Any insurer that decides to include mental health coverage in their plan must provide the same benefits as it does with other types of medical treatments. That is required by the Mental Health Parity Act, or MHPA, enforced by the EBSA.
The MHPA is very important for Delaware employee benefit plans, because will be valid for some time. The MHPA was initially approved in 1996, and included an expiration date of September 21, 2001. But, the expiration has been postponed 5 times. The most recent extension determined that the law is in effect until December 31, 2007.
Prior to 1996, when there wasn’t any law in force, a health insurance plan could give mental health treatments secondary status. A plan might include coverage of $80,000 per year for surgery but $10,000 or less for mental health treatments. The MHPA makes this practice illegal, and any insurer that includes mental health treatments in their plan must cover them on the same basis as other plans.
What are considered mental health treatments under healthcare plans? In general, the category includes appointments with therapists, psychologists or psychiatrists. They also cover treatment for alcohol use or drug dependency, which frequently require periods of rehabilitation. Depression, schizophrenia, and post-traumatic stress, are other ailments frequently covered. Many cases involve admission to mental clinics or mental health divisions of hospitals.
The Employee Benefits Security Administration, or EBSA, is the federal agency that enforces the MHPA. In the US, more than 150 million workers have health insurance under plans that the EBSA oversees.
The EBSA has changed its name several times, and their objectives were adjusted from time to time. The agency was created in 1974, when the Employee Retirement Income Security Act, or ERISA, was approved, with the initial purpose of enforcing this law. In those years, the agency’s name was the Pension and Welfare Benefits Program. In January 1986, the agency’s name changed yet again, and it became known as the Pension and Welfare Benefits Administration, or PWBA. In 2003, the agency received its current name, which reflects the agency’s purpose. Now the EBSA must deal with infringements of the laws regarding both pensions and healthcare.
The latest news out of Dover concerns Delaware employee benefits. Governor Ruth Ann Minner recently launched a new program in conjunction with the State Employment Benefits Committee. The DelaWELL plan applies to workers employed by the state government.
DelaWELL is a voluntary employee health and wellness initiative that will include a personalized health risk assessment, a comprehensive education program, and a lifestyle plan tailored for each participant.
“Our state employees are a vital resource in ensuring Delaware’s continued success,” Gov. Minner said. “As Governor, I know that investing in our state employees’ continued health is critical. DelaWELL will not only provide employees the opportunity to achieve a healthy lifestyle goal, but it will complement our other successful health initiatives, such as the Know Your Numbers Campaign.”
The program will begin with a health risk assessment. This confidential risk assessment is handled through a questionnaire designed to evaluate each person’s health status. After completing the health risk assessment, state workers will receive a personal report that includes feedback, tools and resources to assist them in making important lifestyle changes. An applicant with high blood pressure might be given information on weight control and exercise, for example.
Another feature of the DelaWELL program is personalized lifestyle and disease management coaching programs. Programs are offered for common conditions such as asthma, diabetes and coronary artery disease. The program also includes extensive online health resources including:
Health education center
Daily health updates
If all that doesn’t motivate state employees to get healthy, the program’s incentives will. The DelaWELL program will offer periodic prizes, and limited financial incentives for star performers. All the prizes will be health-related.
Plan participants in a high-risk category will also have unlimited access to a professional healthcare coach via helpline. All of these features place Delaware in the forefront of providing preventative healthcare to state employees.
If you’ve been paying attention to the business news, you know that there is a buzz around the state’s Other Post Employment Benefits for retirees, or OPEB. Here’s the problem in a nutshell: although many retired state workers were promised health care benefits, the state lacks the funds to pay for them.
Delaware currently maintains a balance of approximately $25.2 million for OPEB requirements funded through a payroll charge of 0.3% of payroll. The current actuarial liability for OPEB benefits is almost 15 times higher, at $3.2 billion.
