H&W Mental Health Parity.  Does your health plan measure up?

The Mental Health Parity Act mandates that Group Health Plans that provide mental health coverage must provide parity between medical benefits and mental health/substance use disorder benefits.  Meaning that financial coverage for mental health and substance use disorder benefits cannot be more restrictive than the financial requirements applied for medical benefits under the plan.  This includes things like deductibles, co-payments, out-of-pocket expenses, etc.

To assist entities in determining whether or not their group plan(s) are compliant with regard to Mental Health Parity, the Employee Benefits Security Administration provides a self-compliance tool that you can walk through answering various questions about your plan and the coverage it provides.  Along with these questions, the tool also provides definitions and explanations of the various regulations that provide guidance for each question that it walks through.

Be warned, the tool is not something you can expect to fly through on a lazy afternoon.  The roadmap it provides will require some in-depth time spent reviewing your plan(s).  However, the exercise it provides is a good process to help you further understand Mental Health Parity requirements.

Please note that the Mental Health Parity Act does not require a group health plan to offer mental health or substance use benefits. It also does not require that plans cover any specific type of mental health disorder or treatment. However, where mental health or substance use disorder treatments are covered, the parity rules apply.

For additional information relating to Mental Health Parity that is written in layman terms, there is an activity and reference material available on Compliancedashboard.