Vermont Employee Benefits

May 13th, 2007 Posted by Amelia

A law with an enormous impact on Vermont employee benefit plans, has been extended through December 31, 2007.The Mental Health Parity Act has just received a new lease on life. The MHPA is a law requiring that benefit limits on mental health care coverage must equal the limits on benefits for medical and surgical procedures.

The ruling by the EBSA or Employee Benefits Security Administration involves about 150 million employees throughout the U.S. The EBSA covers a significant majority of businesses nationwide. Its job is to monitor group health insurance plans and guarantee that they comply with any laws covering health insurance and pensions.

The MHPA does not require employers to include mental health care coverage in their group insurance plans. It requires parity. In other words, if a group health insurance plan already has a mental health component, the benefit limits for that mental health portion must not be lower than those for medical and surgical coverage.

Prior to enactment of the law, it would have been entirely legal for an insurance company to have a $250,000 limit as its absolute limit for surgery, but only a $15,000 limit for mental health care coverage. The law also impacts annual benefit caps. Under MHPA, mental health coverage limits must be the same as the lifetime or annual caps on surgery or medical care.

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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