This self-compliance tool is useful for group health plans, plan sponsors, plan administrators, health insurance issuers, and other parties to determine whether a group health plan is in compliance with some of the provisions of Part 7 of ERISA. On October 23, 2020 the Department released a stand-alone update to section II of the self-compliance tool on the requirements of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). As directed by Section 13001(a) of the 21st Century Cures Act, this publicly available tool* is as a compliance program guidance document to improve compliance with MHPAEA and includes additional examples of compliance and non-compliance. The requirements described in the Part 7 tool generally apply to group health plans and group health insurance issuers. However, references in this tool are generally limited to "group health plans" or "plans" for convenience.
Under the Affordable Care Act, there are various provisions that apply to group health plans and health insurance issuers and various protections and benefits for consumers that are beginning to take effect or that will become effective very soon. The Departments are working together with employers, issuers, States, providers and other stakeholders to help them come into compliance with the new law and are working with families and individuals to help them understand the new law and benefit from it, as intended. Compliance assistance is a high priority for the Departments. Our approach to implementation is and will continue to be marked by an emphasis on assisting (rather than imposing penalties on) plans, issuers and others that are working diligently and in good faith to understand and come into compliance with the new law. This approach includes, where appropriate, transition provisions, grace periods, safe harbors, and other policies to ensure that the new provisions take effect smoothly, minimizing any disruption to existing plans and practices. See DOL FAQs About the Affordable Care Act Implementation Part I, question 1.
* Please note that the 2020 MHPAEA Self-Compliance Tool was last updated before the enactment of the Consolidated Appropriations Act, 2021 (CAA), and while it suggests using the tool as a best practice, it does not reflect that plans and issuers subject to MHPAEA are now required to perform and document their NQTL comparative analyses under the CAA. Plans and issuers that have carefully applied the guidance in the Self-Compliance Tool should be in a strong position to comply with the CAA’s requirement to perform and document a comparative analysis with respect to the design and application of NQTLs.