Consistency of Large Employer and Group Health Plan Benefits with Requirements of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Appendix D. Detailed Analysis of Year-by-year Changes in Cost-sharing by Midsized Employers, 2009-2011

11/01/2013

  Pre-Parity
(2008)
  Percent of Plans  
(n = 86)
Post-Parity
(2009 Only)
  Percent of Plans  
(n = 78)
Post-Parity
(2010 Only)
  Percent of Plans  
(n = 40)
Post-Parity
(2011 Only)
  Percent of Plans  
(n = 36)
Cost-Sharing
Inpatient care: cost-sharing for in-network MH/SUD treatment higher than inpatient medical/surgical care 9% 12% 0% 0%
Inpatient care: cost-sharing for out-of-network MH/SUD treatment higher than inpatient medical/surgical care 16% 89% 10% 6%
Outpatient care: cost-sharing for in-network MH/SUD office visits higher than medical/surgical PCP visits 56% 40% 28% 32%
Outpatient care: cost-sharing for in-network MH/SUD office visits higher than medical/surgical specialist office visits 29% 15% 9% 8%
Outpatient care: cost-sharing for out-of-network MH/SUD treatment higher than outpatient medical/surgical treatment 30% 25% 13% 0%
Treatment Limitations
Inpatient: day limitations for MH/SUD treatment more restrictive than medical/surgical care 84% 64% 22% 13%
Outpatient: visit limitations for MH/SUD treatment more restrictive than for medical/surgical care 81% 75% 23% 13%
SOURCE: Author's analysis of SPDs of midsized employers.
NOTE: Detailed information on employer size was unavailable from BLS. Instead, establishment size was used to identify midsized employers (establishment sizes of 51-500).
NOTE: Analyses should be interpreted with caution due to small sample sizes.

 

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