Illinois employee benefits plans will be impacted by a recent ruling. This ruling, made by the US Employee Benefits Security Administration, impacts employers who have health insurance plans that cover mental health treatments. The US Employee Benefits Security Administration (EBSA) is a federal agency that monitors compliance with pension and health insurance laws.
The ruling EBSA issued recently impacts Illinois employee benefits plans because the Mental Health Parity Act, also known as MHPA, has been extended. The Mental Health Parity Act has been a law since 1996, and even though it was to expire at the end of September, 2001, the law’s expiration date has been extended 5 times.
The Mental Health Parity Act requires group health insurance plans that cover mental health treatments not place a lower payment limit for this coverage than for other coverages, such as surgery. For instance, in the past group health insurance plans could set lifetime surgery benefit maximum of $250,000 but place the mental health treatment benefit lifetime maximum at $15,000. MHPA makes this kind of disparity illegal. Now, if $250,000 is the lifetime benefit maximum for surgery and other treatments, then this same amount has to be the lifetime benefit maximum for mental health treatments.
MHPA also applies to annual benefit limits. The annual benefit maximum established by the group health insurance plan for surgery and other medical treatments must be the same amount allocated for mental health treatments. These treatments can include visits to counselors such as psychiatrists, psychologists, and licensed therapists. Other mental health treatments included are mental hospital stays for conditions such as schizophrenia and depression. In addition, covered treatments also may include stays in rehab centers to treat drug and alcohol dependency.
MHPA only applies to group heath insurance plans that include treatments for mental health conditions. The Mental Health Parity Act does not mandate that mental health treatments be included in all group health insurance plans.