New Jersey Mental Health Parity Law

BULLETIN NO. 01-06

BULLETIN NO. 01-06

TO: ALL NEW JERSEY LICENSED HEALTH INSURANCE COMPANIES, HEALTH SERVICE CORPORATIONS, MEDICAL SERVICE CORPORATIONS AND HOSPITAL SERVICE CORPORATIONS

FROM: KAREN L. SUTER, COMMISSIONER

RE: NEW JERSEY MENTAL HEALTH PARITY LAW (P.L. 1999, c. 106)

On May 13, 1999, the New Jersey Mental Health Parity law (P.L. 1999, c. 106) (the "Act") was enacted, which became effective August 11, 1999. The Act requires all health contracts, policies and enrollee agreements issued or renewed on or after August 11, 1999 to provide coverage for biologically-based mental illness under the same terms and conditions as provided for any other sickness by the contract, policy or enrollee agreement. The Act defines "biologically-based mental illness" as a mental or nervous condition that is caused by a biological disorder of the brain and results in a clinically significant or psychological syndrome or pattern that substantially limits the functioning of the person with the illness including but not limited to, schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other psychotic disorders, obsessive-compulsive disorder, panic disorder and pervasive developmental disorder or autism. Under the Act, copayments, deductibles or benefit limits applied to biologically-based mental health benefits cannot be different than those applied to other medical or surgical benefits.

It has recently come to the Department's attention that some New Jersey health insurers may not be complying with the requirements of the Act. The purpose of this Bulletin is to remind insurers of their obligation pursuant to the Act to provide coverage for biologically-based mental illness under the same terms and conditions as provided for any other sickness. Insurers are further reminded that this mandated benefit is required to be included in all new policy and contract forms issued after the effective date of the Act, and in endorsements to inforce policies and contracts upon renewal

their obligation pursuant to the Act to provide coverage for biologically-based mental illness under the same terms and conditions as provided for any other sickness. Insurers are further reminded that this mandated benefit is required to be included in all new policy and contract forms issued after the effective date of the Act, and in endorsements to inforce policies and contracts upon renewal.

Insurers having questions about forms filing requirements related to this mandated benefit may contact the Department's Health Bureau at (609) 292-5427.

5/25/01

/s/ Karen L. Suter, Commissioner