SB 528: Insurance; health benefit plans, policies, or contracts executed by the state to cover medically necessary orthotic devices and prosthetic devices and their materials and components; require

Georgia law already requires many health insurance policies to cover medically necessary orthotic devices (braces and other supports) and prosthetic devices (artificial limbs) and their parts, under O.C.G.A. § 33-24-59.35. But that law currently excludes health plans the state provides to its own employees, meaning state workers were not guaranteed this coverage the way people on other insurance plans were. This bill rewrites the definition of 'health benefit policy' so that, starting January 1, 2027, it includes plans the state provides to state employees, public school teachers and employees, and members and employees of the Board of Regents of the University System of Georgia, along with their retirees and dependents. That change means these state-run plans would now have to comply with the orthotic and prosthetic coverage mandate. Self-funded employer health plans governed by the federal ERISA law remain excluded. The law would take effect as soon as the Governor signs it.

• Removes the exclusion that kept state employee health plans from having to cover orthotic and prosthetic devices under Georgia's coverage mandate (O.C.G.A. § 33-24-59.35).
• Extends the coverage requirement to plans covering public school teachers and employees and to members and employees of the Board of Regents of the University System of Georgia.
• Extends the requirement to retirees and dependents of these state-connected employees, not just active employees.
• Sets January 1, 2027 as the date the new coverage requirement for these state plans takes effect.
• Keeps the existing exclusion for self-funded, employer-sponsored plans governed by the federal ERISA law.

State employees, public school teachers and staff, and Board of Regents employees enrolled in state-provided health plans, along with their retirees and dependents. It also affects the State Health Benefit Plan administrators and insurers who must now cover orthotic and prosthetic devices for this population.

State employees, teachers, and university system workers who need artificial limbs, braces, or similar devices would gain a guaranteed insurance benefit that other Georgians with private major medical plans already have, potentially reducing out-of-pocket costs for these medically necessary devices starting in 2027.

• Section 1 revises paragraph (3) of subsection (a) of O.C.G.A. § 33-24-59.35, changing the definition of 'health benefit policy' used throughout the orthotic and prosthetic coverage law.
• The revised definition removes language that excluded plans executed by the state on behalf of state employees under Article 1 of Chapter 18 of Title 45.
• The revised definition adds coverage for public school teachers and employees and Board of Regents members and employees, plus their retirees and dependents, effective January 1, 2027.
• The bill removes language that had exempted Medicaid contracts between insurers and the Department of Community Health from the coverage requirement.
• Self-funded, employer-sponsored plans subject to the federal Employee Retirement Income Security Act of 1974 remain excluded from the definition.
• Section 2 makes the Act effective immediately upon the Governor's signature or upon becoming law without signature.

1. 2026-02-19Senate Read and Referred (Senado)
2. 2026-02-18Senate Hopper (Senado)

• Randy Robertson (R, SD-029)Patrocinador principal
• Clint Dixon (R, SD-045)
• Matt Brass (R, SD-006)
• Brian Strickland (R, SD-042)
• Billy Hickman (R, SD-004)
• Mike Hodges (R, SD-003)
• Max Burns (R, SD-023)
• Jason T. Dickerson (R, SD-021)
• Lee Anderson (R, SD-024)
• Shawn Still (R, SD-048)
• Chuck Payne (R, SD-054)

• health insurance
• state employee benefits
• prosthetic and orthotic coverage
• teacher benefits
• insurance mandates