Terms Used In 22 Guam Code Ann. § 181103

  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
(a) Except for those offered by a fraternal benefit society, health care insurance service plans issued by a health insurance carrier, hospital service corporation, medical service corporation, insurance company, health maintenance organization, and any other entity delivering or issuing for delivery in Guam Medicare

supplement policies or certificates issued pursuant to 22 Guam Code Ann., Chapter 29 shall not:

(1) exclude or deny coverage for a treatment or impose dollar limits, deductibles and coinsurance provisions based solely on the diagnosis of autism spectrum disorder. For the purposes of this Subsection, “”treatment”” includes diagnosis, assessment, and services; or

(2) exclude or deny coverage for medically necessary behavioral therapy services. To be eligible for coverage, behavioral therapy services shall be provided or supervised by a licensed or certified autism spectrum disorder provider.

(b) This Chapter does not:

(1) apply to a health insurance subscription contract that is issued to an individual or through a small employer; or

(2) apply to bundled or limited benefit coverage as defined in § 181101(f) of this Chapter.

(c) The coverage required by this Chapter is subject to all the terms and conditions of the subscription contract. Nothing in this Chapter prevents a corporation from imposing deductibles, coinsurance or other cost sharing in relation to the coverage required by this Chapter.

(d) Coverage for diagnosis, treatment and behavioral therapy is subject to:

(1) a Seventy-five Thousand Dollars ($75,000) maximum benefit per year for an eligible person up to the age of fifteen (15); or

(2) a Twenty-five Thousand Dollars ($25,000) maximum benefit per year for an eligible person who is between the ages of sixteen (16) and twenty-one (21).

SOURCE: Added by P.L. 34-006:3 (May 10, 2017 as 22 GCA § 29A103. Subsection (d) amended by P.L. 35-019:3 (May 9, 2019).

NOTE: Codified to this section by the Compiler pursuant to 1 Guam Code Ann. § 1606. Internal reference altered to reflect change.

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