Federal Agencies Finalize Resources for Mental Health Parity Compliance
The Departments of Labor, Health and Human Services and the Treasury (Departments) have finalized resources to promote compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA).
MHPAEA requires parity between mental health and substance use disorder (MH/SUD) benefits and medical and surgical benefits. These resources include:
- Final FAQs on mental health parity; and
- A final model form that plan participants may use to request information about their MH/SUD benefits.
The Departments also maintain a self-compliance tool and have identified warning signs of potential MHPAEA violations.
Employers should confirm whether their health plan’s prescription drug coverage is creditable or non-creditable and prepare to send their Medicare Part D disclosure notices before Oct. 15, 2019. “Before” means the individual must have been provided with the notice within the past 12 months. So, if it was provided on or after Oct. 16, 2018, that will suffice.
New State Leave Laws
On Aug. 9, 2019, Oregon Governor Kate Brown signed HB 2005 into law, establishing a statewide paid family and medical leave program effective in 2023. This new paid family and medical leave program will be funded through a mandatory payroll tax on employees and employers with more than 25 workers, beginning in 2022.
Starting in 2023, eligible employees may take up to 12 weeks of protected paid leave per year for certain family and medical reasons. Employees who experience a pregnancy-related serious health condition that results in incapacity will be eligible for up to 18 weeks of paid family and medical leave.
Beginning Jan. 1, 2022, employers must provide written notice to employees of their right to benefits under the law.
Additionally, effective Nov. 18, 2019, a New York law will require employers in New York to grant leave to employees whom they know are victims of domestic violence. Employers will be required to grant leave for a reasonable amount of time for things like seeking medical or psychological treatment, obtaining victim support or legal services or taking action to increase safety from domestic violence in the future. However, an exception will be granted to employers that show the leave will cause them undue hardship.
Employees may need to provide advance notice of the leave or documentation of the leave when it is not foreseeable.
Employers with employees in Oregon or New York should review their leave policies to ensure compliance with these new laws. Existing leave policies may need to be updated to provide the required legal protections to employees.
2019 Kaiser Foundation Employer Health Benefits Survey Released
About 153 million Americans rely on employer-sponsored coverage, and the 21st annual survey of more than 2,000 small and large employers provides a detailed picture of the trends affecting it. This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, offer rates, wellness programs and employer practices. The 2019 survey included 2,012 interviews with nonfederal public and private firms.
Some Key Takeaways
- The average premiums for covered workers in high-deductible health plans with a savings option (HDHP/SOs) are considerably lower than the overall average for all plan types for both single and family coverage. This holds true even though PPOs continue to be the most common plan type, enrolling 44 percent of covered workers in 2019. Thirty percent of covered workers are enrolled in a high-deductible plan with a savings option.
- On average, covered workers contribute 18 percent of the premium for single coverage and 30 percent of the premium for family coverage.
- Sixty-one percent of covered workers, including 17 percent of covered workers in small firms and 80 percent in large firms, are enrolled in plans that are either partially or completely self-funded.
- Among firms offering health benefits, 41 percent of small firms and 65 percent of large firms provide workers the opportunity to complete a health risk assessment. Twenty-six percent of small firms and 52 percent of large firms provide workers the opportunity to complete a biometric screening.
- Sixty-nine percent of firms with 50 or more workers offering health benefits cover the provision of health care services through telemedicine in their largest health plan.
The entire survey results can be found here.
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