Information About the Mental Health Parity and Addiction Equity Act (MHPAEA)
Certain state and local non-federal government health plans can apply for an exemption from MHPAEA. A list of those plans is available here: Exempt state and local nonfederal government plans (HHS/CMS/CCIIO)
Federal Resources for Filing a Complaint
General Department of Labor guide How To File A Claim For Your Benefits with your plan & what to do if denied.
The Employee Retirement Income Security Act of 1974 (ERISA) protects the interests of participants and their beneficiaries who depend on benefits from private employee benefit plans. ERISA sets standards for administering these plans, including a requirement that financial and other information be disclosed to plan participants and beneficiaries and requirements for the processing of claims for benefits under the plans.
Although some employee benefit plans are not covered by the ERISA Act (such as church or government plans), if you are in an employee benefit plan that falls under ERISA's protection, you have certain rights if your claim for benefits is denied.
Your plan must give you the reason for the denial in writing and in a manner you can understand. It also must give you a resonable opportunity for a fair and full review of the decision.
For information on how to file an ERISA complaint or ask about employer based insurance coverage and self-insured plans,
- Call the Department of Labor (DOL)/EBSA toll-free line for Consumer Assistance inquiries: 1.866.444.3272;
- The EFAST Help Line 1.866.463.3278;
- send an email via EBSA website
- Or view the EBSA website
- for Technical Part 7 questions: EBSA Office of Health Plan Standards and Compliance Assistance: 202.693.8335;
- Treasury; 202.622.6080.
Note: The Centers for Medicare and Medicaid Services (CMS) has jurisdiction over self-funded public sector (non-federal governmental) plans.
Public Sector Insurance
For Information on or to file a complaint against a public sector self-funded state or local non-federal government health plan
- Call the CMS Health Insurance Hotline 1-877-267-2323, ext 6-1565;
- Or send an email to firstname.lastname@example.org.
House & Senate
Your Member of Congress and Senator may be able to help you answer questions and resolve problems with government programs such as Medicaid.
Use your zip code to find your Member of Congress