Insurance Plan Coverage

In order to fully understand your rights, it is important to know what type of insurance plan you have. Not all plans are covered by parity laws, and some plans are covered by only the federal law. If you are unsure what type of plan you have, you can ask your HR Director at your employer or call the number on the back of your insurance card. Please reference this document to learn if your insurance plan is covered by the Parity Law.

What does self insured mean?

Normally an employer buys insurance and pays a monthly premium for your coverage (you may pay a portion of that monthly fee through payroll deduction). The insurance company pays all of the medical bills for insured employees. If employees have a large amount of medical bills that exceed the total of the monthly premiums collected by the insurance company, the insurer is “at risk” and pays the difference. Some large companies prefer to hold the risk themselves and contract with insurance companies only to administer their insurance plan (i.e. handling enrollment and paying health care providers for services rendered, with the company’s money). This is referred to as a self insured plan. These plans are not regulated by State Laws.

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Related Article

10 Things You Should Know About the Mental Health Parity Law

1. Current regulations went into effect in January of 2010.
The Wellstone and Domenici Mental Health Parity and Addiction Equity Act was passed in 2008, but Interim Final Regulations were released in 2010. All insurance plans that are not specifically exempted from the law must now be in compliance.

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