Mental Health Benefits Update

Effective for plan years beginning on or after October 3, 2009 (January 1, 2010 for calendar year plans)

Private group health benefit plans that provide mental health and/or substance use disorder benefits as well as medical and surgical benefits, are now required by this Act to do so on an equivalent basis.  Several plan design requirements have been imposed on group health benefit plans that offer mental health and/or substance use disorder benefits including equity in cost sharing, treatment limitations, and coverage decisions requirements.  The current mental health parity law requires parity for annual and lifetime limits on coverage, and this Act builds on those requirements.  The Act contains an exception for small group health benefits plans and for increased costs, however, those exceptions are specific and narrow.  The MHPAEA does not require employers to provide either mental health or substance use disorder benefits.  As a result, plan sponsors may want to reconsider continuing to offer one or both of these types of benefits beyond the effective date of the MHPAEA.