Payer Guide - ASR Health Benefits

ASR Health Benefits ABA coverage: the intake guide.

Last updated October 20264 primary sources

ASR Health Benefits administers employer-funded health plans. In May 2026 it announced its new name, Health Alliance TPA by Henry Ford Health. The announcement says the name change does not change member coverage, benefits or provider networks. This guide keeps the ASR Health Benefits name used on existing cards and payer records.

Verify ABA benefits for the specific employer group. The administrator name or network logo alone does not establish coverage, medical-necessity criteria or prior-authorization requirements.

Prior auth for the assessmentPlan-dependent
Plan-dependent - confirm whether ABA assessment requires prior authorization for this employer group.[1][2]
Ask the plan: Obtain the employer group plan document and confirm its ABA requirements with ASR Claims Department at (800) 968-2449 or (616) 957-1751.
Prior auth for treatmentPlan-dependent
Plan-dependent - confirm whether ABA treatment requires prior authorization and who handles requests for this employer group.[1][2]
Ask the plan: Obtain the employer group plan document and confirm its ABA requirements with ASR Claims Department at (800) 968-2449 or (616) 957-1751.
Autism diagnosis required?Plan-dependent
Plan-dependent - the employer plan document and adopted medical policy determine the diagnosis requirement.[1][2]
Ask the plan: Obtain the employer group plan document and confirm its ABA requirements with ASR Claims Department at (800) 968-2449 or (616) 957-1751.
AdministratorASR Health Benefits; rebranding as Health Alliance TPA by Henry Ford Health
Provider claims and benefitsClaims Department: (800) 968-2449 / (616) 957-1751
ABA coverage and prior authorizationPlan-dependent; confirm against the employer group plan document

Start with the employer group

Collect the employer name and group number, then obtain the plan document. Confirm whether ABA is covered, which diagnoses qualify, and whether assessment and treatment need separate authorization. Record any age, hour, visit or dollar limits for this group.[1][2]

Provider claims and benefits questions

ASR lists its Claims Department for provider claims or benefits questions: (800) 968-2449 or (616) 957-1751. These are not verified prior-authorization numbers. Ask which department or vendor handles ABA authorization for this employer group.[2]

Provider phone hours, the eligibility portal and ABA authorization contacts have not been verified for this guide. Confirm them before relying on a contact route.[2]

Confirm the network separately

ASR lists multiple provider networks. Confirm the network printed on the member card and participation for this plan; network participation does not establish which ABA policy the employer group uses.[4]

How ASR Health Benefits works state by state

The clinical policy above is national, but three state-level layers change what a family's card actually buys: the state autism mandate (what fully-insured plans must cover), the carrier's state Medicaid plans (which follow the state Medicaid rules, not this commercial policy), and plan funding type (self-funded ERISA plans can carve benefits differently). Here's the picture in the states we cover:

GeorgiaMandate: Ava’s Law (O.C.G.A. § 33-24-59.10)

Fully-insured ASR Health Benefits plans issued in Georgia sit under the state mandate above. State Medicaid baseline: Georgia Medicaid guide →

North CarolinaMandate: N.C.G.S. § 58-3-192 (autism coverage)

Fully-insured ASR Health Benefits plans issued in North Carolina sit under the state mandate above. State Medicaid baseline: North Carolina Medicaid guide →

IndianaMandate: Indiana autism insurance mandate (IC 27-8-14.2)

Fully-insured ASR Health Benefits plans issued in Indiana sit under the state mandate above. State Medicaid baseline: Indiana Medicaid (IHCP) guide →

VirginiaMandate: Virginia autism insurance mandate (§ 38.2-3418.17)

Fully-insured ASR Health Benefits plans issued in Virginia sit under the state mandate above. State Medicaid baseline: Virginia Medicaid (DMAS) guide →

TennesseeMandate: Tenn. Code Ann. § 56-7-2367 (neurological parity)

Fully-insured ASR Health Benefits plans issued in Tennessee sit under the state mandate above. State Medicaid baseline: TennCare (Tennessee Medicaid) guide →

OhioMandate: Ohio autism insurance mandate (R.C. 3923.84)

Fully-insured ASR Health Benefits plans issued in Ohio sit under the state mandate above. State Medicaid baseline: Ohio Medicaid guide →

New JerseyMandate: P.L. 2009, c.115 (N.J.S.A. 17:48-6ii et al.)

