Mental health parity continues to be an important compliance obligation for employer-sponsored group health plans. While recent federal actions have created some confusion, employers should understand that the core requirements of the Mental Health Parity and Addiction Equity Act (MHPAEA) remain in effect.

MHPAEA generally requires that mental health and substance use disorder (MH/SUD) benefits be offered on terms that are no more restrictive than those that apply to medical and surgical benefits. The goal is to ensure that participants have meaningful access to mental health and substance use disorder treatment and are not subject to limitations that are more restrictive than those imposed on other healthcare services.

Why Are Employers Hearing About Mental Health Parity Again?

In 2024, federal agencies issued a final rule that would have expanded and clarified certain mental health parity requirements. However, in 2025, the Departments of Labor, Health and Human Services, and Treasury announced a temporary non-enforcement policy for the 2024 final rule while it undergoes further review.

As a result, some employers have mistakenly concluded that mental health parity requirements have been suspended. That is not the case.

The temporary non-enforcement policy applies to the 2024 final rule while federal agencies reconsider its requirements. However, the longstanding mental health parity framework—including requirements established under prior regulations and the Consolidated Appropriations Act of 2021—remains in effect.

What Are Employers Still Required to Do?

For plans that provide mental health or substance use disorder benefits, parity requirements continue to apply. This includes ensuring that financial requirements and treatment limitations are not more restrictive than those that apply to comparable medical and surgical benefits.

Employers must also continue to maintain a written comparative analysis of any non-quantitative treatment limitations (NQTLs) imposed under the plan. NQTLs are non-numerical restrictions that may affect access to benefits, such as prior authorization requirements, utilization management practices, network admission standards, or provider reimbursement methodologies.

The comparative analysis requirement was established by Congress in 2021 and remains in effect despite the temporary non-enforcement of the 2024 final rule.

Why This Matters

Mental health parity remains an active area of regulatory scrutiny. Federal agencies continue to request and review NQTL comparative analyses during investigations and audits, and parity-related issues continue to receive attention from the courts.

Employers do not need to become experts in the technical requirements of parity testing. However, they should understand that compliance efforts should continue, even while the 2024 final rule remains under review.

Practical Steps for Employers

Employers should work with their carriers, third-party administrators, pharmacy benefit managers, and advisors to confirm that mental health parity obligations are being addressed. Plans should maintain current documentation supporting compliance efforts and ensure that any required comparative analyses are completed and readily available if requested.

A proactive approach today can help avoid challenges later if questions arise regarding plan design or administration.

Final Reminder

The temporary non-enforcement of the 2024 final rule did not eliminate existing mental health parity requirements. Employers should continue to monitor compliance efforts and maintain the documentation necessary to demonstrate compliance.

If you have questions about mental health parity requirements or would like assistance understanding your plan’s obligations, your INSURICA team is available to help.

This is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel or an insurance professional for appropriate advice.