Mental Health Parity and Addiction Equity Act

All fully insured health plans sold to individuals, small employer groups, and large employer groups must include benefits for mental health and substance use disorder (MH/SUD) services. These benefits must be provided at the same level as benefits provided for physical illness, also known as “parity.” Self-funded health plans (commonly provided by large employers) aren’t required to cover MH/SUD services. If they do include this coverage, it must be provided in parity with benefits for physical illness.

Compliance Tools

• Reporting Template Instructions
• Quantitative Treatment Limitation (QTL) Reporting Template
• Nonquantitative Treatment Limitation (NQTL) Reporting Template

The Parity Act is a federal law that requires health insurance companies to cover mental health and substance use disorder (MH/SUD) services in parity with medical and surgical (M/S) services. This includes a requirement that any treatment limitations in a benefit plan can be no more restrictive for MH/SUD services than they are for M/S services.

Oklahoma Bulletins and Alerts

• LH Bulletin No. 2020-04 Mental Health Parity
• LH Bulletin No. 2020-05 Mental Health Parity II

Guidance & Resources

• U.S. Department of Labor / Employee Benefits Security Administration

The following resources are available on USDOL/EBSA webpage:

• • Online self-compliance tool
  • FAQs
  • Final Regulation
  • Compliance Assistance National Webcasts
  • Publication: Warning Signs – Plan or Policy NQTLs that require additional analysis to determine mental health parity compliance
  • DOL Report to Congress

• The Consolidated Appropriations Act, 2021
  • Section 203. Strengthening Parity in Mental Health and Substance Use Disorder Benefits (H.R. 133-1719)

• Code of Federal Regulations
  • Title 45, Subtitle A, Subchapter B, Part 146, Subpart C, § 146.136 – Parity in mental health and substance use disorder benefits.

• The National Association of Insurance Commissioners (NAIC) (B) Committee Mental Health Parity and Addiction Equity Act (MHPAEA) Working Group
  • Information on open meetings, publicly available documents and resources

• Oklahoma Statutes, Title 36
  • 6060.11 – Mental Health Parity – Provisions – Reporting

Reporting templates should be completed and saved according to the Reporting Instructions, and then submitted to the Oklahoma Insurance Department at MHPAEAreporting@oid.ok.gov.