Issue # 3 - February, 2009
Self-Insured Employers Cover ABA Intervention for Autism and Other Special Needs
by Laurie Stuebing, Portland, OR, APBA Autism Task Force
Many large employers self-insure under the 1974 federal Employee
Retirement Income Security Act (ERISA). Although states have regulatory
authority over the coverage provided to their citizens who receive health
insurance plans through their employers, state authority is preempted for
citizens receiving coverage directly from self-insuring large employers. Those
employers often comply with state mandates to provide benefits for people
with autism spectrum disorders (ASD).
Many self-insured companies have led the way in
establishing health benefits for children with ASD and
other special needs. Microsoft was the first company in
the U.S. to cover applied behavior analysis (ABA)
treatment in 2001. Now many self-insured companies
cover not only ABA, but also other treatments.
When a company offers an autism benefit that includes
coverage for ABA treatment, practitioners certified by
the Behavior Analyst Certification Board (BACB) are
usually recognized as qualified providers, the same as
licensed professionals.
Because self-insured companies’ benefits are subject to change, it is best to check directly with the company’s Human Resources department about their current ABA benefit and provider qualifications. Each company has third party administrators (TPAs) overseeing their benefit, so BACB certificants will need to contact representatives of the TPAs to become preferred providers. Upon becoming a provider, it is essential to ask administrators which insurance billing code or codes should be used to bill for ABA services. The website of each company can be accessed by clicking on its name in the table below.
The following list of self-insured companies providing autism and/or special needs benefits is not exhaustive. There are some in every state. In addition, some self-insured companies will work with an individual family to cover treatment for their child even in the absence of an autism or special needs benefit.
| Company | Reimbursement For ABA Treatment | Company Locations in U.S.A. |
| Arnold and Porter Law Firm | yes | CO, CA, DC, NY, VA |
| Cisco | yes | CA |
| Deloitte | yes | All states except AK, ME, MT, MS, ND, NH, NM, VT, RI, SD, WV, WY |
| Eli Lilly | yes | All states |
| Greenville Hospital System | yes | SC |
| Halliburton | yes | AK, CA, CO, LA, OK, TX |
| Home Depot | yes | All states |
| IBM | Limited coverage | All states |
| Imation | yes | FL, MN, OK |
| Intel | yes | AZ, CA, CO, MA, NC, NM, NJ, OR, SC, TX, UT, VA, WA |
| Lexington Medical Center | yes | SC |
| Maxim Integrated Products | yes | AZ, CA, CO, FL, GA, IL, IN, MA, MI, NC, OR, RI, TX, WI |
| Mayo Clinic | yes | AZ, FL, MN |
| Michelin | yes | AL, IN, KY, NC, OK, SC |
| Microsoft | yes | All states except AK, DE, HI, KY, LA, MD, MS, MT, NH, NJ, NM, ND, RI, SC, SD, VT, WV, WY |
| Network Appliance, Inc. | yes | CA, MA, NC, MA |
| Symantec | yes | AZ, CA, CO, DC, FL, GA, HI, IL, KS, LA, MA, MD, MI, MN, OH, NJ, NY, OR, PA, TN, TX, UT, VA, WA |
| TriQuint Semiconductor | yes | CA, CO, FL, MA, NC, OR, TX |
| University of Minnesota | yes | MN |