ADA and Health Plan (Self-Insured) Autism Coverage

[Guest mhaysesq]

My client (plan sponsor of a self funded) group health plan is being asked to consider adding coverage for both therapies and ABA for covered individuals with autism spectrum disorders but not any other developmentally impairing condition (eg. Fragile X). Currently such treatments are excluded under the plan by the general educational, custodial and developmental coverage exclusion, or in the case of ABA under medical necessity/investigational guidelines. (The plan is not required to cover under ACA or any state law because it is self funded.) We are struggling with the potential for an autism only benefit to result in claims under the ADA by employees whose children have a need for such treatment but who have a condition that is not on the autism spectrum under the "subterfuge" exception to the bona fide plan rule. There seems to be little guidance on the subject and no recent case law. Any thoughts?