SB518: SB518 Insurance; health benefit policy coverage for medically necessary treatments of alopecia universalis; require

26 LC 46 1305 Senate Bill 518 By: Senator Still of the 48th A BILL TO BE ENTITLED AN ACT To amend Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to1 insurance generally, so as to require health benefit policy coverage for medically necessary2 treatments of alopecia universalis; to provide for definitions; to provide for cost sharing; to3 provide for statutory construction; to provide for applicability; to provide for related matters;4 to repeal conflicting laws; and for other purposes.5 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:6 SECTION 1.7 Chapter 24 of Title 33 of the Official Code of Georgia Annotate d, relating to insurance8 generally, is amended by adding a new Code section to read as follows:9 "33-24-59.37.10 (a) As used in this Code section, the term:11 (1) 'Alopecia universalis' or 'alopecia areata universalis' me ans a severe autoimmune12 condition causing the complete loss of body hair.13 (2) 'Cost-sharing requirement' means a deductible, coinsurance, or copayment and any14 maximum limitation on the application of such a deductible, coinsurance, copayment, or15 similar out-of-pocket expense.16 S. B. 518 - 1 - 26 LC 46 1305 (3) 'Covered person' means an individual covered under a health benefit policy.17 (4) 'Health benefit policy' means an individual or group plan, policy, or contract for18 healthcare services issued, delivered, issued for delivery, or renewed in this state which19 provides major medical benefits by a healthcare corporation, he alth maintenance20 organization, preferred provider organization, fraternal benefit society, hospital service21 corporation, medical service corporation, or other health insurer or similar entity. Such22 term shall not include self-funded, employer sponsored health insurance plans subject to23 the exclusive jurisdiction of the federal Employee Retirement I ncome Security Act of24 1974, as codified and amended at 29 U.S.C. Section 1001, et seq.25 (5) 'Health insurer' means any person, corporation, or other entity authorized to provide26 health benefit policies under this title.27 (b) Beginning January 1, 2027, any health insurer offering a health benefit policy in this28 state shall provide coverage for medically necessary patient ca re costs incurred in29 connection with the diagnosis and treatment of Alopecia universalis. Such covered costs30 include United States Food and Drug Administration approved ora l medications,31 corticosteroids, phototherapy, and cranial prostheses.32 (c) The benefits of a health benefit policy as provided in sub section (b) of this Code33 section shall be subject to the same cost-sharing requirements established for other covered34 benefits within such health benefit policy. Special deductibles, coinsurance, copayment,35 or other limitations that are not generally applicable to other medical devices or services36 covered by a health benefit policy shall not be imposed regarding coverage for Alopecia37 universalis.38 (d) Nothing in this Code section shall be construed to prohibit a health insurer from issuing39 or renewing a health benefit policy which provides benefits gre ater than the minimum40 benefits required under this Code section or from issuing or re newing a policy which41 provides benefits which are generally more favorable to the cov ered person than those42 required under this Code section.43 S. B. 518 - 2 - 26 LC 46 1305 (e)(1) The provisions of this Code section shall apply to all policies, contracts, and44 certificates executed, delivered, issued for delivery, continued, or renewed in this state45 on or after January 1, 2027.46 (2) For purposes of this Code section, all contracts are deeme d to be renewed no later47 than the first anniversary of the contract date."48 SECTION 2.49 All laws and parts of laws in conflict with this Act are repealed.50 S. B. 518 - 3 -