Innovation is a driving force behind mental health parity

One of the many eye-opening lessons from COVID-19 lockdowns was that a healthy mind can be just as important as a healthy body. Isolation triggered a worldwide mental health crisis and exacerbated an already alarming opioid epidemic marked by mounting addiction and overdoses. 

This is the second of a four-part series of articles on how the employee populations that benefit advisers serve are benefiting from post-pandemic silver linings, the positive effects of which are expected to last for years to come.

While the playing field is still largely uneven in terms of how group health plans are treating mental and physical illnesses, positive changes are taking hold across the marketplace. There are numerous paths to parity for behavioral health coverage other than a legislative remedy that needs to be reauthorized or enforced. Look no further than innovation from the carrier community.

Including a rider for mental health treatment in a critical-illness plan represents an example of a novel approach to making traditionally costly coverage more accessible and affordable. It can be a key differentiator that not only refreshes an old benefit offering, but also normalizes an expanded benefits definition to combat untreated illness.

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Mental health issues and substance use disorder can become critical illnesses. Severe mental illnesses, for example, are just as devastating from a clinical and financial standpoint as any other physical critical illness, with significant ramifications for employees and employers alike. Some cases may require hospitalization. 

Critical-illness plans, along with the entire voluntary benefits category, have become largely commoditized with virtually every carrier offering many of the same benefit provisions. Brokers, consultants and advisers are always looking for unique features for a more robust solution within their overall portfolio of products or services. This is an example of different ways to deliver value to those who enroll in benefit plans. 

Although there's still a stigma associated with seeking treatment for mental health and substance abuse, a combination of products can help move the needle on adoption of this benefit and achieve health parity in the process. Between better benefits and reduced out-of-pocket costs, health plan members will be more apt to finally receive the help they've long been putting off for fear of any financial consequences. 

Offering these benefits in a virtual setting also helps make behavioral health more accessible because it's less expensive than in-person treatment. And since this care model vastly improves patient privacy, people suffering from mental illness or substance abuse will be far more receptive to treatment. These factors, along with innovative plan design, converge to help achieve true benefits parity. 

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It also behooves payers to embrace these marketplace changes. I believe many insurance carriers would be willing to cover these conditions if the plan can prevent the need for payment on a serious diagnosis or admission to an inpatient care unit for those types of diagnoses. But there needs to be accounting for that within a health savings account-type of environment. 

You can get innovative from a hospital indemnity standpoint, but it has to be done on an inpatient-only basis. Otherwise, the plan runs the risk of becoming non-HSA compatible. There's likely going to need to be an adjustment or modification in the future for us to be able to incorporate mental health outpatient services such as telemedicine while keeping them HSA compatible and operating on all cylinders. Unfortunately, the Departments of Treasury, Labor and Health and Human Services are moving in the opposite direction — proposing time-period payments on hospital indemnity and fixed indemnity plans, regardless of services provided. This may negatively affect members seeking behavioral health treatment.

Resources such as employee assistance programs and employee resource groups can help remove care obstacles and increase benefits utilization. Many times what is needed to achieve this is simply effective benefits communication, education and engagement. Voluntary benefit carriers are often tasked with spearheading those campaigns to explain the value proposition to employees within employer groups, which can be done in partnership with brokers, consultants and advisers.

With all of the challenges employers are now facing post-pandemic, there's a growing realization about the need to offer more than table stakes in the employee benefits portfolio. Accessible and affordable coverage for mental health and substance abuse will do more than just prevent costly conditions and improve outcomes. It also will help attract and retain top talent. 

Read more: Credentialed recovery programs benefit employees with substance use disorder

That starts with helping remove the stigma associated with using behavioral health benefits by improving communication about the importance of this coverage. We've made incredible headway since COVID-19 helped demystify these conditions and remove shame from the equation. But we're not quite there yet. There needs to be more socialization and testimonials with people who are willing to come forward and share their experiences. 

Another consideration is to recognize generational differences within the workplace when communicating the value proposition of these benefits. A baby boomer, for instance, is going to have a very different approach to mental health than a Gen Z employee — a generation that tends to be more willing to share about their lives. Those two generations are not going to share the same worldview, let alone millennials and Gen Xers. I believe what you'll find is that it's going to vary from one generation to the next. 

The more employees recognize themselves within these testimonials, the more acceptance there will be removing the stigma of these conditions. And with more people seeking treatment, it will be easier to achieve benefits parity, especially if they have the coverage that keeps them financially stable at the same time.