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Mental Health Parity Laws

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) generally prevents group health plans  that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits.

Employer Coverage

Employers with group health plans that provide MH/SUD benefits in addition to medical/surgical benefits are generally subject to the MHPAEA parity provisions. In general, MHPAEA applies to:

  • Large group health plans sponsored by employers with more than 50 employees, including self-insured as well as fully insured arrangements; and 
  • Non-grandfathered, fully insured small group health plans sponsored by employers with an average of at least 2 but not more than 50 employees.

In addition, because many states have enacted their own laws that supplement the requirements of the MHPAEA, insured group health plans are advised to check with their state regulators to understand the full scope of applicable parity requirements.

Exemptions


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