Will this make coverage mandatory in GA?

If this bill is passed during the 2005 General Assembly for GA, with the changes indicated in the full text at http://www.legis.state.ga.us/legis/2005_06/search/hb43.htm , will this mean that insurance coverage is mandatory for morbid obesity and specific exclusions are not allowed? It's how it reads to me, but you never know with the verbage of these things where a loophole may lie. Melissa

It sounds like if it is a non self funded ERISA governed plan then coverage will have to be mandatory. Sadly, there will probably be lobbying by the insurance industry against it, but the people should get together and get it passed. New York has a similar law that says any treatment deemed medically necessary must be covered regardless of what the policy says if it is a non selfunded plan. But, that said, people get denied in New York all the time because companies want to fight to the end to try and get around it. This Statute in Georgia sounds like it would be very comprehensive and great. By the end of the year most policies would have to cover it. Self funded plans are plans where your employer funds the plan and hires a carrier just to administer claims. Those plans are subject only to ERISA a federal law that allows employers to do almost anything they please. Gary Viscio www.obesitylawyers.com

Melissa, It's hard to believe our legislators are actually doing something other than legislating morality, or the stupid flag isn't it? Unfortunately, 80% of employees covered under an employee plan are self insured. The other 20% usually are fully insured insurance policies, bought by small employers, who typically don't buy the rider for WLS due to the financial constraints. There's always Canada...but don't get me started!