Mental Health Parity: NQTL Comparative Analysis Requirements

The Consolidated Appropriations Act, 2021 (CAA), enacted in December 2020, amended the Mental Health Parity and Addiction Equity Act of 2008 (MPHAEA) to require employers that sponsor self-funded group health plans that cover mental health or substance use disorder benefits to perform a “comparative analysis” of any non-quantitative treatment limitations (NQTLs) effective February 10, 2021. All group health plans are subject to the CAA. Fully insured plans, however, have relief from this requirement as the insurance carrier has the obligation to perform the comparative analysis, not the employer.

Though the MPHAEA already required group health plans and insurers to perform an analysis of NQTLs, the CAA’s requirement to produce written documentation of the comparative analysis is new and bolsters the DOL’s, IRS’s and HHS’s (collectively, the Agencies’) increasing focus and ongoing commitment to MPHAEA enforcement. Due to the time constraints and potential penalties, employer-sponsors of self-insured health plans should focus on understanding this complex new requirement and prioritize their next steps to ensure compliance.

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