Why your self-funded plan should cover autism
Autism coverage is becoming the standard. Laws in 42 states, including Utah, now require some form of coverage. Medicaid, considered by some to be the low standard for health plans, will begin covering autism in Utah in 2015 for those that meet the requirements.
Most employers that provide a “self-funded” health benefit plan are not subject to state insurance law and are allowed to choose what coverage they want1. Many employers choose to cover autism. In fact, 78% of large employers offer some autism benefit and 31% voluntarily include intensive behavioral therapy such as ABA2.
Why do they do this? It may be that the company has a commitment to family values. Maybe employee retention is a key issue. Maybe they just want their benefits package to stay competitive.
We can tell you this:
When an employee has a child with autism, they may deal with tantrums, sleep disruption, and a myriad of other issues. Behavioral therapy has been proven to help, if they can afford it. You may be paying your employee a competitive salary, but they may be paying as much as $50,000 per year out-of-pocket for therapy and other expenses. That's where your health benefit plan is supposed to come in.
Autism coverage has been shown to have negligible impact on premiums. If you'd like to learn more about how to provide it for your employees, please contact us at utahautismcoalition@gmail.com.
Below are a sampling of employers in a variety of industries with self-funded plans who have chosen to provide an autism benefit3.
Technology:
Healthcare and pharmaceuticals:
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City/County Governments:
Financial:
Insurance:
Universities
Other:
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1. In Utah, state insurance mandates are applied to school districts, public charters, state-funded higher ed institutions, and the state public employees health program (SB138).
2. Source: 2011 Mercer HealthCare Survey
3. Source: Autism Speaks
