From the September 2009 issue of Ceridian Connection.

If health care reform, recent COBRA subsidy changes under the American Recovery and Reinvestment Act (ARRA) and other legislative ups and downs were not enough, employers will be putting the pieces of another legislative puzzle together later this year. With the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 comes true equality for medical/surgical, mental health and substance abuse benefits in health care plans. The law, which takes effect January 1, 2010, requires employee sponsored health insurance plans sponsored by businesses with more than 50 employees to provide comparable day and visit limits, deductibles, copays, and out-of-network charges for mental health and substance abuse benefits. This expands on a prior federal law with narrower parity provisions. Self-insured plans, which are regulated under ERISA, do not have to comply with state parity laws, but they will need to comply with the new federal regulation. Changes under the law could impact as many as 82 million individuals.

According to the Congressional Budget Office (CBO), the cost of parity legislation increases, on average, group health care premiums by 0.2 percent to 0.4 percent. It is estimated that an individual would pay an extra 46 cents per biweekly paycheck; a family would pay an estimated $1.02. According to CBO's estimate, employers would bear the cost of only 1.6 percent of the estimated premium increase.

The previous 1996 federal parity law required parity coverage only for lifetime and annual dollar limits. It did not apply to benefits for substance abuse disorders. Building on the 1996 parity law, the new law requires parity coverage for annual and lifetime dollar limits. However, some loopholes may still exist under the new provisions for the act. Only those plans that offer mental health or substance use benefit coverage must provide it at parity. Also, the law does not address the uninsured.

Bank on your EAP
Mental health is increasingly being recognized as part of the overall health and wellness equation. Partnership for Workplace Mental Health, a program of the American Psychiatric Foundation, cites a Harvard study that shows more than 35 million persons -- approximately 14 percent of the U.S. adult population -- suffer from a moderate or serious mental disorder in any given year. Eighteen million Americans are affected specifically by depression on an annual basis -- twice as many as those who are affected by coronary artery disease. Partnership for Workplace Mental Health also reports that:

• Mental illnesses frequently coexist with other diseases.


• Recent advances in medical science have yielded successful treatments for mental disorders.
  
• Mental illness saps productivity.


• Untreated mental illnesses contribute to overall health care costs.


• Disability for mental illnesses is a serious and growing problem.


• When appropriately designed and managed, mental health care results in minimal costs.

Employee assistance programs (EAPs) can help organizations cost-effectively ensure mental health parity by addressing the majority of mental health issues before the issues have the opportunity to develop into larger, more costly mental health concerns and claims. EAPs can also advocate for those who do need to gain access into the health plan's behavioral health benefits -- sooner rather than later -- for conditions covered under Parity. This can help averting costly, acute inpatient hospitalizations and reduce the incidence of mental health crises.

"With an EAP, you are identifying early onset of mental health issues and providing appropriate care," said Rob Kramer, Ph.D., Ceridian LifeWorks director of institutional and global sales. Kramer's background in administering substance abuse and mental health programs provides unique insight into effective mental health components of employee assistance programs. "Untreated mental health conditions also can manifest in physical problems. These include gastrointestinal disorders, headaches or high blood pressure, which can lead to coronary artery disease. Stress can have a substantial impact on one's immune system and makes individuals more vulnerable to other diseases and medical problems. Early identification and treatment of mental health issues may actually help to reduce health claims."

The Partnership for Workplace Mental Health further reinforces the impact of mental health issues on worker productivity and health costs. Employees with depression cost employers an estimated $44 billion per year in lost productive time. Mental illness and substance abuse annually cost employers an estimated $80 to $100 billion in indirect costs.

To help employers plan for the upcoming legislative changes related to the Parity Act, Ceridian is consulting with customers to explore additional ways they can use their EAP to proactively address mental health issues in their employee population. Ceridian is also providing clients with resources to promote their EAP as the first course of action for their employees to help reduce behavioral health costs.

"When employers address issues within the EAP, it can lessen the impact on their health plan dollars," adds Kramer. "Ceridian's Employee Assistance Program, integrated with Ceridian's Work-Life Program, Health and Wellness Services, and Health and Productivity Solutions, are all designed to work together."

Ceridian's holistic approach complements, rather than duplicates, mental health provisions within your health plan. When you address mental health issues early on, your business will benefit with increased productivity and efficiency -- and may even reduce overall health care costs. Visit us online and learn more about how our comprehensive resources can enhance your business performance.