Common State Insurance Mandates
- Infertility treatment coverage (required in 20+ states)
- Autism spectrum disorder coverage (required in all 50 states)
- Mental health parity (state laws may be more stringent than federal MHPAEA)
- Contraceptive coverage (required in many states)
- Telehealth coverage parity (required in many states)
- Surprise billing protections (state laws may supplement federal No Surprises Act)
- Network adequacy standards (state-specific requirements)
Multi-State Compliance
Multi-state employers with fully insured plans must comply with insurance mandates in each state where the plan is issued. This can create significant complexity — a plan that complies with mandates in one state may not comply with mandates in another. Work with your carrier to confirm compliance with state insurance mandates in all states where you have employees.
Self-Funding as a Solution
IQ Insight
One of the primary advantages of self-funding is exemption from state insurance mandates under ERISA preemption. A self-funded employer with employees in 20 states does not need to comply with 20 different sets of state insurance mandates — it only needs to comply with federal law. This simplification is a significant compliance advantage for multi-state employers.