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Summary of differences between federal and state regulations
Employee health plans are generally covered under the federal jurisdiction of the Employee Retirement Income Security Act (ERISA).
Federal ERISA plans generally do not have to comply with state laws. ERISA rules preempt or block state laws that relate to ERISA plans. State insurance laws, however, do apply.
Mississippi laws include the following provisions:
- If the plan covers drugs, it must allow participants to choose a pharmacy or pharmacist who has agreed to participate in the plan. §83-9-6
- If the plan covers drugs, it cannot exclude drugs used for the treatment of cancer on the grounds that the drug has not been approved by the Federal Food and Drug Administration for the treatment of the specific type of cancer for which the drug has been prescribed. §83-9-8
- If the plan provides for the reimbursement for loss resulting from sickness, from bodily injury by accidental means, or both, it must include health service benefits for care and treatment of alcoholism on the same basis as other benefits. §83-9-27
- If the plan covers family members, it must cover newly born children of the insured from the moment of birth. §83-9-33
- If the plan covers family members, it must offer optional coverage for immunizations of each newly born child of the insured, from birth through 24 months of age. §83-9-34
- Plans must cover the treatment of mental illness. §83-9-39
- Plans must offer coverage for diabetes treatments, including, but not limited to, equipment, supplies used in connection with the monitoring of blood glucose and insulin administration and self-management training/education and medical nutrition therapy in an outpatient, inpatient or home health setting. §83-9-46
- If the plan provides for reimbursement for services of a duly certified nurse practitioner, it must reimburse for such services, whether they are performed by a physician or by a nurse practitioner working under the supervision of a duly licensed physician. §83-41-213
- If the plan provides for reimbursement for any diagnosis and treatment of mental, nervous, or emotional disorders, it must reimburse for such services whether they are performed by a physician, psychologist, professional counselor, or a clinical social worker. §83-41-211
- If the plan provides for reimbursement for service of practice of a duly licensed dentist, it must reimburse for such services, whether they are performed by a physician or a dentist. §83-41-209
- If the plan provides for reimbursement for any visual service of an optometrist, it must reimburse for such services, whether they are performed by a physician or an optometrist. §83-41-203
- If the plan provides for reimbursement for diagnosis or treatment of mental, nervous, or emotional disorders, it must reimburse for such services whether they are performed by a psychologist, professional counselor, social worker, or marriage and family therapist. §83-41-211
- If the plan provides for reimbursement for services of a chiropractor, it must allow participants the right to choose the place where the service is to be performed as well as the chiropractor to perform such service. §83-41-215
- Health insurance policies delivered, executed, issued, amended, adjusted, or renewed on or after January 1, 2016 must provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. §83-9-26
For information on women’s health care coverage, see the Women’s Health Rights topic.
State
Contact
Mississippi Department of Insurance
Regulations
Mississippi Code, Title 83 Insurance, Chapter 9 Accident, Health, and Medicare Supplement Insurance
Mississippi Code, Title 83 Insurance, Chapter 41 Hospital and Medical Service Associations and Contracts
Federal
Contact
Employee Benefits Security Administration (EBSA)
Regulations
29 CFR chapter XXV (Parts 2509 – 2590)