Illinois Health Care Benefits Changes

May 25th, 2007 Posted by Mark

If we had to list the priorities of this blog, I don’t know if we could do it. There’s of course the federal minimum wage issue (which we have a lot to talk about tomorrow), there are all of the state minimum wage issues, not to mention family and medical leave issues, health care issues, worker safety issues and safety poster requirements—and we haven’t even listed workers’ comp yet. So no, all of these topics are just as important as the next. It’s like trying to pick a favorite child out of your sons and daughters.

It just so happens, though, that the next topic is near and dear to my heart—health care benefits—but don’t be getting any ideas that I like talking about it more than the federal minimum wage or the FMLA federal labor law poster. It just happens to be next on my list of things to talk about.

Now that I have that all cleared up, let’s get into the nitty gritty of it—the state of Illinois’ legislature just passed a bill that would make dramatic and important changes to the way that health care benefits are done in the state. If this law gets signed by the governor of Illinois, it would prevent health care insurance companies from rejecting claims made by people who got hurt while they were drunk or high on drugs.

The law was already passed by both the House and the Senate in the state, so it is a matter of time before it hits the governor’s desk. It would be interesting to see just what sort of effect this law would have on the health care insurance premiums of employers in Illinois. I would suspect it would not make them any cheaper. At the moment, Oregon just passed a similar law earlier in the month, and Washington DC, Maryland, Delaware, and Indiana have similar laws.

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Illinois Employee Benefit

May 8th, 2007 Posted by Amelia

A bill putting mental health insurance coverage on a par with surgery and other medical procedures has just been extended to the end of 2007.

The ruling by an agency that monitors compliance with health insurance and pension laws applies to 150 million workers nationwide, and has a dramatic influence on Illinois employee benefit plans.

The law is the Mental Health Parity Act, or MHPA, passed originally in 1996, and was just extended through a ruling by the U.S. Employee Benefits Security Administration (EBSA). Benefits under the bill are now valid at least through December 31, 2007.

Mental health treatment includes the following:

  • Visits to a psychologist, licensed therapist, or psychiatrist.
  • Stays in rehabilitation facilities for drug or alcohol dependencies.
  • Stays in mental hospitals or the mental health sections of hospitals for such ailments as schizophrenia, depression, and post-traumatic stress disorder.

The law does not mandate that all health insurance plans include treatment for mental health. What it requires is that, if an existing health plan already includes mental health benefits, those benefits cannot have a lower limit on payments than those for medical and surgical treatment.

Annual caps on benefit amounts must be equal. In other words, mental health coverage must be the same as the limits – whether lifetime or annual – of other treatments. The coverage may not put a lower lid on mental health coverage. For example, before the advent of the law, a plan could clamp a lifetime benefit limit of a quarter of a million dollars for medical/surgical treatment, but just $15,000 for mental health care. Under the MHPA, however, any plan putting a $250,000 lid on medical care must put the same among on mental health treatment.

The ruling by EBSA was released without attention. In essence, it continues the MHPA through the end of 2007. The MHPA has been amended five times to extend its original “sunset clause” expiration date beyond September 31, 2001.

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