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Mental Health Parity 2008 and Eliminating Related Benefits


Guest anygig
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Are folks seeing plans eliminate substance abuse and/or mental health benefits, or restrict the types of benefits payable, in response to the MHPAEA of 2008? It seems to me that this is not what Congress intended, but may be an unintended consequence. At least one TPA has claimed that this is how plans are handling this, by eliminating any substance abuse or mental health coverage before the law becomes effective for the particular plan, but I have yet to see that and would like to know if others are seeing such a move. I am not finding that the law contains a provision that plans offering such benefits as of the law's enactment date must comply, so it would appear that only plans offering such benefits as of the date the law is effective must comply, which does appear to leave time for plans to eliminate or reduce benefits before the effective date.

Thank you.

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  • 4 weeks later...

We are seeing different carriers handle it differently. It appears that the major driving force (from the carrier's point of view) is "how easy will it be to administer" as well as the fact that their plans have to be filed with the state Dept of Insurance.

Examples: Carrier A: fully insured plans will include N&M benefits for group sizes above 26 employees.

Carrier B: fully insured plans will include N&M benefits for group sizes above 2 employees.

It would seem that both of these carrier examples are putting themselves at a rate disadvantage (carrier B more so than carrier A) by not increasing the number of employees to 50 (which is where the MHPAEA requirements kick in). But none of the carriers I've heard about so far have changed their rating crossover points. Probably because this law is not anticipated to have more than a 1-2% rate impact.

So, no, we're not seeing much of a change, if any. I expect most of the action will be with self-insured plans.

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As a mid-size employer with 4 SI plans, we removed all prior restrictions (e.g. # of annual visits for BH or annual $ restriction for SA) to ensure parity. According to our TPAs, the cost increase was estimated to be ~1%. We also have 8 FI plans which have basically also eliminated any restrictions and increased copay amounts both for inpatient and outpatient.

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