Mental health parity, which is at the heart of the Mental Health Parity and Addiction Equity Act (MHPAEA), is in the headlines. The term mental health parity refers to the idea that mental health and addiction services need to have the same insurance coverage as physical health services. Many insurers still treat coverage for mental and physical health differently, which can directly impact the benefits you’re offering your employees.
While enforcement of the 2024 version of the MHPAEA is not happening currently, and federal regulators have indicated that they are disregarding all changes made in that version, the underlying rules from 2013 are still standing. How could mental health parity and the broader MHPAEA impact everything from recruitment to employee engagement at your business?
Why Is Mental Health Parity Critical for Employers?
Even though 2024 MHPAEA changes are not being enforced, prior versions of the rule are still subject to regulation. If the plans you’re offering are not compliant, you could face an audit or have to change your plan offerings. Additionally, an increasing number of adults are seeking mental health treatment. In just four years, the percentage of adults receiving mental health care rose from 19% to 23%. If you aren’t offering benefits that account for this, your employees might hesitate to get the help that they need. This can worsen burnout or depression and increase absenteeism and turnover. Furthermore, some candidates may opt for positions at other companies with better benefits.
How Can You Stay Compliant?
Because the 2024 changes to the MHPAEA are not being enforced, there is a good chance that the plans you are offering are already compliant. Some of the areas that are known for having compliance issues include:
- Financial Parity: Copays, deductibles, and coinsurance for mental health care should be in line with physical care
- Coverage Requirements: Under the 2013 MHPAEA, plans must offer “meaningful” coverage, which includes at least one treatment in each benefit classification
- Comparative Analyses: Plans must complete a comparative analysis to show the impact of non-quantitative treatment limitations (NQTLs) on mental health and/or substance use disorder benefits (MH/SUD benefits)
- Treatment Limitations: NQTLs have to be similar to the requirements for medical and surgical benefits (like prior authorization requirements) when applied to MH/SUD benefits
These mental health parity requirements are designed to make sure that people seeking mental health or substance use disorder treatment are able to access care as easily as if they had a sprained ankle or broken arm.
How Can We Help You Stay Compliant?
Working with an employee benefits and HR advisory firm is the best way to make sure that you stay compliant now and in the future. How can we help?
- Audit Potential Plans for Violations: We can carefully review what benefits are included in the plan and utilization patterns to ensure that there are no hidden violations.
- Include Parity Metrics in Your Reports: When we present you with reports, we’ll consider parity metrics to help you see if a disproportionate number of mental health claims are being denied or if employees are not able to use their benefits.
- Ensure Your Contracts Include Mental Health Parity: When we walk you through the process of choosing benefits to offer, we’ll ensure that contracts include language about parity.
- Educate Your Team and Employees: Your employee benefits are only useful if employees know that they’re there and what they include. We can educate your staff and team to ensure that they understand what access exists for mental health coverage. Additionally, when you are determining what plans to offer, we can explain the importance of mental health parity to your stakeholders.
We’re Here to Help Support You
When you want to make sure that your benefits are meeting all legal standards, especially when those standards are changing, you need the right team on your side. We are always here to help you and your employees thrive. To learn more, please call our office at 240-422-8799 or email Jessica Storck at Jessica.storck@tribridgepartners.com.
