New Draft Model Form for Mental Health Parity Requests

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).

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DISCLOSURE

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The information provided is for informational purposes only and does not constitute legal advice. The information above contains only a summary of the applicable legal provisions and does not purport to cover every aspect of any particular law, regulation or requirement. Depending on the specific facts of any situation, there may be additional or different requirements. This is to be used only as a guide and not as a definitive description of your compliance obligations.