Do you have health insurance provided through your employer? Does your plan cover mental health care? If it does, a recent update to the law will interest you.
Louisiana employee benefit plans are affected by a recent low profile decision concerning group health insurance. The MHPA, or the Mental Health Parity Act, has been extended through the very end of this year. The president recently signed his approval to extend the 1996 bill until December 31st.
Millions of Americans are provided health care coverage through their employers. The Employee Benefits security Administration, or EBSA, enforces the federal regulations regarding all of the various group health care plans that are employer provided. The MHPA states that any group health insurance plan that provides the funding for mental health treatment has to do so at an equal rate as it covers other medical treatments, including surgery.
In 1986, EBSA was actually called PWBA, or the Pension and Welfare Benefits Administration. Before that, when it began in 1974, it was known as the Pension and Welfare Benefits Program. The Employee Benefits security Administration is currently the most appropriate name, because they deal with just as many health care issues as they do pension problems.
Normally, mental health insurance covers psychiatric visits, drug or alcohol rehabilitation, and inpatient mental health care (in a hospital or mental health facility). Treatments for depression and post-traumatic stress are also often covered. Regardless of which treatment is being covered, it should not be covered at a lower rate than medical types of treatment.
The annual limits on mental health must also be at least equal to those of other medical treatments. If the annual limit for the coverage of surgery is $120,000 that has to be the minimum at which mental health treatment is covered. Anything less than that would be a violation of the law.
Here’s good news for anyone covered by a Louisiana employee benefit plan. A recent ruling extends benefits under the MHPA.
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.
As you may remember, several years ago the MHPA was enacted to ensure that healthcare plans that covered mental health, did so at the same level as other medical treatments such as surgery.
The ruling EBSA issued recently impacts Louisiana 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.
This law requires that group health insurance plans place the same limits on mental health coverage that they place on other medical treatments. Insurance companies used to be able to set a maximum lifetime benefit for medical treatments and surgery at one amount and then set a lifetime benefit maximum for mental health treatments at a lower amount. MHPA requires that these amounts be the same.
For instance, if a group health insurance plan has a lifetime maximum benefit for surgery or other medical treatments of $250,000, the lifetime maximum benefit for mental health treatments also has to be $250,000. This rule also applies to the benefit amounts allowed per year. The coverage amount allowed for medical treatments must be the same as the amount allowed for mental health treatments.
If a business has a group health insurance plan that does not cover mental heath treatments, MHPA has no impact. This law only applies to group health insurance plans that have coverage for mental health treatments.