Mental Health and Addiction Equity Act of 2008

(Effective 1/1/09)

H.R. 1424, P.A. 110-343

This law was attached to the financial system bailout bill and was one of the compromises inserted in the negotiations to get the bill passed. It is significant because it amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, and the Internal Revenue Code to require group health plans to apply the same treatment limits on mental health (or substance abuse related disorders) as they do for ordinary medical and surgical benefits. This is the “parity”€ requirement. It includes inpatient and outpatient services as well as emergency care.

In this new law, for the very first time, group health plans must apply the same beneficiary financial requirements to mental health (or substance abuse related) benefits as are applied to medical and surgical benefits, including limits on deductibles, co-payments, and out-of-pocket expenses. The definition of “€œmental health benefits”€ is revised to include substance related disorder benefits.

These provisions apply to group plan years beginning on or after January 1, 2009 and to group health plans under a collective bargaining agreement at the expiration of the agreement or by January 1, 2009. States are allowed by the Act to grant more rights than that parity act but the Act does provide a minimum threshold.

Please note that this law does not cover individual health plans and is only applicable to group plans. It signals a new era in required insurance coverage and can be found here in its entirety, for your review.