The 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 than on medical /surgical ones.
MHPAEA originally applied to group health plans and group health insurance coverage and was amended by the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the “Affordable Care Act”) to also apply to individual health insurance coverage. The United Stated Department of Health and Human Services (HHS) has jurisdiction over public sector group health plans (Referred to as “non-Federal government plans”), while the Department of Labor and the Treasury have jurisdiction over private group health plans.
Employment related group health plans may be either “insured” (purchasing insurances from an insurer in the group market) or “self-funded”. The insurance that is purchased, whether by an insured group health plan or in the individual market, is regulated by the State’s insurance department. Group health plans that pay for coverage directly, without purchasing health insurance from an insurer, are called self-funded group health plans. Private employment-based group health plans are regulated by the Department of Labor Non-Federal governmental plans are regulated by HHS. Contact your employer’s plan administrator to find out if your group coverage is insured or self-funded and to determine what entity or entities regulate your benefits