Overview
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was intended to improve access to services for mental health and substance abuse disorders.. MHPAEA requires group health plans to ensure that the mental health and substance use disorder benefits they offer are in parity with medical and surgical benefits. Recently, with the passage of the Consolidated Appropriations Act of 2021 (CAA), intentions became codified. The Departments of Labor, Treasury, and Health and Human Services are now required to select, collect, and review comparative analyses from employers that demonstrate their offered health plan’s compliance with MHPAEA regulations. The Department of Labor (DOL) has elevated MHPAEA compliance to a top priority, working to develop a dedicated task force to identify instances of MHPAEA noncompliance. If a health plan is found noncompliant, or if no comparative analysis is produced, the employer may be required to notify all participants in the plan of noncompliance. This could potentially result in lawsuits against the plan. In extreme cases, the plan could be required to re-adjudicate claims that were previously denied.
Our team was uniquely positioned in the industry as it offered a robust solution that has been thoroughly vetted by a leading employee benefits attorney and a former DOL investigator. At a base level, a team of expert analysts reviews each self-funded health plan offered and provides a detailed report of potential points of noncompliance. Additionally, our team of experts offers a full-service option which requires cooperation with the client’s third-party administrator(s) to obtain claims data in addition to plan documents. After receiving data, our team produces a custom comprehensive report, complete with all required testing and analysis, plus recommendations for bringing any inconsistencies or areas of noncompliance into parity.
Challenge/The Situation
The passage of the CAA in 2021 left many employers scrambling, at best, or at worst, unwittingly noncompliant. Bluebonnet Electric Cooperative had no idea that this new requirement existed until they learned just last year in 2022 that their plans required a MHPAEA comparative analysis. “Our broker strongly recommended having [the comparative analysis] done,” Bluebonnet’s HR Manager, Jennifer Foery shared; “there are very few providers in the market to do this sort of analysis and I heard good feedback about this group.”
Resolution
Bluebonnet entrusted Lumelight’s team of experts to complete their analysis. After receiving Bluebonnet’s plan documents and claims data, Lumelight’s expert, dedicated analyst team was eager to turn their proven process into a polished comprehensive MHPAEA Comparative Analysis Report complete with findings and recommendations. Jennifer and her executive team were thrilled with the ease of the process. “There wasn’t too much that we had to do other than pull the trigger and say go,” Jennifer said; “overall I thought it was a very easy process and I’m glad we did it.” She further noted that “the (final results) call was really good about clarifying and confirming what I was seeing in the report.” Additionally, after the completion of every report, Lumelight experts includes consulting and support for clients and Jennifer shared, “we’re also pleased that there is the future audit support if we happen to be audited by the DOL…that was a clincher for us!”
Key Takeaways
Working with our team of experts on a MHPAEA Comparative Analysis gives clients a jumpstart on compliance, safeguarding not only their financial and legal interests, but also the overall mental and emotional wellbeing of their employees. Should Bluebonnet undergo an investigation by the DOL, Jennifer is much more confident and, “in terms of mental health parity, absolutely, I can say yes, without a doubt, I feel much more prepared for that and I’ve got that documentation, whereas prior to this I would have been clueless!”
