Mental health conditions affect more than one in five Americans at some point. However, only about half of those individuals receive professional mental health treatment. One of the primary factors influencing access to mental health care is whether a person has health insurance that includes mental health benefits.
With the enactment of the Affordable Care Act (ACA), non-grandfathered health plans in the individual and small group markets must cover mental and behavioral health services as part of the 10 essential health benefits. This means most fully insured group health plans sponsored by small businesses—typically those with fewer than 50 employees—now include mental health coverage.
Health plans must also comply with the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008. This law ensures that group health plans and insurance providers offering mental health and substance use disorder benefits do not impose stricter limitations on these services than they do on medical and surgical care. The MHPAEA applies to plans regulated under the Employee Retirement Income Security Act (ERISA) of 1974, meaning self-funded plans must also meet federal mental health parity requirements. Employers that fail to comply with MHPAEA may face IRS excise taxes, typically $100 per affected individual per day unless they qualify for an exemption.
Mental health conditions, including depression and anxiety, significantly impact the workplace. Employees with untreated or unmanaged mental health issues often experience higher medical costs and an increased likelihood of utilizing general healthcare services rather than seeking psychiatric care. Despite this, many employers underestimate the broader impact of mental health disorders, such as absenteeism, decreased productivity, and compromised decision-making, which can lead to financial losses.
Some forward-thinking employers recognize that the loss of productivity associated with mental health issues surpasses the cost of treatment. This realization, coupled with the ongoing need to control healthcare expenses, motivates more businesses to implement strategies that support employees’ mental well-being.
Human resource professionals and business leaders can take proactive steps to promote mental well-being in the workplace while managing healthcare costs. The following strategies can create a more supportive environment for employees:
Employee Assistance Programs (EAPs): Offering EAPs can help remove the stigma surrounding mental health treatment while providing cost-effective counseling services. These programs encourage employees to seek professional help without financial barriers.
Mental Health Screenings: Regular screenings can help identify early signs of mental health conditions, allowing employees to receive timely intervention and support.
Employee Education Initiatives: Raising awareness about mental health through workshops, seminars, and training sessions can reduce stigma and encourage open discussions about mental well-being.
Primary Care Physician Involvement: Encouraging primary care providers to discuss mental health with employees can lead to early diagnosis and appropriate treatment referrals.
For those seeking further information on mental health benefits, the following resources provide valuable guidance:
U.S. Department of Labor: www.dol.gov
Substance Abuse and Mental Health Services Administration (SAMHSA): www.samhsa.gov
National Institute of Mental Health (NIMH): www.nimh.nih.gov
By prioritizing mental health benefits in workplace insurance plans, employers can improve overall employee well-being, reduce healthcare costs, and foster a more productive work environment. Investing in mental health initiatives is not just a corporate responsibility—it is a strategic decision that benefits both employees and businesses alike.
Talk to a TPG Health and Benefits Specialist for more valuable Employee Benefits guidance; Give us a call at 909.466.7876 today!
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