Are Separate Deductibles and Out-of-Pocket Maximums Allowed?
Facing the challenge of complying with the new mental health parity requirements that become effective for plan years beginning after October 3, 2009, employers and their advisers are asking whether separate deductibles and out-of-pocket maximums are allowed for mental health and substance abuse disorder benefits. As we await official guidance, the law is less than clear. New Financial Requirements Apply The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (the Act) was passed as part of the larger Emergency Economic Stabilization Act of 2008. It expands the mental health parity requirements in the Employee Retirement Income Security Act, the Internal Revenue Code and the Public Health Services Act by imposing new mandates on group health plans that provide both medical and surgical benefits and mental health or substance abuse disorder benefits.
Related Questions
- How do the network and out-of-network deductibles and out-of-pocket maximums work together if I sometimes go to network doctors and sometimes to out-of-network doctors?
- What options for deductibles and out-of-pocket maximums are insurers allowed to offer to employers or individual consumers?
- Are there separate deductibles and out-of-pocket maximums for in-network and out-of-network expenses?
