Dept. of Financial Services Enforces Timothy’s Law

Since it took effect January 1, 2007 and was made permanent in 2009, New York’s mental health insurance coverage and parity statute, Timothy’s Law, has helped over five million New Yorkers by requiring private state-regulated group health plans to provide coverage for mental heath services and to make their coverage comparable to other health benefits.

Many states (and until recently Federal laws) exempt small employers from various insurance mandates because of cost concerns. In order to assure that small groups could access the same complete coverage as is required of large groups in New York, Timothy’s Law requires that insurers notify companies with 50 employees or fewer of the option to purchase a higher level of mental health coverage. As the law was being implemented, several small businesses complained that they were never told about the optional coverage, and thereby denied the right to purchase a benefit to which they were entitled and wished to buy. This placed families in costly financial jeopardy with mounting medical bills for services that were not covered, and sparked an investigation of plan non-compliance with the notice requirement by the State.

New York’s Department of Financial Services yesterday released the results of the investigation and cracked down on the non-compliant plans with $2.7 million in fines. The department published the fine amounts and stipulations containing corrective actions signed by 15 insurers that were found to have failed to comply with the notification requirement.

From the DFS Press Release:

“Mental illness can have devastating consequences for families. It’s essential that people understand that insurance benefits are available for treating mental illnesses and that businesses know this option is available,” [DFS] Superintendent Lawsky said.

“We are very pleased that the Department of Financial Services has taken our concerns seriously. Superintendent Lawsky and his team are to be commended for upholding the right of small groups to purchase the complete Timothy’s Law mental health benefit as required by the statute,” said Shelly Nortz, Deputy Executive Director with Coalition for the Homeless and Steering Committee member of the Timothy’s Law Campaign.

You can read more about Timothy and Timothy’s Law in our newsletter article “Timothy’s Law Made Permanent.”

Read news coverage of the enforcement action at the Buffalo News, Times Union, New York Daily News, Wall Street Journal, Insurance and Financial Advisor and Life Health Pro.

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