Your employer’s health insurance plan does not have to include therapy, counseling, or even a stay in a psychiatric center or the mental health section of a hospital.
You may already know that. But did you know that when a group health insurance plan does include mental health treatment, the limits of that treatment must equal the limits of other treatments like surgery? There was a time when insurers could set lower limits on mental health treatment. But since 1996, that has not been the case.
Federal law guarantees that Oregon employee benefits include this equal coverage, or “parity,” thanks to the Mental Health Parity Act of 1996. The MHPA was extended in February of 2007 until the December 31 of 2007. The MHPA is enforced by a special agency that was originally created to deal with violations of the laws regarding pensions. Since then its responsibilities have been extended to include employee benefits. The agency is the Employee Benefits Security Administration. Some 150 million employees throughout the U.S. are covered by the EBSA’s enforcement powers.
Before the MHPA was passed in 1996, a group health insurance policy could offer substantial coverage limits for physical health treatments, but comparatively very low limits for mental health treatments. For example, the plan could have a $100,000 yearly limit on surgery but little more than a hundredth of that, of $1,500 a year, for any kinds of treatments related to mental health. Since the passage of the law, such disparities have been illegal.
When it was passed in 1996 the MHPA included a provision that would have caused it to expire on September 30 of 2001. But the act was extended, and has been extended a total of 5 times, to keep it alive. Those frequent extensions imply that the MHPA will probably be around for a long time to come.
Most employers now offer group health insurance plans that include mental health treatment coverage.
Obtaining mental health care need not present so much of a problem for Oregon employee benefit plan participants.
There are over 150 million workers that are covered by group health insurance plans throughout the United States.
The president signed a law called the Mental Health Parity Act, or MHPA, which was recently extended through December 31, 2007.
This means that the original bill of 1996 has been extended. It originally included a “sunset clause.” This meant that it was due to expire on September 31, 2001. But after 5 amendments, the expiration date has been extended.
In 1974, the Employee Benefits Security Administration was created. One of its purposes was to enforce the Employed Retirement Income Security Act of 1974. This has become known as ERISA. This agency was previously known as the Pension and Welfare Benefits Program. The name was changed again in January 1986. This time it became known as the Pension and Welfare Benefits Administration, also known as PWBA.
This agency was upgraded in 2003. It was upgraded to sub-cabinet level. The Assistant Secretary of Labor has oversight of the present agency.
The new name is meant to show that the agency handles both pensions and violations of law regarding health care.
The Mental Health Parity Act means that it is illegal for public health care plans to set a limit on funds available for the treatment of mental illness at a much lower rate than funds available for the treatment of other medical conditions.
In the past, employees have found that while in some cases as much as $100,000 per year or more is available for the treatment of medical illnesses, when it came to finding funds for the treatment of mental illness it was much less. In some cases, it would amount to only $5,000 to $10,000 dollars, or sometimes even less.
The Oregon leave law would not cover all employers in its requirements for them to give the right of unpaid time off to victims of domestic violence, sexual assault, or stalking. Instead, the bill as passed now would only require that certain employers with six or more employees on their pay roll have to follow the law. And the law would not be binding even for employers with six or more employees on their books.
According to my sources, the law allows employers to request that workers come back to work any time their unpaid time off starts to become a burden for the employer. Employees could also use vacation time and other paid time off in order to get paid while they are on this break as well. The official terms for this might be undue hardship on the employer, and that the unpaid time off period must also be for a “reasonable” amount of time. I guess that would leave it up to the employer and the employee to determine exactly what is “reasonable” when it comes to the length of their unpaid time off, and that could also open up interpretation to lawyers and the courts.
The bill, however, does say that the Bureau of Labor and Industries in the state would play the roll of regulating and administering the unpaid leave system, and the bureau would also set the specific guidelines for whether or not a new Oregon labor law poster will be required, and how the unpaid leave time will work.
But I am getting ahead of myself here. The law still needs to go to the House in Oregon and get passed as is by them. If the House makes any changes to the law, then it would need to go back to the Senate, and they would need to OK those changes. If those changes could not get ironed out, then the bill will stall. Or the House could simply not vote on the bill at all.
A similar bill as the one in Washington is under consideration in the legislature of a neighbor up there in the Pacific Northwest. Oregon is considering a type of time off law, though it will not be as extensive as the one proposed in Washington, where the family leave law will allow workers to take five weeks paid leave off to care for a sick family member or heal up themselves.
In the case of the Oregon leave law, the bill is specifically for those workers who just suffered through a domestic violence issue, or who have been sexually assaulted or stalked recently. The law would give these particular victims the right to take unpaid leave off from their jobs in order to get treatment, heal, and take care of themselves. The other obvious difference between the Oregon bill and the Washington bill is that the Washington bill gives the workers paid time off, but the Oregon bill gives them unpaid time off.
The Oregon bill, as is, passed the state Senate this past Wednesday, by a vote of 25 to 2. The bill is called Senate Bill 946 there. The next step is for the bill to go to the House, which would also have to vote on and OK the bill as is for it to be passed to the state governor as a potential new law.
The bill’s particulars go like this: the law would give victims unpaid time off to be able to get their homes in order and safe again if necessary, as well as time to talk to law enforcement if they are pressing charges. The unpaid time off could also cover the time needed to get help from a lawyer, as well as help from the proper medical and psychological authorities or counselors and other such professionals.
While we’re on this new topic of sick leaves laws, the Family and Medical Leave Act, and other labor laws—state and federal—that have to do with how employers alloww their employees time off, we should cover a breaking news item out of the capital of Oregon, Salem. There, the state House just approved a bill this past Monday that would give workers the option of using their paid sick leave in a more flexible manner.
According to the new bill, workers could then use their paid sick leave days, given to them by their employers, in order to also do family leave type of things, such as taking care of little ones, or caring for a sick spouse, or taking family members to the doctor and such.
There is already a law in the books, from 1995, that allows people to take family leave from their jobs in order to take care of a sick child or a sick spouse, or to have a baby or recover from a serious health issue of their own. That’s the famous Family and Medical Leave Act that we’re always talking about here at this blog, and for which you have the FMLA poster in all of your work sites.
Under that law, however, the family leave time that is required by the government for employers to provide can be unpaid time off, unless that employee chooses to use their vacation time as paid time off. This new law, though, would allow employees in Oregon to use their paid sick time off for these family reasons (without having to lie about to an employer that might not be flexible and kind enough to already allow that).
The bill passed the House by the count of a 40 to 18 vote, but it still needs to go to the Senate and be voted on there before it can become a law.