2023 ushered in new areas of compliance which employers need to know and prioritize. These areas reflect the current regulatory climate, as well as issues which have arisen in our post-pandemic period. Human resource executives, along with corporate counsel and plan fiduciaries should be particularly mindful of these three areas.
Mental Health Parity and Abortion
- Mental health parity – New rules in the Consolidate Appropriations Act (CAA) have expanded the Mental Health Parity. This legislation, along with the Addiction Equity Act (MHPAEA) now requires health plan sponsors to disclose a new non-quantitative treatment limitation (NQTL) comparative analysis. This analysis must be readily available upon request by government agencies including the Department of Labor. It requires that the terms and conditions applying to mental health and substance abuse disorder benefits not be less favorable than their health plan’s medical and surgical benefits. All plans, including fully- and self-insured, must comply.
- Abortion-related matters – In the summer of 2022, when the Supreme Court overruled Roe vs. Wade, it set in motion new considerations related to states now having the ability to enact their own abortion laws. For employers and plan sponsors with members in multiple states, this requires being aware of and regularly monitoring each state’s abortion rules and complying with them. Depending on whether their plan is fully- or self-insured, companies need to consider options pertaining to abortion-related travel and lodging reimbursements in the states where members work. In some cases, health reimbursement arrangements (HRAs) and employee assistance programs (EAPs) may be applicable.
- Amendments to ERISA made by the CAA now require employers and plan sponsors to obtain fee disclosures from brokers, consultants, or other covered service providers (CSPs). The reason for this disclosure is to ensure the fees are reasonable under the laws. CSPs must disclose any fee of $1,000 or more from any single group health plan. This disclosure requirement applies to any fully- or self-insured’s health, prescription, dental, vision, health financial savings accounts (FSAs), health reimbursement accounts (HRAs), wellness plans, and employee assistance programs.
To ensure their compliance with all of the aforementioned requirements, employers and plan sponsors should consider establishing a fiduciary committee for your health plan similar to what is in place for their retirement plans.