North Carolina § 58-51-55 - No discrimination against mentally ill or chemically dependent individuals.

§ 58-51-55. No discrimination against mentally ill or chemically dependent individuals.

Definitions. - As used in this section, the term: "Mental illness" has the same meaning as defined in G.S. 122C-3(21), with a mental disorder defined in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, or a subsequent edition published by the American Psychiatric Association, except those mental disorders coded in the DSM-5 or subsequent editions as autism spectrum disorder (299.00), substance-related disorders (291.0 through 292.9 and 303.0 through 305.9), those coded as sexual dysfunctions not due to organic disease (302.70 through 302.79), and those coded as "V" codes. "Chemical dependency" has the same meaning as defined in G.S. 58-51-50, with a mental disorder defined in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, or subsequent editions published by the American Psychiatric Association. Coverage of Physical Illness. - No insurance company licensed in this State under this Chapter shall, solely because an individual to be insured has or had a mental illness or chemical dependency: Refuse to issue or deliver to that individual any policy that affords benefits or coverages for any medical treatment or service for physical illness or injury; Have a higher premium rate or charge for physical illness or injury coverages or benefits for that individual; or Reduce physical illness or injury coverages or benefits for that individual. [Expired October 1, 2001.] Chemical Dependency Coverage Not Required. - Nothing in this section requires an insurer to offer coverage for chemical dependency, except as provided in G.S. 58-51-50. Applicability. - This section applies only to group health insurance contracts, other than excepted benefits as defined in G.S. 58-68-25. For purposes of this section, "group health insurance contracts" include MEWAs, as defined in G.S. 58-50A-1. Nothing in this section requires an insurer to cover treatment or studies leading to or in connection with sex changes or modifications and related care. History (1989, c. 369, s. 3; 1991, c. 720, s. 81; 1997-259, s. 21; 1999-132, s. 4.2; 2007-268, s. 1; 2015-271, s. 3; 2019-202, s. 8; 2020-69, s. 3(f).) Editor's Note. - Session Laws 2007-268, s. 6, provides: "This act becomes effective July 1, 2008, and applies to health benefit plans that are delivered, issued for delivery, or renewed on or after that date. For purposes of this act, renewal of a health benefit policy, contract, or plan is presumed to occur on each anniversary of the date on which coverage was first effective on the person or persons covered by the health benefit plan." Session Laws 2015-271, s. 6, made the amendment to subsection (a) of this section by Session Laws 2015-271, s. 3, which substituted "DSM-5" for "DSM-IV" three times in subdivisions (a)(1) and (a)(2); and inserted "autism spectrum disorder (299.00)" preceding "substance-related disorders" in subdivision (a)(1), applicable to insurance contracts issued, renewed, or amended on or after July 1, 2016. Session Laws 2019-202, s. 8, provides: "The Revisor of Statutes is hereby authorized to make any changes to the General Statutes made necessary by the recodification in Section 2 of this act, including changes to the following sections of the General Statutes: G.S. 58-2-161 , 58-3-122, 58-3-167, 58-3-169, 58-3-174, 58-3-176, 58-3-178, 58-3-190, 58-3-200, 58-3-215, 58-3-225, 58-3-227, 58-3-275, 58-28-35, 58-51-55, 58-65-90, 58-67-75, 58-68-25, and 90-21.50." In subsection (d), "G.S. 58-50A-60(a) [G.S. 58-50A-1]" was substituted for "58-49-30(a)" at the direction of the Revisor of Statutes. Session Laws 2019-202, s. 9 is a severability clause. Session Laws 2019-202, s. 10 made the amendment to this section by Session Laws 2019-202, s. 8, effective October 1, 2019, and applicable to contracts entered into, amended, or renewed on or after January 1, 2020. Effect of Amendments. - Session Laws 2015-271, s. 3, effective July 1, 2016, substituted "DSM-5" for "DSM-IV" three times in subdivisions (a)(1) and (a)(2); and inserted "autism spectrum disorder (299.00)" preceding "substance-related disorders" in subdivision (a)(1). For applicability, see editor's note. Session Laws 2020-69, s. 3(f), effective July 1, 2020, substituted "G.S. 58-50A-1" for "G.S. 58-50A-60(a)" in the second sentence of subsection (d).