The Federal Mental Health Parity Act was signed into law on Oct. 3, 2008, as part of the economic recovery package. We have and will continue to work to ensure our benefit plan designs are compliant with mental health parity legislation.

In addition, the new law:

• Prohibits treatment limits on mental health/substance use disorder benefits that are more restrictive than those of other medical/surgical benefits (i.e., day or visit limits must be equal to or less than medical limits).
• Requires an explanation of denial of benefits for mental health and substance use disorder treatment (if requested).
• Requires non-network coverage for mental health and substance use disorder treatment if non-network coverage is available for medical/surgical benefits.

Parity Relevance

Federal mental health parity is relevant to all group health plans (fully insured or self-funded) with a few exceptions (e.g. non-federal self-funded government plans that follow appropriate opt-out procedures) and exempts businesses with 50 or fewer employees.

Federal parity does not:

• Pre-empt stronger state parity laws to applicable plans unless such state law "prevents the application" of the requirements of the federal law.
• Mandate inclusion of mental health and substance use disorder benefits in a plan.

The interplay of state mandates and federal parity laws will require analysis on a state-by-state basis to determine whether a state mandate interferes with the application of the parity law and is thus pre-empted. For example, some states mandate coverage of autism spectrum disorder up to a certain financial limit. How these mandates and limits will be affected by the federal parity law requires further review and may be clarified by the forthcoming regulations.

UnitedHealthcare's Position

This legislation will help Americans receive better access to mental health care. It is important not only for those individuals needing such care, but also for better mental health care to help reduce medical costs and improve workplace productivity.

As a leading company in organizing integrated medical and behavioral health solutions for millions of Americans, UnitedHealthcare, as well as the rest of the UnitedHealth Group organization, understands the importance of this legislation in advancing parity in mental health benefits.

Benefit Categories Impacted by Federal Mental Health Parity for Employers