Mental Health

Mental Health Parity and Addiction Equity

Comparative Analysis

Plan sponsors must complete extensive analysis regarding the broad plan limits, Quantitative Treatment Limitations (QTLs) and Non-Quantitative Treatment Limitations (NQTLs) of their plans.

Each plan sponsor must complete a detailed analysis of their plan, both written and in operation.

In December of 2020 Congress passed into law the Consolidated Appropriations Act. This Bill addresses how the DOL, HHS and IRS will assess how well employer plan sponsors and Health Insurance Carriers are keeping up with the compliance requirements under the Mental Health Parity and Addiction Equity Act (MHPAEA).

The analysis must be performed on all vendors offering services under your plan, and must be made available to plan members upon request and the DOL starting February 10th, 2021.

Our Analysis includes

1

full analysis of broad plan limits

This item is mainly about documentation and not likely much of a challenge since the enactment of ACA restrictions on annual and lifetime limits.

2

analysis of quantified treatment limitations

Including applying the substantially all and predominant tests to the necessary classifications and sub-classification of expected, future plan claims

3

analysis of non-quantified treatment limitations

Including a review of medical management standards, prior authorization, concurrent review, network tier decision criteria, standards for network participation, and more

$3,999 package price

 

  • Comparative analysis is required to maintain ongoing compliance.  This involves ongoing analysis of networks, vendors, expected claim amounts, formularies and provider reimbursements.  To that end, MHPAEA compliance requires ongoing work.
  • We do however expect renewal rates to be less expensive than first year rates.
  • For up to 3 plans. If you have more than 3 plans, it is $750 for each additional plan.
  • If an employer has fewer than 100 employees, there is a $1,000 discount, making the standard price $2,999.