Fully-insured ASR Health Benefits plans issued in New Jersey sit under the state mandate above. State Medicaid baseline: NJ FamilyCare (New Jersey Medicaid) guide →

MarylandMandate: Habilitative services mandate (Md. Ins. § 15-835 + COMAR 31.10.39.03)

Fully-insured ASR Health Benefits plans issued in Maryland sit under the state mandate above. State Medicaid baseline: Maryland Medicaid (Medical Assistance) guide →

ColoradoMandate: Colorado autism insurance mandate (C.R.S. § 10-16-104(1.4))

Fully-insured ASR Health Benefits plans issued in Colorado sit under the state mandate above. State Medicaid baseline: Health First Colorado (Colorado Medicaid) guide →

UtahMandate: Utah autism insurance mandate (Utah Code § 31A-22-642; caps removed 2020)

Fully-insured ASR Health Benefits plans issued in Utah sit under the state mandate above. State Medicaid baseline: Utah Medicaid guide →

ArizonaMandate: Steven’s Law (A.R.S. § 20-826.04; dollar caps repealed by SB 1590, 2025)

Fully-insured ASR Health Benefits plans issued in Arizona sit under the state mandate above. State Medicaid baseline: AHCCCS (Arizona Medicaid) guide →

New YorkMandate: NY autism mandate (Ins. Law §§ 3216(i)(25), 3221(l)(17), 4303(ee))

Fully-insured ASR Health Benefits plans issued in New York sit under the state mandate above. State Medicaid baseline: New York Medicaid (NYS DOH / eMedNY) guide →

New MexicoMandate: New Mexico autism insurance mandate (NMSA 1978 § 59A-22-49)

Fully-insured ASR Health Benefits plans issued in New Mexico sit under the state mandate above. State Medicaid baseline: New Mexico Medicaid (Turquoise Care) guide →

MissouriMandate: Missouri autism insurance mandate (RSMo § 376.1224)

Fully-insured ASR Health Benefits plans issued in Missouri sit under the state mandate above. State Medicaid baseline: MO HealthNet (Missouri Medicaid) guide →

TexasMandate: Texas autism mandate (Tex. Ins. Code § 1355.015)

Fully-insured ASR Health Benefits plans issued in Texas sit under the state mandate above. State Medicaid baseline: Texas Medicaid (THSteps-CCP) guide →

MassachusettsMandate: ARICA — Ch. 207, Acts of 2010 (M.G.L. c. 175 § 47AA et al.)

Fully-insured ASR Health Benefits plans issued in Massachusetts sit under the state mandate above. State Medicaid baseline: MassHealth (Massachusetts Medicaid) guide →

FloridaMandate: Steven A. Geller Autism Coverage Act (§ 627.6686, Fla. Stat.)

Fully-insured ASR Health Benefits plans issued in Florida sit under the state mandate above. State Medicaid baseline: Florida Medicaid — Behavior Analysis Services (AHCA) guide →

KansasMandate: Kansas autism insurance mandate (K.S.A. 40-2,194)

Fully-insured ASR Health Benefits plans issued in Kansas sit under the state mandate above. State Medicaid baseline: KanCare (Kansas Medicaid) guide →

NebraskaMandate: Neb. Rev. Stat. § 44-7,106 (autism coverage, 25 hr/wk cap)

Fully-insured ASR Health Benefits plans issued in Nebraska sit under the state mandate above. State Medicaid baseline: Nebraska Medicaid (Heritage Health) guide →

IdahoMandate: No autism statute — DOI Bulletin 18-02 (habilitative-parity floor, plan years from 2019)

Fully-insured ASR Health Benefits plans issued in Idaho sit under the state mandate above. State Medicaid baseline: Idaho Medicaid guide →

IowaMandate: Iowa autism mandates (Iowa Code §§ 514C.31, 514C.28; caps and age limits removed by H.F. 330 from 1/1/2026)

