Many employers now offer group health insurance plans that include coverage for mental health treatments.
If they do, the coverage limits for those treatments must be equal to the limits on physical health coverage. The law requires it, whether the treatments are therapy, counseling, or stays in a mental health center or the mental health wing of a hospital.
West Virginia employee benefits are covered by the requirement that has been in place since 1996. The law has been extended 5 times since its enactment, and in February of 2007 it was extended until December 31 of 2007.
The law is called the Mental Health Parity Act of 1996. It requires that, if your group health insurance plan includes mental health treatment, the coverage limits must be the same as for other treatments such as surgery. The MHPA was originally scheduled to run out on September 30 of 2001, but the 5 extensions have kept it alive since then. Extensions are likely to continue in the future.
Before the law was passed, wide differences between physical and mental health coverage limits were allowed. A group health insurance plan, for example, could put a $100,000 annual limit on surgery, but a mere $1,500 limit on mental health treatment costs.
Enforcing this law is an agency known as the Employee Benefits Security Administration (EBSA). Once charged only with investigating violations of the pension law, its duties have been expanded to include enforcement of laws, like the MHPA, regulating employees’ group insurance plans. Employee benefit plans, of course, account for most Americans’ insurance coverage. In fact, more than 150 million workers receive such coverage. Their plans are monitored by the EBSA.
While the law guarantees parity, it does not require an employer’s group insurance plan to include mental health treatment. The MHPA only requires that, if a plan does include mental health treatment, its coverage limits be equal to those of physical health treatments.
West Virginia employee benefit plans will continue to include mental health treatment coverage on a par with medical and surgical coverage thanks to the extension of the bill known as MHPA.
The bill is the Mental Health Parity Act. It has been extended to December 31 of 2007 after being signed into law by the President.
As the name suggests, it assures that all group health plans include a mental health component that is equal in coverage limits to their limits on corresponding medical/surgical treatment coverage.
The MHPA has been given new life five times through amendments, since its original expiration date of September 31, 2001. That was because the original bill, signed into law in 1996, included what is called a “sunset clause,” effectively causing it to expire unless extended.
The bill impacts the roughly 150 million workers who are covered by group health insurance plans. Before the MHPA, health plans could have ceilings on mental health treatment coverage that were much lower than those on medical and surgical treatment. For example, a plan might have a $100,000 yearly limit on medical and surgical procedures, but just $5,000 or $10,000 for mental health treatment. Under MHPA, that is against the law.
Some of what is included in mental health treatment coverage is:
Stays in rehabilitation facilities for drug and alcohol abuse problems.
Stays in psychiatric centers, or mental hospitals, for treatment of a wide variety of illnesses such as schizophrenia, depression, and post-traumatic stress disorder.
Visits to mental health professionals. These include licensed therapists, psychologists, and psychiatrists.
The Employee Benefit Security Administration (EBSA) is the enforcing federal agency. It was originally created in 1974 to oversee enforcement of the Employee retirement Income Security Act (ERISA) of 1974. Since then it has gained sub-cabinet level status and its mandate includes health care as well as pension oversight. The upgrade came in 2003. It is now under the auspices of an Assistant secretary of Labor.