Maryland Employee Benefits

May 8th, 2007 Posted by Amelia

If your employee – or employer – is driving you crazy, there’s a better chance that it will be covered under your group health insurance plan. A recent ruling has extended the Mental Health Parity Act (MHPA) until December 31, 2007.

If you’re an employer with a health plan that includes mental health treatment, did you know that the caps on benefit amounts for that care cannot be lower than the limits on other medical care?

The act will have a strong effect on Maryland employee benefit plans, and nationwide applies to 150 million employees. The ruling extending the law comes down from the Employee Benefits Security Administration (EBSA).

This law doesn’t require that every health insurance plan cover mental health treatments. It simply mandates the level of coverage, if mental health treatments are included.

In requiring parity between mental and physical health plans, the MHPA says in essence that group health insurance plans must not put a lower limit on payments for mental health coverage than for it does other coverage. In short, it is illegal for a health insurance plan, for example, which sets a maximum benefit of $250,000 for surgery and $15,000 for treatment in the mental health field. Under the law, the mental health coverage limit must also be $250,000.

The MHPA, passed in 1996, included what is called a “sunset clause.” In other words, it had an expiration date. That date was September 31, 2001. Since that time, however, the law has gone through five amendments extending that expiration date. The latest ruling received little attention when information about it was released.

What is considered covered under mental health treatment? The list includes visit to licensed therapists or other mental health professionals, such as psychiatrists and psychologists. It also includes stays in mental health facilities – whether mental hospitals or the mental health section of medical hospitals for illnesses ranging from depression and schizophrenia to post-traumatic stress disorder.

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