Sponsors (2)
Last progress June 5, 2025 (8 months ago)
Introduced on June 5, 2025 by Mark James Desaulnier
Referred to the House Committee on Education and Workforce.
Requires disability benefit plans to treat mental health conditions and substance use disorders the same as physical conditions by banning more restrictive limits or exclusions for behavioral-health disabilities. It creates a new ERISA enforcement authority that lets the Secretary of Labor assess civil penalties against plan sponsors, administrators, and service providers for noncompliance, directs education and a study, authorizes implementation funding, and sets an effective date 18 months after enactment (with a delay for some collective bargaining plans).
The Advisory Council on Employee Welfare and Pension Benefit Plans was created under section 512 of the Employee Retirement Income Security Act of 1974 to give advice and recommendations to the Secretary of Labor (referred to as the ERISA Advisory Council).
In 2023, the ERISA Advisory Council published a report to the Secretary titled "Long-Term Disability Benefits and Mental Health Disparity."
The 2023 report found that discriminatory benefit limitations, including duration limits found in nearly all long-term disability plans, block or impede access to disability benefits for workers whose disability is caused by a behavioral health condition.
The report recommended that the Secretary work with Congress to ensure parity in disability benefits provided to workers.
It is the Sense of Congress that benefit limitations for workers whose disability is caused by a behavioral health condition are discriminatory.
Who is affected and how:
Plan participants and beneficiaries with mental health conditions or substance use disorders: Likely to gain stronger protection, fewer duration-based denials, and better parity in long-term disability benefits. This should improve access to long-term disability support for behavioral‑health conditions.
Employees and workers generally: Workers who rely on employer-provided disability plans will see changes in eligibility and benefit application for behavioral‑health disabilities; greater clarity and legal protections may speed claims and appeals.
Employers, plan sponsors, plan administrators, and service providers: Will face new compliance obligations, possible administrative changes (plan documents, claims processes, documentation and medical-review standards), and exposure to civil penalties for noncompliance. Those costs may include plan administration updates, legal and compliance counseling, and potential increases in benefit payouts depending on claim patterns.
Group health plans and insurance issuers: Insurance products covering disability benefits may need revisions to remove discriminatory limits and ensure parity; state-regulated issuers will be subject to State enforcement and oversight.
State governments and insurance regulators: Will be responsible for enforcing the parity rules for insurers; where States do not act, the Department of Labor can impose enforcement actions.
Department of Labor: Will incur administrative and enforcement duties — conducting a study, leading education efforts, issuing regulations, and collecting penalties — supported by the authorized funding.
Broader implications:
Potential for improved outcomes and financial protection for people with behavioral-health conditions, reducing a barrier to disability support.
Possible short-term administrative costs for employers and insurers; potential longer-term effects on premiums or plan design depending on claim experience and how insurers/practices adapt.
Gives federal backstop to state enforcement but preserves non‑conflicting State laws, aiming to balance federal baseline protections with State regulation of insurance markets.