Summary — HB 523: “First Responders Mental Health” (First Responders Mental Healthcare Plan Act)
Status / Context
- Commonly filed in North Carolina as the “First Responders Mental Healthcare Plan Act” (HB 523). Versions were introduced in 2023 and again in 2025; the bill has undergone committee referral and reading activity. The text summarized below reflects the substantive provisions that establish a supplemental mental–health insurance program for first responders.
Purpose
- Establish a supplemental insurance benefits program to support first responders diagnosed with employment‑related mental health conditions, promote recovery, and facilitate return to service.
Key definitions
- First responder: broad category including law enforcement officers (and dispatchers), firefighters (including volunteers, inspectors, marshals, and fire dispatchers), EMTs and emergency medical dispatchers, 911 dispatchers, detention/correction/probation officers, and first responders employed by state, local, or nongovernmental entities.
- Eligible mental condition: medically diagnosed anxiety disorders, conduct disorders, depressive disorders, obsessive‑compulsive and related disorders, sleep‑wake disorders, and trauma/stressor‑related disorders (per the most recent DSM).
- Program administered by the State Department of Insurance as a supplemental insurance policy.
Eligibility
- Must be a currently employed first responder.
- Must have a diagnosis from a healthcare provider who finds, to a reasonable degree of medical certainty, that the condition resulted from a singular incident or the cumulative effect of employment‑related activities, and that it arose while acting within the scope of employment.
- Not eligible if already receiving mental‑condition benefits under the State’s Workers’ Compensation Act.
Benefits (major provisions)
1. Medical cost reimbursement
- Up to $5,000 per 12‑month period for out‑of‑pocket medical expenses (deductibles, copays, coinsurance) for the eligible mental condition. Receipts required. Not combinable with the disability benefit.
2. Salary benefit (short‑term leave)
- If treatment requires leave (e.g., FMLA or local leave) and documentation is provided, a full‑time first responder receives a monthly benefit equal to either 75% of monthly salary or $5,000 per month, whichever is less.
- Benefit may be used up to 12 workweeks in any 12‑month period. This can be combined with the medical reimbursement benefit.
3. Disability benefit (longer‑term)
- After six months from onset of total disability or inability to perform duties, disability benefits begin.
- For full‑time non‑volunteer first responders: monthly benefit equal to 75% of monthly salary or $5,000 per month, whichever is less.
- For volunteer firefighters: $1,500 per month.
- Benefits are limited to a maximum of 36 consecutive months.
- Benefits are subordinate to other sources of disability payments (except private insurance purchased solely by the first responder); the program covers the difference up to the statute’s amounts.
- Re‑evaluation provisions allow benefits to cease if recovery is certified.
Administration, timing, and other notes
- Program to be administered by the Department of Insurance.
- Some bill text versions specify an effective date of January 1, 2024; timing may vary by filing/version and session.
- The bill requires medical documentation and proof of employment‑related causation; processes for claims, verification, and coordination with other benefits are to be implemented by the administering entity.
Potential impacts
- Direct financial effects depend on enrollment, prevalence of qualifying conditions, benefit utilization, and premium or funding design (the bill text creates the benefit framework but does not specify premium funding mechanisms in the text summarized).
- Employers and insurers may incur administrative workload for verification and coordination with workers’ compensation and other disability sources.
- Intended policy effects: increase access to treatment, support return to work, and provide income and medical expense relief for eligible first responders with work‑related mental health conditions.
Note: Multiple jurisdictions and unrelated bills also carry the HB 523 number in different states/sessions; this summary pertains to the North Carolina “First Responders Mental Healthcare Plan” text contained in the provided materials.
