Actuaries have been testing employer-sponsored health plans for mental health parity and have found that most of them are failing, according to Sara Teppema, staff fellow for Society of Actuaries, Schaumburg, Illinois.
The tests come as employers prepare to implement the Mental Health Parity and Addiction Equity Act, a statute signed into law by President George W. Bush in 2008 that requires group health plans with more than 50 employees to cover treatment for mental illness or substance abuse on the same terms and conditions as all other medical illnesses.
Under the new act, financial requirements such as deductibles, copayments or coinsurance, and treatment limitations–such as frequency of treatment, number of visits or days of coverage–may be no more restrictive for behavioral health care than for general medical care.
“The idea is that mental health benefits need to be as good as or better than medical benefits,” Teppema says.
There are 6 classifications of benefits being used to determine whether a plan satisfies the parity requirements, including inpatient in-network, inpatient out-of-network, outpatient in-network, outpatient out-of-network, emergency care, and prescription drugs.