Employers Mull Mental Parity Rules, but Most Plan to Maintain Coverage
by Joanne Wojcik of Business Insurance News, www.businessinsurance.com
Only a few employers are considering dropping mental health coverage in response to new parity rules that take effect for plan years beginning after Oct. 3, according to a survey.
Meanwhile, nearly 38% of responding employers plan to increase the promotion and use of employee assistance program services to help them achieve mental health parity, which is required under a 2008 law, concludes the survey conducted by the Partnership for Workplace Mental Health.
“Employers don’t yet know what they’re planning to do. But there’s good news in that very few employers are thinking about dropping coverage,” said Clare Miller, director of the Partnership for Workplace Mental Health, a program of the American Psychiatric Foundation in Arlington, Va.
The partnership launched the 10-question Web-based survey on March 10, sending it to approximately 2,000 partnership employer contacts including the Center for Health Value Innovation, the Mid-America Coalition on Health in Kansas City, Mo., and the Disability Management Employer Coalition. It also was featured on the Business Insurance Web site after preliminary results were released during an April 28 online executive forum hosted by BI.
The survey, which closed May 12, received 143 responses primarily from human resource and benefits managers. Other respondents reported they worked in the EAP field (17%), and the remainder said they served in roles such as consultants, chief executive officers, disability managers, directors of health and wellness, customer care advocates, and directors of behavioral health.
The survey found 7.1% of employers are considering dropping mental health benefits and 7.8% are thinking about discontinuing coverage for substance abuse treatment.
However, 73.5% said they would not drop mental health coverage, while 76.7% said they don’t plan to discontinue coverage for substance abuse treatment. Another 19.5% said they do not know whether they plan to drop mental health coverage, while 15.5% are undecided about whether to discontinue coverage for substance abuse treatment.
In addition to the 38% of respondents who plan to step up EAP use and promotion, 26.1% plan to increase promotion and disease management to achieve mental health parity. In addition, 23.9% are considering adding or increasing use of case and/or disability management, while 21.7% plan to increase utilization management and/or prior authorization for mental health treatment.
The two benefit features employers responding to the survey said they are most likely to change for the 2010 plan year are copays, which 36.7% reported they would change, and outpatient visit limits, which 35.7% said would change. Other features that employers are looking at altering are: coinsurance (25.5%); deductibles (28.6%); inpatient day limits (28.6%); and out-of- network coverage (28.6%).
A large proportion of respondents-35.7%-said they expected their health benefit costs to increase less than 2% as a result of instituting mental health parity; 23.8% said they anticipate costs will remain the same. Another 16.7% said they expect cost increases exceeding 2%, while 21.4% said they were uncertain what costs will do. An equal number-1.2%-said they expect costs to increase more than 2% or decrease less than 2%.
While the vast majority of respondents-78.3%-sponsor self-funded plans, 29.4% of those offering fully insured plans said they were concerned about how the new law will integrate with existing state laws requiring mental health parity. About 41% said they didn’t know and 29.4% said they were not concerned about this issue.
The partnership is asking the Labor Department for clarification about the interaction of state and federal mental health parity laws, Ms. Miller said.
Unlike many state laws that specify which diagnoses are required to have parity, “the federal law doesn’t define which illnesses need to be covered under the law,” she said.
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