10/05/2007   We are implementing mandated changes for 2008

This year the Washington State Legislature made several changes in legislation that affect our health plans. As we continue to be committed to transforming health care in our community within legislative intent and guidelines, we will make changes to certain medical benefits effective Jan. 1, 2008, to comply with the new laws.

Mental Health (Both Group and Individual Products)
Mental health benefits are now required on all small-group and Individual plans at coinsurance and copay levels that are consistent with other medical and surgical coverage. As a result of House Bill 1154, we have revised mental health coverage on all of our small-group plans and added coverage to our Individual and Conversion plans. Large-group mental health parity was implemented in 2006 as a result of previous legislation.

The mandated mental health benefit changes will apply to small-group plans effective Jan. 1, 2008, as groups enroll or renew. Mental health coverage on small-group plans will mirror coverage on our large-group plans. Outpatient mental health coinsurance levels on Preferred, FourFrontSM, InnovaSM, EngageSM and HSA-qualified plans will increase from 50% to the same coinsurance levels required by other outpatient medical services. Outpatient mental health coverage on Preferred, FourFront, Innova, Engage, Traditional and Selections® plans will be revised to accumulate toward the coinsurance maximum. Current benefit limits on small-group plans will remain unchanged.

Mental health coverage will be added to Individual and Conversion plans across the board effective Jan. 1, 2008. Inpatient and outpatient services will be covered at the same coinsurance and copay levels as other medical and surgical services. Both inpatient and outpatient services will accumulate to the coinsurance maximum. Benefits will be limited to eight inpatient days and 12 outpatient visits per calendar year on Preferred, Regence BreakthruSM, HSA and Conversion plans. On Individual Selections plans, benefits will be limited to eight inpatient days and 12 outpatient visits per calendar year for in-network services. Extended network services will be limited to six inpatient days and 10 outpatient visits per calendar year.

Chemical Dependency (Group Only)
As required by Washington state law, the benefit limit for chemical dependency coverage on all group plans will increase to $14,000 every two calendar years. This change will apply as groups enroll or renew in 2008.

Dependent Age
Senate Bill 5223 requires covered dependents to be included on health plan coverage until age 25. Our small-group and large-group medical and dental plans currently comply with this new requirement. Negotiated groups that currently cover dependents to a lower age limit will be required to change to the minimum of age 25 at their 2008 renewal.

We appreciate your role as the advisor and navigator of your clients' health care needs. If you have questions about these mandates, please talk to your Regence Sales contact.

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