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Renewals May Not Include Updated Mental Health

Jul 18, 2014

Group employers who recently received their Anthem fully-insured health plan renewals will get a follow-up communication about any needed updates to their plan's mental health benefits.

Recent changes in health benefits law take place for groups renewing July 1, 2014 and later. Federal law requires group health plans to cover services for mental health care or substance abuse at the same levels as medical services. This is called mental health parity. Generally speaking, this means visit limits and cost-sharing amounts, such as copayments and deductibles, must be the same for medical and mental health benefits.

As a result, Anthem reviewed their fully-insured group plans to make sure all benefits comply with the law. But they weren't able to get all of the work done and make any necessary changes in time for the recently released group renewals. That's why they're preparing separate communications that will go out to the employers who already got their renewals, letting them know what's happened and what's changed. If any mental health benefits were changed, they'll also include a new rate quote that reflects those changes.

Changes specific to Large Group ASO plans
Anthem also developed a recommendation for Large Group administrative services only (ASO) plans about what benefits they have to cover to comply with the rule. This applies to ASO plans that use Anthem's standard benefits. Please go over the following recommendation with your ASO clients:

Many of Anthem's ASO groups design their own plans and do not rely on their standard benefit design. For that reason, Anthem should expect that they have consulted with outside counsel and other advisors to determine their compliance needs. Anthem simply requires written guidance from them as to how they want their benefits to be administered.

Going forward, updates to the mental health benefits will be included and explained in all group renewal information and quoted accordingly.

For questions, please contact a member of your b&p Sales Team - 888.722.3373.

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