Mental Health Parity
[12/17/2004]
Volume 69, Number 242, Page 75797-75799
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Part IV
Department of Labor
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Employee Benefits Security Administration
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29 CFR Part 2590
Mental Health Parity; Final Rule
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DEPARTMENT OF LABOR
Employee Benefits Security Administration
29 CFR Part 2590
RIN 1210-AA62
Mental Health Parity
AGENCY: Employee Benefits Security Administration, Department of Labor.
ACTION: Interim final amendment to regulation.
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SUMMARY: This document contains an interim final amendment to modify
the sunset date of interim final regulations under the Mental Health
Parity Act (MHPA) to be consistent with legislation passed during the
108th Congress.
DATES: Effective date. The interim final amendment is effective
December 31, 2004.
Applicability dates. The requirements of the interim final
amendment apply to group health plans and health insurance issuers
offering health insurance coverage in connection with a group health
plan beginning December 31, 2004. The MHPA interim final amendment
extends the sunset date from December 31, 2004, to December 31, 2005.
Pursuant to the extended sunset date, MHPA requirements apply to
benefits for services furnished before December 31, 2005.
FOR FURTHER INFORMATION CONTACT: Mark Connor, Employee Benefits
Security Administration, Department of Labor, at (202) 693-8335.
Customer Service Information: Individuals interested in obtaining
additional information on the Mental Health Parity Act and other health
care laws may request copies of Department of Labor publications
concerning changes in health care law by calling the EBSA Toll-Free
Hotline at 1-866-444-EBSA (3272), or access the publications on-line at
http://www.dol.gov/ebsa, the Department of Labor's Web site.
Information on the Mental Health Parity Act and other health care laws
is also available on the Department of Labor's interactive Web pages,
Health Elaws (http://www.dol.gov/elaws/ebsa/health).
SUPPLEMENTARY INFORMATION:
A. Background
The Mental Health Parity Act of 1996 (MHPA) was enacted on
September 26, 1996 (Pub. L. 104-204, 110 Stat. 2944). MHPA amended the
Employee Retirement Income Security Act of 1974 (ERISA) and the Public
Health Service Act (PHS Act) to provide for parity in the application
of annual and lifetime dollar limits on mental health benefits with
dollar limits on medical/surgical benefits. Provisions implementing
MHPA were later added to the Internal Revenue Code of 1986 (Code) under
the Taxpayer Relief Act of 1997 (Pub. L. 105-34, 111 Stat. 1080).
The provisions of MHPA, as originally enacted, are set forth in
Part 7 of Subtitle B of Title I of ERISA, Chapter 100 of Subtitle K of
the Code, and Title XXVII of the PHS Act.\1\ The MHPA provisions in
ERISA generally apply to all group health plans other than governmental
plans, church plans, and certain other plans. These provisions also
apply to health insurance issuers that offer health insurance coverage
in connection with such group health plans. Generally, the Secretary of
Labor enforces the MHPA provisions in ERISA, except that no enforcement
action may be taken by the Secretary against issuers. However,
individuals may generally pursue actions against issuers under ERISA
and, in some circumstances, under state law.
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\1\ Part 7 of Subtitle of Title I of ERISA, Chapter 100 of
Subtitle K of the Code, and Title XXVII of the PHS Act were added by
the Health Insurance Portability and Accountability Act of 1996
(HIPAA), Public Law 104-191.
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B. Overview of MHPA
The MHPA provisions set forth in section 712 of ERISA apply to a
group health plan (or health insurance coverage offered by issuers in
connection with a group health plan) that provides both medical/
surgical benefits and mental health benefits. MHPA's original text
included a sunset provision specifying that MHPA's provisions applied
to benefits for services furnished before September 30, 2001. On
December 22, 1997, the Departments of Labor, the Treasury, and Health
and Human Services issued interim final regulations under MHPA in the
Federal Register (62 FR 66931). The interim final regulations included
this statutory sunset date.
On January 10, 2002, President Bush signed H.R. 3061 (Pub. L. 107-
116, 115 Stat. 2177), the 2002 Appropriations Act for the Departments
of Labor, Health and Human Services, and Education. This legislation
extended MHPA's original sunset date under ERISA, the Code, and the PHS
Act, so that MHPA's provisions would apply to benefits for services
furnished before December 31, 2002.
