Common use of NOTICES AND DISCLOSURES Clause in Contracts

NOTICES AND DISCLOSURES. Behavioral Health Care Parity This plan provides parity in benefits for behavioral health services. This means that coverage of benefits for mental health and substance use disorders is generally comparable to, and not more restrictive than, the benefits for physical health. Financial requirements, such as deductibles, copayments, or benefit limits that may apply to a behavioral health service benefit category, such as inpatient services, are not more restrictive than those that apply to most medical benefits within the same category. Different levels of financial requirements to different tiers of prescription drugs are applied without regard to whether a prescription drug is generally prescribed for physical, mental health, or substance use disorders. Other requirements, that are not expressed numerically, are applied to behavioral health services in comparable ways as medical benefits. Such requirements may include medical management standards, formulary design, network tier design or standards for provider admission into a network.

NOTICES AND DISCLOSURES. Behavioral Health Care Parity This plan provides parity in benefits for behavioral health services. This means that coverage of benefits for mental health and substance use disorders is generally comparable to, and not more restrictive than, the benefits for physical health. Financial requirements, such as deductibles, copayments, or benefit limits that may apply to a behavioral health service benefit category, such as inpatient services, are not more restrictive than those that apply to most medical benefits within the same category. Different levels of financial requirements to different tiers of prescription drugs are applied without regard to whether a prescription drug is generally prescribed for physical, mental health, or substance use disorders. Other requirements, that are not expressed numerically, are applied to behavioral health services in comparable ways as medical benefits. Such requirements may include medical management standards, formulary design, network tier design or standards for provider admission into a network.