Fully-insured ASR Health Benefits plans issued in Iowa sit under the state mandate above. State Medicaid baseline: Iowa Medicaid (IA Health Link) guide →

OklahomaMandate: Nick’s Law (36 O.S. § 6060.21; age and hour caps removed 2022)

Fully-insured ASR Health Benefits plans issued in Oklahoma sit under the state mandate above. State Medicaid baseline: Oklahoma Medicaid (SoonerCare / SoonerSelect) - Oklahoma Health Care Authority guide →

MichiganMandate: Michigan autism mandate (MCL 500.3406s, 550.1416e; through age 18, $50K/$40K/$30K caps allowed)

Fully-insured ASR Health Benefits plans issued in Michigan sit under the state mandate above. State Medicaid baseline: Michigan Medicaid guide →

HawaiiMandate: Luke’s Law (HRS § 431:10A-133; under 14, $25,000/yr ABA cap)

Fully-insured ASR Health Benefits plans issued in Hawaii sit under the state mandate above. State Medicaid baseline: Hawaii Medicaid (Med-QUEST / QUEST Integration) guide →

CaliforniaMandate: SB 946 autism mandate (H&S § 1374.73, Ins. Code § 10144.51; no age or dollar caps)

Fully-insured ASR Health Benefits plans issued in California sit under the state mandate above. State Medicaid baseline: Medi-Cal (California Medicaid) guide →

PennsylvaniaMandate: Act 62 of 2008 (40 P.S. § 764h; under 21, CPI-adjusted cap $51,908 for 2026)

Fully-insured ASR Health Benefits plans issued in Pennsylvania sit under the state mandate above. State Medicaid baseline: Pennsylvania Medicaid (Medical Assistance) guide →

New HampshireMandate: RSA 417-E:2 autism coverage (HB 569, 2010; no age or dollar caps in current text)

Fully-insured ASR Health Benefits plans issued in New Hampshire sit under the state mandate above. State Medicaid baseline: New Hampshire Medicaid guide →

Intake gates

The questions that decide whether a family can start with ASR Health Benefits, and what they have to bring. Each maps onto something intake should ask on the first call.

Age limitPlan-dependent

Plan-dependent - confirm any age limit in the employer plan document.[1][2]

Ask the plan: Obtain the employer group plan document and confirm its ABA requirements with ASR Claims Department at (800) 968-2449 or (616) 957-1751.

Referral required?Plan-dependent

Plan-dependent - confirm whether this employer group requires a physician referral or order for ABA.[1][2]

Ask the plan: Obtain the employer group plan document and confirm its ABA requirements with ASR Claims Department at (800) 968-2449 or (616) 957-1751.

Diagnosis recencyUnverified

Diagnosis recency has not been verified.[1][2]

Blocked on: Ask ASR for the diagnosis recency requirement and the applicable group plan criteria.

What intake should collect for ASR Health Benefits
Employer name and group number — Use both to identify the employer plan whose ABA benefits must be checked.
Member ID and both sides of the card — Capture the administrator, network and plan-specific contact details.
Plan document and ABA terms — Obtain coverage, diagnosis, referral, prior-authorization, age and service-limit requirements for this employer group.
Plan funding and other coverage — Confirm plan type and other insurance before relying on state coverage rules or deciding payer order.
Download the free verification-call checklist (PDF)

Common questions

Does ASR Health Benefits cover ABA?

Coverage depends on the employer group plan. Obtain its plan document and confirm ABA coverage, diagnosis requirements and authorization before scheduling services.

Is Health Alliance TPA the same administrator as ASR Health Benefits?

ASR announced its rebrand to Health Alliance TPA by Henry Ford Health in May 2026. The announcement says member coverage, benefits and provider networks are unchanged by the name change.

Primary sources
  1. ASR Health Benefits - About Us
  2. ASR Health Benefits - Contact Us
  3. ASR Health Benefits rebrands as Health Alliance TPA by Henry Ford Health
  4. ASR Health Benefits - Home

Payer policies change frequently and vary by plan, state, and funding type. This guide was compiled from the sources above and last reviewed October 2026; it is general information, not billing, legal, or clinical advice. Always verify current requirements against the payer's live policy and a benefits check for the specific member.

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