2014-12 Autism Spectrum Disorder Maximum Benefit for Coverage for Behavioral Therapy

South Carolina Department of Insurance Capitol Center 1201 Main Street, Suile 1000 Columbia, South Carolina 29201 Mailing Address: P.O. Box 100105, Columbia, S.C. 29202·3105 Telephone: (803) 737·6160 BULLETIN NUMBER 2014-12 NIKKI R. HALEY Go\'crnor RAYMOND G. FARMER Director TO: All Insurers and HMOs Writing Accident and Health Insurance Coverage in South Carolina, including the State Health Plan FROM: D R~ymond fGI' Farmer (? 4:.".,~~ __ ... _~/J II. "'1..CI;" ...... ______ _ Irector 0 nsurance lc..., . r )I V.J. "T~ ~ SUBJECT: Section 38-71-280, Autism Spectrum Disorder Maximum Benefit for Coverage for Behavioral Therapy DATE: August 29, 2014 I. PURPOSE AND SCOPE OF THIS BULLETIN The purpose of this bulletin is to address a provision of S.c. Code of Laws Section 38-71-280, added by 2007 S.c. Act No. 65. Subsection (E) requires that annual adjustments of the maximum benefit for coverage for behavioral therapy shall be made to reflect any change from the previous year in the Consumer Price Index. S.c. Code Section 38-71-280 (E) provides as follows: ..... Coverage for behavioral therapy is subject to a fifty thousand dollar maximum benefit per year. Beginning one year after the effective date of this act, this maximum benefit shall be adjusted annually on January I of each calendar year to reflect any change from the previous year in the current Consumer Price Index, All Urban Consumers, as published by the United States Department of Labor's Bureau of Labor Statistics." The South Carolina Department of Insurance has reviewed the current Consumer Price Index and determined that the maximum benefit for coverage for behavioral therapy shall be increased to $54,200 for the calendar year beginning January I, 2015. II. QUESTIONS Any questions or concerns about this Bulletin should be submitted in writing to the attention of: Andrew Dvorine, ASA, MAAA Life Actuary South Carolina Department of Insurance 145 King Street, Suite 228 Charleston, South Carolina 2940 I Facsimile: (843) 722-6105 Email: advorine@doi.sc.gov Bulletins are the method by which the Director of Insurance formally communicates with persons and entities regulated by the Depanment Bulletins are departmental interpretations of Soulh Carolina insurance Jaws and regulations and provide guidance on the Dep3.rtment's enforcement approach. Bulletins do not provide legal advice. Readers should consult applicable statutes and regulations or contact an attorney for legal advice or for additional information on che impact of that legislation on their specific situation.