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IntroductionThe Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits. Show
MHPAEA does not apply directly to small group health plans, although its requirements are applied indirectly in connection with the Affordable Care Act’s essential health benefit (EHB) requirements as noted below. The Protecting Affordable Coverage for Employees Act amended the definition of small employer in section 1304(b) of the Affordable Care Act and section 2791(e) of the Public Health Service Act to mean generally an employer with 1-50 employees, with the option for states to expand the definition of small employer to 1-100 employees. The Employee Retirement and Income Security Act and the Internal Revenue Code also define a small employer as one that has 50 or fewer employees. (Some states may have mental health parity requirements that are stricter than federal requirements. To view State specific information visit www.ncsl.org, and on the right hand side of the page enter "mental health parity" then select "State Laws Mandating or Regulating Mental Health Benefits".) Summary of MHPAEA ProtectionsThe Mental Health Parity Act of 1996 (MHPA) provided that large group health plans cannot impose annual or lifetime dollar limits on mental health benefits that are less favorable than any such limits imposed on medical/surgical benefits.
Key changes made by MHPAEAKey changes made by MHPAEA, which is generally effective for plan years beginning after October 3, 2009, include the following:
ExceptionsThere are certain exceptions to the MHPAEA requirements. Except as noted below, MHPAEA requirements do not apply to:
Note, these exceptions do not apply to those non-grandfathered plans in the individual and small group markets that are required by Affordable Care Act regulations to provide EHB that comply with the requirements of the MHPAEA regulations. MHPAEA RegulationA final regulation implementing MHPAEA was published in the Federal Register on November 13, 2013. The regulation is effective January 13, 2014 and generally applies to plan years (in the individual market, policy years) beginning on or after July 1, 2014. See http://www.gpo.gov/fdsys/pkg/FR-2013-11-13/pdf/2013-27086.pdf for the full text of the final regulation. This followed an interim final regulation, which was published in the Federal Register on February 2, 2010 and generally applies to plan years beginning on or after July 1, 2010. See http://edocket.access.gpo.gov/2010/pdf/2010-2167.pdf - Opens in a new window for the full text of the regulation. The final regulation applies to non-Federal governmental plans with more than 50 employees, and to group health plans of private employers with more than 50 employees. It also applies to health insurance coverage in the individual health insurance market. It does not apply to group health plans of small employers (except as noted above in connection with the EHB requirements). Like the statute, it does not require group health plans to provide MH/SUD benefits. If they do, however, the financial requirements and treatment limitations that apply to MH/SUD benefits cannot be more restrictive than the predominant requirements and limitations that apply to substantially all of the medical/surgical benefits. The provisions of the regulation include the following:
We anticipate issuing further responses to questions and other guidance in the future. We hope this guidance will be helpful by providing additional clarity and assistance. If you have concerns about your plan's compliance with MHPAEA, contact our help line at 1-877-267-2323 extension 6-1565 or at . You may also contact a benefit advisor in one of the Department of Labor’s regional offices at www.askebsa.dol.gov or by calling toll free at 1-866-444-3272. Fact Sheets and FAQsRegulations and GuidanceWhich of the following best explains how data is typically assembled in packets for transmission over the Internet ?\?Which of the following best explains how data is typically assembled in packets for transmission over the Internet? Each packet contains data to be transmitted, along with metadata containing information used for routing the data.
How are messages typically transmitted over the Internet?Packets will travel from one machine to another until they reach their destination. As the packets arrive, the computer receiving the data assembles the packets like a puzzle, recreating the message. All data transfers across the Internet work on this principle.
Which of the following best explains how the Internet is a fault tolerance system?The Internet is fault-tolerant because there are usually multiple paths between devices, allowing messages to sometimes be sent even when parts of the network fail.
Which of the following best describes how the file is sent to the user?Which of the following best describes how the file is sent back to the user? The file is broken into packets and sent over a network. The packets must be reassembled by the user's computer when they are received. If any packets are missing, the browser re-requests the missing packets.
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