Announcing Product Changes to Comply with Timothy's Law

 

In December 2006, New York State enacted legislation, known as "Timothy's Law," requiring that health insurance products provide coverage for at least 30 inpatient days and at least 20 outpatient days for the diagnosis and treatment of mental, nervous, or emotional disorders. Depending upon the class of contract, the law may also require coverage of treatment of biologically based mental illnesses, and children with serious emotional disturbances, on a par with coverage for other types of conditions. The law affects group health insurance policies as they issue or renew on or after January 1, 2007. The new benefits levels take effect for new policyholders on their coverage effective date and for in-force policyholders on their renewal date.

While benefits provided under many GHI products already meet or exceed these mental health coverage requirements, GHI must increase the benefits under other products to comply with the law. In the cases where GHI's coverage already exceeds the requirements, GHI will not reduce those benefits at this time.

NOTE: Small groups with one to fifty (1-50) eligible employees will also have the option to buy additional coverage, at extra cost, that will provide full parity of benefits for severe emotional disturbances in children and for biologically based mental illnesses, such as schizophrenia, major depression, bipolar disorders, anorexia and bulimia. Full parity means that GHI will cover these diagnoses according to the same day and visit limits, cost-sharing, and other coverage terms that apply under your contract for physical illness and injury.

Two-Step Notification Process

New York State requires that all affected groups and group members whose coverage renews on or after January 1, 2007 and up to and including April 1, 2007 receive written notification from their insurer regarding Timothy's Law on or about February 15, 2007. Please click on the following links for samples of the notifications GHI has mailed:


GHI conducted a second mailing, including revised contract and Certificate of Insurance documents, after those documents were approved. Groups and members were notified in a timely manner for plans that issue or renew after April 1, 2007.