It’s time for group health plans offering mental health or substance abuse benefits to examine their policies to see if they’re in compliance with laws that take effect in 2010.
The Mental Health Parity and Addiction Equity Act of 2008 was passed last fall and is set to take effect on Jan. 1, 2010.
It says employers will now have to offer equivalent costs and treatment limits for mental health and substance abuse benefits as medical and surgical benefits.
So if your health plan offers mental health or substance abuse benefits, it cannot have:
- lower annual or lifetime dollar maximums for those benefits as medical and surgical benefits
- more restrictive limits on the number of covered office visits or days of inpatient care to treat mental health or substance abuse
- higher copays, deductibles or out-of-pocket limits for mental health and substance abuse treatments
- separate cost sharing applied to mental health and substance abuse benefits, or
- exclusions for out-of-network treatment for mental health and substance abuse issues — if out-of-network treatment is provided for medical and surgical issues.
Employers will need to realign their benefits policies to meet these new requirements. These new regs must also be reflected in at-a-glance summaries and summary plan descriptions.
Note: Employers with 50 or fewer employees during the preceding calendar year are not required to comply with these new regs.
