Mental Health Parity
What is MHPAEA?
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires that group health plans ensure that the financial requirements and treatment limitations on mental health or substance use disorder (MH/SUD) benefits they provide are no more restrictive than those on medical or surgical (M/S) benefits.
What do I do?
The Consolidated Appropriations Act of 2021 (CAA) amended MHPAEA by requiring group health plans that offer both M/S and MH/SUD benefits to perform and document comparative analyses of the design and application of any Quantitative Treatment Limits (QTL) or Non-Quantitative Treatment Limits (NQTL) that apply to the plan.
Why Should I Comply?
If the DOL deems your plan noncompliant, the plan must notify all individuals enrolled in the plan of this noncompliance with MHPAEA. Participants in noncompliant plans can sue the plan sponsor under ERISA for violating MHPAEA. The Departments will also share findings of noncompliance with the State where the group health plan is located.
Our Services
Comparative Analysis
Detailed analysis of Quantitative Treatment Limits (QTL) or Non-Quantitative Treatment Limits (NQTL)
Plan Document Review
Detailed review of all plan documentation by MHPAEA experts, including former DOL investigators
Information Requests
Customized information requests for TPAs and other service providers
Operations Review
Detailed plan operations review based on information collected from service provider(s)
Recommendations
Recommendations to remedy plans deemed not to be compliant with MHPAEA
Annual Update
Annual updates to account for plan changes and updated Department of Labor (DOL) guidance
Our Differentiation
Detailed QTL and NQTL analysis backed by leading benefits attorneys
Full-service plan document review, conducted by our plan document experts
Supports plans with multiple service providers (TPAs, PBMs, etc.)
Audit support in the case of an investigation by the DOL requesting any comparative analysis