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.