labor lawAdivision of labor law center

Iowa employee benefit plans will continue to include mental health treatment coverage on a par with medical and surgical coverage thanks to the extension of the bill known as MHPA.

The bill is the Mental Health Parity Act. It has been extended to December 31 of 2007 after being signed into law by the President.

As the name suggests, it assures that all group health plans include a mental health component that is equal in coverage limits to their limits on corresponding medical/surgical treatment coverage.

The MHPA has been given new life five times through amendments, since its original expiration date of September 31, 2001. That was because the original bill, signed into law in 1996, included what is called a “sunset clause,” effectively causing it to expire unless extended.

The bill impacts the roughly 150 million workers who are covered by group health insurance plans. Before the MHPA, health plans could have ceilings on mental health treatment coverage that were much lower than those on medical and surgical treatment. For example, a plan might have a $100,000 yearly limit on medical and surgical procedures, but just $5,000 or $10,000 for mental health treatment. Under MHPA, that is against the law.

Some of what is included in mental health treatment coverage is:

• Stays in rehabilitation facilities for drug and alcohol abuse problems.
• Stays in psychiatric centers, or mental hospitals, for treatment of a wide variety of illnesses such as schizophrenia, depression, and post-traumatic stress disorder.
• Visits to mental health professionals. These include licensed therapists, psychologists, and psychiatrists.

The Employee Benefit Security Administration (EBSA) is the enforcing federal agency. It was originally created in 1974 to oversee enforcement of the Employee retirement Income Security Act (ERISA) of 1974. Since then it has gained sub-cabinet level status and its mandate includes health care as well as pension oversight. The upgrade came in 2003. It is now under the auspices of an Assistant secretary of Labor.

The Iowa Workers’ Compensation law requires most employers to provide wage loss and medical benefits to employees who are injured while working.

In Iowa, an injury may include any health condition caused by work activities other than the normal building up and tearing down of body tissues. Diseases and hearing losses caused by work activities or exposures are also injuries. Preexisting health conditions are not considered injuries unless work aggravates or worsens them.

The employer has the right to choose the medical care and must provide medical care reasonably suited to treat an injury. If a worker is dissatisfied with that care, they should discuss the problem with their employer (or its insurance carrier). The employee can request alternate care, and if an employer (or its carrier) does not allow that care, they may file a petition for alternate medical care before the Iowa Workers’ Compensation Commissioner.

An employer must pay for all reasonable and necessary medical care required to treat an injury. This includes reasonable and necessary travel expenses for treatment. An employer may also pay temporary total disability, temporary partial disability, permanent partial disability benefits, or permanent total disability benefits.  If an employee dies from a work-related injury, their dependents may receive benefits as well.

Unless an employer has notice or knowledge of a worker’s asserted injury within 90 days of its occurrence, the employee may be denied benefits. When an employee reports a work related injury, the employer must file a first report of injury if the employee loses more than three days of work, or sustains permanent injury or death on account of the injury. The employer (or its carrier) must file the first report within four days of notice or knowledge of the alleged injury with the Workers’ Compensation Commissioner.

A worker must receive Iowa weekly workers’ compensation benefits or file an application for arbitration within two years of an alleged injury or benefits may be denied.

The employer must post the Iowa Workers’ Compensation Benefits notice in a prominent place in their business.