U.S. Department of Labor
Health Benefits Advisor for Employers
Determining Compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) and Mental Health Parity Act (MHPA) Provisions in Part 7 of ERISA
Plan Compliance Results
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires group health plans and health insurance issuers to ensure that financial requirements (such as co-pays, deductibles) and treatment limitations (such as visit limits) applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits. Although MHPAEA provides significant new protections to participants in group health plans, it is important to note that MHPAEA does not mandate that a plan provide MH/SUD benefits. Rather, if a plan provides medical/surgical and MH/SUD benefits, it must comply with the MHPAEA's parity provisions.
MHPA required parity with respect to aggregate lifetime and annual dollar limits. However, MHPA did not apply to substance use disorder benefits. MHPAEA continued the MHPA parity rules as to limits for mental health benefits, and amended them to extend to substance use disorder benefits.
Based on your responses, your plan appears to be in compliance with the following MHPAEA and MHPA provisions:
Based on your responses, your plan does NOT appear to be in compliance with the following MHPAEA and MHPA provisions:
Note: If you would like to review the information provided within this Advisor, you may select that issue above and it will take you back to that section in the Health Benefits Advisor where you can reread the description and answer the question again. This Advisor provides general guidance and users are encouraged to review their specific health plan or health plan options in conjunction with the general information provided. In addition, the Advisor does not address health benefits offered through Federal, state, or local government plans or church plans.
Determine compliance with other applicable ERISA Laws:
The following health laws under Title I of ERISA may apply to your employer sponsored group health plan. You may select the following laws to determine compliance.
For more information on complying with MHPAEA and MHPA requirements, visit:
- Compliance Assistance Guide
- MHPAEA Fact Sheet
- MHPA Fact Sheet
- Frequently Asked Questions About MHPAEA
- Frequently Asked Questions About MHPA
- Statute: 29 USC § 1185a
For more information on Compliance Assistance visit:
The Affordable Care Act (ACA) provides additional health protections. This website does not reflect the passage of the ACA. For an overview of the Affordable Care Act, please visit the ACA Summary. For regulations, guidance and additional information, please visit the Department of Labor's ACA webpage.
