The Affordable Care Act extends the reach of MHPAEA’s requirements. In 2014, all small group and individual market plans that were created after March 23, 2010, will have to comply with federal parity requirements. All qualified health plans that are offered through the Health Insurance Marketplace in every state will have to include coverage for mental and/or substance abuse disorders. The Affordable Care Act adds mental and/or substance abuse disorders to the top 10 categories of Essential Health Benefits. This act also influences the coverage complies with MHPAEA’s requirements.
Small health group plans are defined as employment-based plans that include no more than 50 employees. Small group plans created before March 23, 2010, will be exempt, and not subject to the Essential Health Benefits requirements or MHPAEA.
Large group plans are employment-based plans that include 51 or more employees. Individual plans are plans that are purchased individually direct from an insurance company, and aren’t employment-based.
The Department of Health and Human Services (HHS) has recent information that explains how the federal parity requirements will apply to the Medicaid managed-care organizations, Children’s Health Insurance Program (CHIP), and in states that make expand Medicaid, to Alternative Benefit Plans.
You can find the link here: Guidance: Centers for Medicare & Medicaid Services (CMS) Letter to State Medicaid Directors – 2013 (PDF | 157 KB)