certain rights or plan benefits that may apply. Review additional state required notices. 

Connecticut:

 

Senate Bill No. 1085

This bill went into effect 1/1/16 and expands the services certain health insurance policies must cover for mental and nervous conditions. By law, a policy must cover the diagnosis and treatment of mental or nervous conditions on the same basis as medical, surgical, or other physical conditions (i.e., parity).

Below are the non-traditional behavioral health services included in this bill that Optum will now cover under the outpatient mental health benefit for plans mandated by this bill ie: fully insured commercial plans, sitused in the State of CT and State of CT employees. All of these services do require prior authorization both in and out of network.

  • Intensive, home-based services addressing specific mental or nervous conditions in a child while remediating problematic parenting practices and addressing other family and educational challenges that affect the child's and family's ability to function;
  • Intensive, family- and community-based treatment programs that focus on environmental systems impacting chronic and violent juvenile offenders.


Review Senate Bill No. 1085.

 

Senate Bill No. 811

Information for Members in Connecticut Insurance Plans: Surprise Bills
Out-of-Network Costs for Members in Connecticut Insurance Plans

 

Illinois:

Optum Takes Action to Support People Affected by Flooding in Illinois - Optum is taking actions to support members in Calhoun, Jackson, Jersey, Madison, Monroe, Randolph, Alexander, Cass, Christian, Clinton, Cumberland, Douglas, Iroquois, Lawrence, Marion, Menard, Morgan, Moultrie, Pike, Richland, Sangamon, Vermilion and St. Clair counties in Illinois, who may have been affected by the recent floods. Click here to learn more.

 

Maryland:

Maryland Mental Health Parity and Addiction Equity Act (MHPAEA) Healthplan Subscriber Notice - For full mental health benefit information please refer to your Certificate of Coverage (COC) and Schedule of Benefits, or contact your healthcare provider. In addition, you may refer to the Maryland Insurance Administration website: http://www.mdinsurance.state.md.us

 

New York:

Information for Members in New York Insurance Plans: Emergency Services and Surprise Bills - What to do if you receive a surprise bill from an out-of-network provider
Claim Submission Information for Members in New York Insurance Plans