H.B. 1197                                                     VETOES

1.        80 PERCENT FOR THE FIRST 5 VISITS IN ANY CALENDAR
YEAR OR BENEFIT PERIOD OF NOT MORE THAN 12 MONTHS;

2.        65 PERCENT FOR THE 6TH TO THROUGH 30TH VISIT IN
ANY CALENDAR YEAR OR BENEFIT PERIOD OF NOT MORE THAN 12 MONTHS; AND

3.        50 PERCENT FOR THE 31ST VISIT AND ANY VISIT AFTER
THE 31ST VISIT IN ANY CALENDAR YEAR OR BENEFIT PERIOD OF NOT MORE THAN 12
MONTHS.

(C) (1) THE BENEFITS UNDER THIS SECTION SHALL BE REQUIRED ONLY
FOR EXPENSES ARISING FOR TREATMENT OF MENTAL ILLNESSES, EMOTIONAL
DISORDERS, DRUG ABUSE AND ALCOHOL ABUSE WHICH IN THE PROFESSIONAL
JUDGMENT OF PRACTITIONERS IS MEDICALLY NECESSARY AND TREATABLE.

(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 CERTIFICATE SHALL HAVE THE SAME
TERMS AND CONDITIONS.

(5)      EXCEPT AS PROVIDED FOR THE COINSURANCE PROVISIONS IN
SUBSECTION (B)(2)(III), A CONTRACT OR CERTIFICATE 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.

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