The Mental Health Parity Act (MHPA)

As required by federal law, the Southern California IBEW-NECA Retiree Health Plan is required to furnish you with information on the Mental Health Parity Act, or also known as MHPA. Generally speaking, the purpose of the MHPA is to require health plans that offer mental health benefits, to provide parity in the application of lifetime dollar limits on mental health benefits in the same manner as provided for medical/surgical benefits.

There are however many other provisions of the law which also allow health plans flexibility. For example, there is no requirement that health plans even provide mental health benefits. Also, this law does not apply to benefits for substance abuse or chemical dependency.

Another important aspect of this law is that a health plan can choose to remove mental health benefits from their core medical plan, and offer a separate mental health plan (called a "carve out") with a totally separate set of benefits. For example, the plan can require that all hospital stays be approved, and further that the number of days of coverage be limited. There can also be limits on the number of outpatient visits for psychotherapy allowed under the plan.

Below is a simplified explanation of the benefits you are entitled to for mental health benefits under the Southern California IBEW-NECA Retiree Health Plan provided you are enrolled in an HMO.

Kaiser Permanente (Early Retirees & Senior Advantage), PacifiCare and Secure Horizons Participants

HMO members will receive benefit coverage for the diagnosis and medically necessary treatment of serious mental illness (SMI) and serious emotional disturbances (SED) of a child. SMI includes the following conditions:

• Anorexia Nervosa
• Bipolar Disorder
• Bulimia Nervosa
• Major Depressive Disorder
• Obsessive-Compulsive Disorder
• Panic Disorder
• Pervasive Developmental Disorder, including Autistic Disorder, Rett’s Disorder, Asperger’s Disorder and Pervasive Developmental Disorder not otherwise specified, including Atypical Autism.
• Schizoaffective Disorder
• Schizophrenia

PacifiCare Early Retiree Participants

PacifiCare early retiree participants are covered for mental health benefits under a separate "carve out" plan.  Refer to the separate Summary Plan Description listed in the Table of Contents under the heading "Mental Health and Chemical Dependency Plan – PacifiCare Early Retirees Only".