In the workplace, absences and illnesses related to mental health have increased significantly. Depression-related absenteeism and low productivity cost American employers an estimated $44 billion a year. Further, depressive disorders amount to more than half of medical plan dollars spent for health problems. And with the holidays around the corner, absences related to mental health typically increase.
Which brings us to our first acronym – MHPA. The Mental Health Parity Act (MHPA) of 1996 requires that annual or lifetime dollar limits on mental health benefits be no lower than the limits for medical and surgical benefits offered by a group health plan. Employers could still have discretion in the scope and extent of the mental health benefits they offer workers and their families, such as number of visits and cost sharing.
Now enters the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, which continues and expands the MHPA. MHPAEA continued the MHPA parity rules as to limits for mental health benefits and amended them to extend to substance use disorder benefits. This new law also requires that financial requirements (such as premiums and co-payments) and treatment limitations (such as number of doctor visits or out of network visits) are no more restrictive than those applied to medical and surgical benefits covered by the plan. There are some limitations for application of these acts, depending on group size and other factors.
As you review your health insurance policy and renewal information, which sometimes is quite complicated, you may now be able to identify and understand more about these two provisions. For more information, please check out these fact sheets: