Mental Health Parity and Addiction Equity Act (MHPAEA)

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Summary: BCBSND ensures compliance with the MHPAEA by providing mental health and substance use disorder (MH/SUD) benefits that are no more restrictive than the medical and surgical benefits offered under our health plans. This commitment guarantees that individuals seeking mental health and addiction services receive equitable coverage and access comparable to those seeking medical and surgical care.

Who this applies to: This applies to those with individual policies, as well as fully insured and self-funded group health plans. This does not apply to grandfathered plans.

Regulatory Adherence: BCBSND conducts comparative analyses and maintains documents regarding its standard processes, strategies, and evidentiary standards supporting compliance with MHPAEA for its fully insured and self-funded lines of business. These analyses ensure that the non-quantitative treatment limitations (NQTLs)and quantitative treatment limitations (QTLs) applied to MH/SUD benefits are comparable to those applied to medical and surgical benefits.

Action Required: BCBSND will provide a summary of its most current comparative analyses upon request.