Connecticut Employee Benefit

May 7th, 2007 Posted by Amelia

A bill requiring that mental health benefit limits equal those for surgery and other medical procedures has been extended again, this time until the end of 2007.

The ruling affects all employers whose health plans include mental health benefits.

The extension of the Mental Health Parity Act, known as the MHPA, will have a major impact on Connecticut employee benefit packages. Nationwide, it applies to more than 150 million employees.

The law does not demand that employers’ health plans must cover mental health – only that if a plan has mental health coverage, it should be on a par with surgical or other medical treatments. The payment limits must be the same.

The Employee Benefits Security Administration, or EBSA, issued the ruling. The agency is the watchdog group guaranteeing adherence to health insurance and pension law compliance.

The law was originally enacted in 1996, and through a “sunset clause” expired on September 31 of 2001. Five amendments have extended that expiration date since then. The new ruling received little attention when it was released recently.

In requiring parity between mental and physical health plans, the MHPA says in essence that group health insurance plans must not put a lower limit on payments for mental health coverage than for it does other coverage. In short, it is illegal for a health insurance plan, for example, which sets a maximum benefit of $250,000 for surgery and $15,000 for treatment in the mental health field. Under the law, the mental health coverage limit must also be $250,000.

The law puts the same restrictions on annual caps of benefits. In short, mental health coverage must equal the lifetime or annual caps for treatment such as surgery or other medical work.

Mental health treatments involve a wide array of services. It includes stays in rehab clinics for dependency issues, as well as visits to a psychiatrist, psychologist, or licensed therapist. Depression, post-traumatic stress disorder, and schizophrenia are among the many conditions covered.

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