July 28, 2015
On July 6, 2015, Gov. Ige signed HB 174 into law. The new law requires group health plans to provide coverage for medically necessary orthodontic services for the treatment of orofacial anomalies resulting from birth defects. The maximum benefit per treatment phase is $5,500, which will be indexed for inflation in later years. The coverage may be subject to a deductible, coinsurance or copayment but cannot be less favorable than the cost sharing provisions for medical services under the plan. Coverage cannot be denied on the basis that the treatment is habilitative or non-restorative in nature. The insurer must distribute a notice summarizing the coverage with 2016 plan materials. The law is effective for policies issued or renewed on or after Jan. 1, 2016.
HB 174 »