Recently, Delaware Governor Ruth Ann Minner reported that $30.5 million has been allocated to the OPEB. These funds don’t come out of the state’s current budget. Instead, they were made available through a surplus in the state employee health insurance funds. With the cooperation of the Sate Employee Benefits Committee (SEBC), the Governor has reallocated the funds.
“Throughout the years, Delaware has maintained a long-standing record of responsible fiscal stewardship,” Gov. Minner said. “By addressing our OPEB liability through the use of surplus health insurance funds we have laid the groundwork for a comprehensive approach to this important issue.”
In 2004, the Governmental Accounting Standards Board announced measures that would require state and local governments to report the liability for post-employment benefits, specifically, health and prescription drug benefits for retirees on their financial statements.
“The State Employees Benefit Committee has worked hard over the course of the Minner administration to aggressively control rising health care costs for state employees and retirees,” according to Jennifer Davis, Director of the Office of Management and Budget. Davis is also chair of the SEBC. She adds that through the success of a variety of programs, the state has been able to gain more control over rising prescription drug costs and other health care expenses. The $30.5 million is a surplus generated through these savings. According to Davis, it’s a “prudent and appropriate decision” to redirect the surplus to ensure the financial health of the retiree health program.
Now on to the First State, Delaware, which will always go down in American history as the first former colony turned state to sign the Constitution. But what if you are a first time employer? What do you sign to make sure that you are OK with the law in the First State?
All first time employers in the state of Delaware are instructed to sign and fill out a Form UC-1, or a Report to Determine Liability and If Liable Application for Employer Account Number form. Try to say that one five times fast!
Employers in Delaware are supposed to have this Report to Determine Liability and If Liable Application for Employer Account Number form filled out and submitted no later than 20 days after their first day as an employer. And don’t worry about copying the Report to Determine Liability and If Liable Application for Employer Account Number and sending it in to all of the correct departments in the state. One Report to Determine Liability and If Liable Application for Employer Account Number form is enough—the state makes sure that seven state agencies get their hands on it.
But there is just one place for getting this Report to Determine Liability and If Liable Application for Employer Account Number form. You need to contact the Delaware Unemployment Insurance Employer Contributions Unit. You will be expected, once you are determined to be liable for unemployment insurance, to provide taxes on the first $8500 of wages for every employee on your roll books.
The percentage tax rates that you pay on those wages are determined by the state by the way you are paying your taxes. There is a pay rate for new employers, for employers who owe taxes, a rate determined by how much unemployment insurance your past employees have collected, and a rate for businesses that are bought or acquired.
In addition to Delaware Unemployment Insurance posters, materials from the Delaware Department of Labor emphasize what employers can do to minimize their unemployment insurance tax premiums. Delaware depends on t he employer, to supply information necessary to process claims promptly and efficiently. This can be done by maintaining the required employee records in the required form, posting the Delaware Unemployment Insurance posters, and posting a statement of the employer’s policies regarding unemployment insurance.
For example, employers have the responsibility to provide prompt and accurate information to insure that only those claimants meeting the necessary eligibility requirements will receive benefits. This action will avoid unnecessary charges to your account. It is noted that without employer representation at an appeals hearing, there is only the employee’s account of the separation for use in a determination.
In the case of a firing, the burden of proof is on the employer to show that it was for just cause. Employers are encouraged to document employee actions that lead to termination for cause and by having the employee sign it.
Delaware Unemployment Insurance posters provide employees information regarding their right for coverage and other relevant information. To be eligible an individual must have earned a minimum amount of wages, be able to work, available for work and actively seeking work, and register for work with the Division of Employment and Training (unless exempt by law) at the Unemployment Insurance Claims Office.
When filing, the applicants are required to provide their name, address, social security card (may substitute W2 or pay stub with name and social security number imprinted on it, accompanied by picture ID such as driver’s license), work history – names and addresses of all employers over the last 18 months, and reason for loss of job.
The Delaware Unemployment Insurance posters are currently available.