Under a Federal law known as the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, as amended ("HIPAA"), group health plans must generally comply with the parity in the application of certain limits to mental health requirement.
However, the law also permits local governmental employers that sponsor health plans to elect to exempt a plan from these requirements for any part of the plan that is "self-funded" by the employer, rather than provided through a health insurance policy. Maricopa County has elected to exempt the Maricopa County Accident and Health Insurance Premium Plan (Second Amendment and Restatement) from the parity in the application of certain limits to mental health benefits requirement.
Parity in the Application of Certain Limits to Mental Health Benefits
Group health plans (of employers that employ more than 50 employees) that provide both medical and surgical benefits and mental health or substance use disorder benefits must ensure that financial requirements and treatment limitations applicable to mental health or substance use disorder benefits are no more restrictive than the predominant financial requirements and treatment limitations applicable to substantially all medical and surgical benefits covered by the plan.
The exemption from these Federal requirements has been in effect since the Maricopa County Plan Year (PY) 2010-11, beginning July 1, 2010 through June 30, 2011 and has been renewed for PY 2011-12, PY 2012-13, PY 2013-14, PY 2014-15 and PY 2015-16.
The election may be renewed for subsequent plan years.