BIP Fall 2024

Industry Innovation

Be a mental health advocate Brokers have a role in helping clients access the continuum of care.

The legal landscape Most health insurance plans cover mental health, but the average American employee doesn’t realize it’s a covered benefit, Kennedy told attendees at NABIP’s Annual Convention. The first Mental Health Parity Act in 1996 affected large groups only and said if the plan includes mental health, there must be parity with medical and surgical benefits. In 2008, the Mental Health Parity and Addiction Equity Act expanded parity to Medicaid and CHIP. It established categories of treatment with care parity. Another major change came in 2010 with the Affordable Care Act, which defined essential health benefits. Mental health had to be covered by every ACA compliant plan, expanding parity into small-group and individual and family plans.“So now we have all commercial plans having to adhere to the Mental Health Parity and Addiction Equity Act,” said Kennedy. “Things must be comparable. You can’t restrict access to care based on the size of your network. You can’t require that you ‘fail first,’ meaning that someone must go through detox, go home and relapse before they can have access to inpatient treatment.” The case for comprehensive care But while mental healthcare is supposed to be as accessible

Eleven years: that’s the average delay from when a mental health symptom emerges to when treatment begins, according to National Institute of Health data. That treatment delay is only exacerbated by the fraud, waste and bad actors who have flocked to the system. Benefit brokers have an essential role as advocates for clients to

help ensure they have all the information they need to gain efficient access to the continuum of mental healthcare. It starts by understanding what the law requires, says Dede Kennedy, chair of the NABIP Mental Health Working Group and president of BenAssist Health Insurance Services, LLC, in Pasadena, California.

Olga Strelnikova/ iStock

10 bip magazine Fall 2024