Annual Attestations under Acts 89 and 92; Notice 2021-05
[51 Pa.B. 2610]
[Saturday, May 8, 2021]
The General Assembly of the Commonwealth enacted the act of October 29, 2020 (P.L. 736, No. 89) (Act 89), adding 40 Pa.C.S. Chapter 43 (relating to mental health parity and access to addiction treatment), and the act of October 29, 2020 (P.L. 769, No. 92) (Act 92), add- ing sections 604.1-B and 604.2-B of the Insurance Company Law of 1921 (40 P.S. §§ 908-14a and 908-14b) to require annual attestation of efforts to comply with the Paul Wellstone and Pete Domenici Mental Health Parity and Addition Equity Act of 2008 (MHPAEA) (Pub.L. No. 110-343) (42 U.S.C. §§ 300gg—300gg-95) and Federal regulations regarding parity in mental health and substance use disorder benefits (MH/SUD Parity Federal regulations). In addition, Congress recently amended MHPAEA regarding compliance with nonquantitative treatment limitation requirements. See section 2726(a)(8) of the Public Health Service Act (42 U.S.C. § 300gg-26(a)(8)), as added by the Consolidated Appropriations Act of 2021 (Pub.L. No. 116-260).
The Insurance Department (Department) provides the following guidance to insurance entities (insurers) seeking to demonstrate compliance with the annual attestation requirements established under Acts 89 and 92.
Acts 89 and 92 require insurers to annually file a statement with the Department attesting to either the insurer's efforts to comply with MHPAEA and the MH/SUD Parity Federal regulations, or the nonapplicability of MHPAEA, as to the form for each health insurance policy offered, issued or renewed by an insurer. Attestation filing requirements apply to forms for each insurance policy to be offered, issued or renewed in the Commonwealth after December 31, 2021.
If a form for a health insurance policy to be offered, issued or renewed is required to be filed with the Department, the attestation shall be submitted with the form filing. To facilitate an efficient review, insurers are encouraged to submit the attestation with the form filing in SERFF as part of the supporting documentation.
If a form for a health insurance policy to be offered, issued or renewed is not required to be filed with the Department, as set forth in Department Notice 2018-10 (48 Pa.B. 7282 (November 17, 2018)), the attestation shall be made by no later than April 30 after the policy is offered, issued or renewed. To facilitate an efficient review, insurers are encouraged to submit the attestation in SERFF using the appropriate major medical type of insurance and, where applicable, referencing the previously approved form number and corresponding SERFF tracking number.
To comply with the annual attestation requirement, an insurer may file with the Department an attestation executed by an authorized representative of the insurer substantially identical to the attestation form on the following Attachment A. Attachment A is also available in the Product Filing section on the Department's web site at https://www.insurance.pa.gov/Companies/ProductAndRateRequire/Pages/default.aspx.
Questions regarding this notice may be directed to Tracie Gray, Director, Bureau of Accident and Health, Insurance Department, 1311 Strawberry Square, Harrisburg, PA 17120, RAfirstname.lastname@example.org.
JESSICA K. ALTMAN,
Exemplar Attestation Form
______ [Company Name] ______ , through the undersigned authorized representative, hereby attests that, as required by Acts 89 and 92 of 2020:
[ ] [Company Name] has performed and documented analyses of its efforts to comply with the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended, and the Mental Health/Substance Use Disorder Parity Federal regulations (MH/SUD Parity Federal regulations) for Form [Form Number]. The performed and documented analyses for each quantitative treatment limitation (including financial requirements) (QTL) and each non-quantitative treatment limitation (NQTL) applicable to a Mental Health or Substance Use Disorder (MH/SUD) benefit covered under the policy form, as required by Act 89 and Act 92 of 2020, include each of the following:
(i) Baseline analyses pursuant to § 604.2-B(a)(1) for the first year the limitation applies;
(ii) Analyses of each change thereafter to a limitation pursuant to § 604.2-B(a)(2);
(iii) Disclosure documents required pursuant to § 604.2-B(a)(3).
[ ] [Company Name] has NOT performed and documented analyses of its efforts to comply with the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended, and the Mental Health/Substance Use Disorder Parity Federal regulations (MH/SUD Parity Federal regulations) for [Form Number]. MHPAEA does not apply to [Form Number] because [provide reason, e.g., retiree-only plan, excepted benefits, small employer exception, increased cost exception].
I, ______ (authorized representative's name) ______, hereby warrant that I have full, complete and final authority to make this attestation on behalf of the Company, and that the representations set forth in this Attestation are true, correct, and complete.
Policy Form # _________________
Name and Title of Authorized Representative of the Company
Signature of Authorized Representative of the Company
[Pa.B. Doc. No. 21-729. Filed for public inspection May 7, 2021, 9:00 a.m.]
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