On June 16, 2017, the Departments of Labor, Health and Human Services, and the Treasury (Departments) released a draft model form that plan participants may use to request information on their mental health and substance use disorder (MH/SUD) benefits.
A federal law—the Mental Health Parity and Addiction Equity Act (MHPAEA)—requires most group health plans to provide parity between MH/SUD benefits and medical and surgical benefits.
Under MHPAEA, group health plans and health insurance issuers must provide plan participants with certain information regarding their MH/SUD benefits. The Departments released the draft model form to help participants request relevant information.
ACTION STEPS
Employers with group health plans should review the draft model form in anticipation of participants’ requests for information on their MH/SUD benefits. It is possible that the availability of the model form will generate requests for detailed information on plan benefits.
Plan sponsors should respond to these information requests within 30 calendar days in order to avoid possible penalties under the Employee Retirement Income Security Act (ERISA).