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Kim Willis

Aetna Prepares for Implementation of Federal Mental Health Parity


By: Health Insurance
Submitted: 2009-10-30 09:03:47 | Word Count: 460


The Mental Health Parity and Addiction Equity Act of 2008, passed by Congress in October 2008, promotes equitable care for mental health illnesses by requiring parity between medical and mental health benefits. The law applies to group health plans, including both fully insured and self-funded plans. However, small employers with 2-50 employees and individual coverage are exempt.

The new law was implemented on October 3, 2009 and plan sponsors will need to be in compliance beginning with their first plan year renewal after that date.

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Beginning with October 15, 2009 renewals, Aetna customers with 51+ employees will automatically renew their coverage in compliance with the federal mental health parity law. Groups with union contracts in place are required to comply with the federal mental health parity mandate but have the option to delay until their union contract is up for renewal.

How this new law will affect Aetna’s 51+ customers
For health plans that offer medical benefits and mental health and/or substance abuse benefits, the new law has the following impact:

* Eliminates more restrictive financial requirements, such as copays or deductibles, for mental health/substance abuse benefits than are applied to medical/surgical benefits
* Eliminates more restrictive treatment limitations, such as day or visit limits, for mental health/substance abuse benefits than are applied to medical/surgical benefits

Please be aware that in states with stronger parity requirements, the state law will continue to apply and may, for example, mandate mental health/substance abuse coverage or particular mental health or substance abuse benefits.

We will work with our customers to help them meet the new law’s requirements
Aetna supports this law because we believe it promotes timely and appropriate care for mental health, which is essential to the overall health of our members. Our goal is to help our customers lower their overall medical costs and improve employee health and productivity by providing plans that harness the value of behavioral health benefits.

Please also note that the regulations under the new law have not yet been issued, and are now expected in January of 2010. Aetna will closely evaluate those regulations when issued and we may revise our practices if those regulations change our view of what the law requires.

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