You can find information about individual state mandates from several sources: Under the ACA, all new (effective since 2014) individual and small group plans in all states must include coverage for the EHBs, must have adequate provider networks, and must cover pre-existing conditions and be issued without regard for medical history.That's the minimum standard to which the plans must adhere, but states can go beyond the ACA's requirements.Some examples of additional state-specific benefit mandates are infertility coverage, autism coverage, and limiting out-of-pocket costs for prescriptions.But there are rules that require states—rather than insurers—to cover the cost of benefit mandates that go beyond the ACA's requirements, which means that some states have opted to apply new mandates only to large group plans, which aren't subject to the ACA's essential health benefit requirements (note however, that self-insured plans are regulated under federal rules rather than state oversight, so they are not subject to new requirements that states impose; the majority of very large group plans are self-insured).Pregnancy Discrimination Act Health plans maintained by employers who have 15 or more employees must provide the same level of coverage for pregnancy as for other conditions.The states differ greatly in the number and type of mandated benefits, but across all 50 states, there are around 2,000 benefit mandates that have been put in place over the last 30 years.
For example, most states mandate coverage for chiropractors, but the number of allowed visits may vary from state to state.
Family and Medical Leave Act (FMLA)Requires an employer to maintain health coverage for the duration of a FMLA leave.
Uniformed Services Employment and Reemployment Rights Act (USERRA)Gives an employee the right to continuation of health coverage under the employer’s health plans while absent from work due to service in the uniformed services.
Reconstructive surgery after mastectomy A health plan must provide someone who is receiving benefits related to a mastectomy with coverage for reconstruction of the breast on which a mastectomy has been performed.
Americans with Disabilities Act (ADA)Disabled and nondisabled individuals must be provided the same benefits with regard to premiums, deductibles, limits on coverage, and pre-existing condition waiting periods.