Table 1—Accounting Statement
Benefits: • Improved understanding of and compliance with MHPAEA by plans and issuers, resulting in better frameworks for determining whether plans and issuers are complying with MHPAEA with respect to NQTLs applicable to mental health and substance use disorder benefits and medical/surgical benefits. • Greater access and utilization of mental health and substance use disorder services by reducing barriers to coverage of mental health and substance use disorder treatment, which will result in better health outcomes for those with mental health conditions or substance use disorders. • Reduction in the negative impacts on families, friends, caregivers, and coworkers of those with untreated or poorly managed mental health conditions or substance use disorders based on their improved access to treatment. Costs: • Increased costs to plans and issuers to implement changes associated with the revision of plan provisions, which would result in increased costs from expanded coverage of mental health and substance use disorder services. • Costs to plans and issuers from collecting and evaluating outcomes data and documenting NQTL comparative analyses consistent with the requirements of these final rules of approximately $656.2 million in the first year and approximately $131.2 million in subsequent years or between 0.07 percent and 0.01 percent of total health insurance premiums in the group and individual markets. • Costs to plans and issuers for preparing and mailing the comparative analyses upon request to participants, beneficiaries, and enrollees of approximately $14.8 million annually. • Cost to plan and issuers for providing comparative analyses for audits is approximately $23,800. • First-year regulatory review costs to plans and issuers for familiarizing themselves with these final rules of approximately $10.8 million. • Cost to plan and issuers to maintain recordkeeping is approximately $12.2 million. • Potential increase in cost-sharing requirements and/or treatment limitations for medical/surgical benefits for participants, beneficiaries, and enrollees, if plans and issuers try to achieve parity by imposing new restrictions on medical/surgical benefits, rather than by reducing restrictions on access to mental health or substance use disorder benefits. • Potential costs to self-funded non-Federal governmental plans that opted out of MHPAEA to come into compliance with requirements under MHPAEA. • Cost savings to self-funded non-Federal governmental plans of approximately $11,783 annually in total from no longer sending opt-out notices regarding a plan's MHPAEA opt-out election. • Cost savings for the Federal Government of approximately $5,200 annually from fewer opt-out notices being submitted by self-funded non-Federal governmental plans.