icon on Beginning with health plan years on or after January 1, 2025, employers must prepare a “fiduciary certification” stating that the employer has satisfied its fiduciary obligation to prudently select and monitor any service providers to its health plan.
What Does this Mean Exactly?
The Mental Health Parity and Addiction Equity Act (MHPAEA) limits the restrictions health plans can place on mental health and substance abuse treatment. Health plans cannot place greater restrictions (ex, higher copays, prior authorization) on mental health and substance abuse benefits than the restrictions placed on medical/surgical benefits. As proof of this, plans must annually prepare comparative analysis for each benefit showing that no greater restrictions are placed on mental health and substance abuse benefits. Because employers often hire outside vendors to maintain their health plans, such as third-party administrators and health consultants, employers have a fiduciary duty to monitor the service providers to ensure they are maintaining their health plan in compliance with all applicable laws, including the MHPAEA. This new fiduciary certification simply affirms that the employer prudently selects and monitors its health plan service providers and has reviewed the MHPAEA comparative analysis.
How can Howard & Howard Assist?
The MHPAEA and the new fiduciary certification requirement contain complex rules that can be difficult for employers to navigate. Howard & Howard can help employers understand the limits that the MHPAEA places on the ability to impose limitations on mental health and substance abuse benefits, as well as prepare the new fiduciary certifications for employers. We can also work with third party administrators and other health plan service providers to ensure that the comparative analyses are being properly prepared, as well as help employers when requesting the necessary information from their service providers in order to prepare the fiduciary certification. For more information, please contact Maria Topalovic.