WILLIAM DONALD SCHAEFER, Governor

Ch. 2

(2)      THE BENEFITS REQUIRED UNDER THIS SECTION SHALL BE
PROVIDED AS ONE SET OF BENEFITS COVERING MENTAL ILLNESSES, EMOTIONAL
DISORDERS, DRUG ABUSE AND ALCOHOL ABUSE.

(3)      THE BENEFITS REQUIRED UNDER THIS SECTION MAY BE
DELIVERED UNDER A MANAGED CARE SYSTEM.

(4)      EXCEPT AS SPECIFICALLY PROVIDED IN THIS SECTION, BENEFITS
FOR ILLNESSES COVERED BY THIS SECTION AND THE BENEFITS FOR PHYSICAL
ILLNESSES COVERED UNDER A CONTRACT OR POLICY SHALL HAVE THE SAME
TERMS AND CONDITIONS.

(5)      EXCEPT AS PROVIDED FOR THE COINSURANCE PROVISIONS IN
SUBSECTION (B)(2)(III) OF THIS SECTION, A CONTRACT OR POLICY THAT IS SUBJECT
TO THIS SECTION MAY NOT HAVE:

(I)       SEPARATE LIFETIME MAXIMUMS FOR PHYSICAL ILLNESSES
AND ILLNESSES COVERED UNDER THIS SECTION;

(II)     SEPARATE DEDUCTIBLES AND COINSURANCE AMOUNTS FOR
PHYSICAL ILLNESSES AND ILLNESSES COVERED UNDER THIS SECTION; OR

(III)    SEPARATE OUT-OF-POCKET LIMITS IN A BENEFIT PERIOD OF
NOT MORE THAN 12 MONTHS FOR PHYSICAL ILLNESSES AND ILLNESSES COVERED
UNDER THIS SECTION.

(6)      ANY COPAYMENTS REQUIRED UNDER A CONTRACT OR
CERTIFICATE FOR BENEFITS FOR ILLNESSES COVERED UNDER THIS SECTION SHALL
BE:

(I)       ACTUARIALLY EQUIVALENT TO ANY COINSURANCE
REQUIREMENTS UNDER THIS SECTION; OR

(II)     WHERE THERE ARE NO COINSURANCE REQUIREMENTS, NOT
GREATER THAN A COPAYMENT REQUIRED FOR BENEFITS A BENEFIT UNDER THE
CONTRACT OR A CERTIFICATE FOR PHYSICAL ILLNESSES A PHYSICAL ILLNESS.

(D)     NOTWITHSTANDING THE PROVISIONS OF SUBSECTION (B)(2)(I)1 OF THIS
SECTION, UNTIL JULY 1, 1995, A CONTRACT OR POLICY THAT IS SUBJECT TO THIS
SECTION THAT OFFERS LESS THAN 60 DAYS COVERAGE FOR INPATIENT CARE FOR
HEALTH CARE FOR PHYSICAL ILLNESS MUST ONLY INCLUDE COVERAGE FOR
MENTAL ILLNESS, EMOTIONAL DISORDERS, DRUG ABUSE AND ALCOHOL ABUSE
THAT IS AT LEAST EQUAL TO THE BENEFIT OFFERED FOR THOSE OTHER TYPES OF
HEALTH CARE. ON AND AFTER JULY 1, 1995, THE PROVISIONS OF SUBSECTION
(B)(2)(I)2 OF THIS SECTION SHALL APPLY.

(E)     AN OFFICE VISIT TO A PHYSICIAN OR OTHER HEALTH CARE PROVIDER
FOR THE PURPOSE OF MEDICATION MANAGEMENT MAY NOT BE COUNTED AGAINST
THE NUMBER OF VISITS REQUIRED TO BE COVERED AS A PART OF THE BENEFITS
REQUIRED UNDER SUBSECTION (B)(2)(II) OF THIS SECTION AND SHALL BE
REIMBURSED UNDER THE SAME TERMS AND CONDITIONS AS AN OFFICE VISIT FOR
PHYSICAL ILLNESSES COVERED UNDER THE CONTRACT OR POLICY.

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