On March 9, 2002, President Bush signed H.R. 3090, the Job Creation
and Worker Assistance Act of 2002 (Pub. L. 107-147, 116 Stat. 21), that
included an amendment to section 9812 of the Code (the mental health
parity provisions). This legislation further extended MHPA's original
sunset date under the Code to December 31, 2003.
On September 27, 2002, the Department of Labor issued an interim
final amendment for mental health parity in the Federal Register (67 FR
60859). The interim final amendment included the new statutory sunset
date under H.R. 3061, so that MHPA's provisions would apply to benefits
for services furnished before December 31, 2002. The Department made
the effective date of this interim final amendment to the regulations
September 30, 2001.
On December 2, 2002, President Bush signed H.R. 5716, the Mental
Health Parity Reauthorization Act of 2002 (Pub. L. 107-313, 116 Stat.
2457), an amendment to section 712 of ERISA and Section 2705 of the PHS
Act. This legislation further extended MHPA's original sunset date
under ERISA and the PHS Act to December 31, 2003. On April 14, 2003,
the Department of Labor issued an interim final amendment for mental
health parity in the Federal Register (68 FR 18048). The interim final
amendment included the new statutory sunset date under H.R. 5716, so
that MHPA's provisions would apply to benefits for services furnished
before December 31, 2003.
On December 19, 2003, President Bush signed S. 1929, the Mental
Health Parity Reauthorization Act of 2003 (Pub. L. 108-197, 117 Stat.
2998), an amendment to section 712 of ERISA and Section 2705 of the PHS
Act. This legislation further extended MHPA's original sunset date
under ERISA and the PHS Act to December 31, 2004. On January 26, 2004,
the Department of Labor issued an interim final amendment for mental
health parity in the Federal Register (69 FR 3815). The final rule
included the new statutory sunset date under S. 1929, so that MHPA's
provisions would apply to benefits for services furnished before
December 31, 2004.
On October 4, 2004, President Bush signed H.R. 1308, the Working
Families Tax Relief Act of 2004 (Pub. L. 108-311, 118 Stat. 1166), an
amendment to section 712 of ERISA, Section 9812 of the Code, and
Section 2705 of the PHS Act. This legislation further extends MHPA's
original sunset date under ERISA, the Code, and the PHS Act to December
31, 2005. Like MHPA, this amendment to MHPA applies to a group health
plan (or health insurance coverage offered by issuers in connection
with a group health plan) that provides both medical/surgical
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benefits and mental health benefits.\2\ As a result of this statutory
amendment, and to assist employers, plan sponsors, health insurance
issuers, and workers, the Department of Labor has developed this
amendment of the interim final regulations, in consultation with the
Departments of the Treasury and Health and Human Services, conforming
the regulatory sunset date to the new statutory sunset date. The
Department is also making conforming changes extending the duration of
the increased cost exemption to be consistent with the new sunset date.
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\2\ The parity requirements under MHPA, the interim regulations,
and the amendment to the interim regulations do not apply to any
group health plan (or health insurance coverage offered in
connection with a group health plan) for any plan year of a small
employer. The term ``small employer'' is defined as an employer who
employed an average of at least 2 but not more than 50 employees on
business days during the preceding calendar year and who employs at
least 2 employees on the first day of the plan year.
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Since the extension of this sunset date is not discretionary, this
amendment to the MHPA regulations is promulgated on an interim final
basis pursuant to Section 734 of ERISA. This interim final amendment is
also promulgated pursuant to Section 553(d)(3) of the Administrative
Procedure Act, allowing for regulations to become effective immediately
for good cause.
C. Executive Order 12866
Under Executive Order 12866, the Department must determine whether
a regulatory action is ``significant'' and therefore subject to the
requirements of the Executive Order and subject to review by the Office
of Management and Budget (OMB). Under section 3(f), the order defines a
``significant regulatory action'' as an action that is likely to result
in a rule: (1) Having an annual effect on the economy of $100 million
or more, or adversely and materially affecting a sector of the economy,
productivity, competition, jobs, the environment, public health or
safety, or state, local or tribal governments or communities (also
referred to as ``economically significant''); (2) creating serious
inconsistency or otherwise interfering with an action taken or planned
by another agency; (3) materially altering the budgetary impacts of
entitlement grants, user fees, or loan programs or the rights and
obligations of recipients thereof; or (4) raising novel legal or policy
issues arising out of legal mandates, the President's priorities, or
the principles set forth in the Executive Order.
