As part of the economic-emergency legislation, Congress passed and made permanent the Mental Health Parity and Addiction Equity Act. It sets out the new requirements for employer-sponsored health coverage.
First, let’s cover what the act isn’t. It’s not a mandate that your health insurance must offer benefits for mental health benefits or addiction treatment. Employers still have the choice of whether they want those types of coverages for their employees.
Now, let’s consider what the act prohibits if you offer benefits for mental health and addiction treatment:
- Group health plans (or health insurance coverage offered by such plans) can’t impose more burdensome financial requirements or greater cost-sharing for mental health or substance-use-disorder benefits than are required for substantially all medical or surgical benefits covered by the plan. So you can’t have higher deductibles and co-pays for mental-health and addiction treatment.
- Your plan can’t impose stricter treatment limitations on mental-health or substance-use-disorder benefits than those that apply to substantially all medical or surgical benefits.
- And your plan can’t impose treatment limitations only on mental health or substance use disorder benefits.
Two notes: (1) For most plans, the act goes into effect January 1, 2010. (2) The act doesn’t apply to companies that have fewer than 50 employees.
