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Mental Health Parity (MHPAEA) Disclosure

Discloses the right to request the plan's comparative analyses and criteria for MH/SUD treatment limitations. Include with materials for plans offering MH/SUD benefits.

Companies Eligible

Plans that cover mental health or substance-use-disorder benefits: every self-funded plan, and fully insured large-group plans.

Small-group insured plans satisfy parity through the state benchmark and the carrier's design, so the carrier handles it. For everyone else the plan is the party that must be able to answer a request.

What it is

The disclosure tells participants they can request the criteria the plan uses for medical necessity determinations on MH/SUD benefits, the reason for any denial, and the plan's comparative analyses of non-quantitative treatment limitations (prior authorization, network adequacy, reimbursement methods, exclusions) required by the CAA 2021. It is a statement of rights, not a copy of the analysis.

What needs to be done

  • When: No fixed date. Include it in the annual packet and the SPD so participants know how to request; then respond to requests promptly — comparative analyses go to regulators within 10 business days of a request, medical-necessity criteria and denial reasons to participants on request.
  • To whom: Participants and beneficiaries.
  • Who performs: Insured: the carrier prepares the comparative analysis — obtain a copy or written confirmation. Self-funded: the sponsor commissions it from the TPA, PBM or a vendor and is the fiduciary.
  • Customize: Plan name and the contact for requests.
  • Deliver: With the annual packet and SPD.
  • Keep: The comparative analysis on file with its date and preparer.

Status as of September 2026: the Departments' May 2025 non-enforcement of the 2024 rule's new provisions continues, they told the court in March 2026 they will issue a new proposed rule by December 31, 2026 rather than defend the 2024 rule, and EBSA published a parity bulletin and enforcement tool in September 2026. The statutory duty to perform and document the comparative analysis remains in effect and enforcement focuses on exclusions, prior authorization, network adequacy and reimbursement.

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