Pursuant to the terms of the Executive Order, it has been
determined that this action is not a ``significant regulatory action''
within the meaning of the Executive Order. This action is an amendment
to the interim final regulations and merely extends the regulatory
sunset date to conform to the new statutory sunset date added by H.R.
1308.
D. Paperwork Reduction Act
The information collection provisions of MHPA incorporated in the
Department's interim final rules are currently approved under OMB
control numbers 1210-0105 (Notice to Participants and Beneficiaries and
Federal Government of Electing One Percent Increased Cost Exemption),
and 1210-0106 (Calculation and Disclosure of Documentation of
Eligibility for Exemption). Because this action does not change the
approved information collection provisions, no submission for OMB
approval is being made in connection with this interim final amendment.
However, because OMB's approval for the information collection requests
approved under control numbers 1210-0105 and 1210-0106 were scheduled
to expire on November 30, 2004 and October 31, 2004, respectively, the
Department requested public comment on their proposed renewal, and has
submitted requests to OMB for continuing approval. OMB is currently
reviewing those requests.
E. Regulatory Flexibility Act
The Regulatory Flexibility Act (5 U.S.C. 601 et seq.) (RFA) imposes
certain requirements with respect to federal rules that are subject to
the notice and comment requirements of section 553(b) of the
Administrative Procedure Act (5 U.S.C. 551 et seq.). Because this
amendment to the interim final regulations is being published on an
interim final basis, without prior notice and a period for comment, the
Regulatory Flexibility Act does not apply.
F. Unfunded Mandates Reform Act
For purposes of the Unfunded Mandates Reform Act of 1995 (Pub. L.
104-4) (UMRA), as well as Executive Order 12875, this interim final
amendment does not include any federal mandate that may result in
expenditures by state, local, or tribal governments, and does not
include mandates that may impose an annual expenditure of $100 million
or more on the private sector.
G. Congressional Review Act
This interim final amendment is subject to the Congressional Review
Act provisions of the Small Business Regulatory Enforcement Fairness
Act of 1996 (5 U.S.C. 801 et seq.) (SBREFA), and has been transmitted
to Congress and the Comptroller General for review. This amendment to
the interim final regulations is not a major rule, as that term is
defined by 5 U.S.C. 804.
H. Federalism Statement
Executive Order 13132 (August 4, 1999) outlines fundamental
principles of federalism and requires the adherence to specific
criteria by federal agencies in the process of their formulation and
implementation of policies that have substantial direct effects on the
states, the relationship between the states, the relationship between
the national government and the states, or on the distribution of power
and responsibilities among the various levels of government. This
interim final amendment does not have federalism implications as it
only conforms the regulatory sunset date to the new statutory sunset
date added by H.R. 1308.
List of Subjects in 29 CFR Part 2590
Continuation coverage, Disclosure, Employee benefit plans, Group
health plans, Health care, Health insurance, Medical child support,
Reporting and recordkeeping requirements.
Employee Benefits Security Administration
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29 CFR part 2590 is amended as follows:
PART 2590--RULES AND REGULATIONS FOR GROUP HEALTH PLANS
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1. The authority for part 2590 is revised to read as follows:
Authority: 29 U.S.C. 1027, 1059, 1135, 1161-1168, 1169, 1181-
1183, 1181 note, 1185, 1185a, 1185b, 1191, 1191a, 1191b, and 1191c,
sec. 101(g), Pub. L. 104-191, 101 Stat. 1936; sec. 401(b), Pub. L.
105-200, 112 Stat. 645 (42 U.S.C. 651 note); Secretary of Labor's
Order 1-2003, 68 FR 5374 (Feb. 3, 2003).
Sec. 2590.712 [Amended]
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2. Amend Sec. 2590.712(f)(1), (g)(2), and (i) by removing the date
``December 31, 2004'' and add in its place the date ``December 31,
2005'' wherever it appears in these paragraphs.
Signed in Washington, DC this 10th day of December, 2004.
Ann L. Combs,
Assistant Secretary, Employee Benefits Security Administration.
[FR Doc. 04-27531 Filed 12-16-04; 8:45 am]
BILLING CODE 4510-29-P
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