f 1974 (ERISA). ERISA forbids states from regulating self-insuring companies. It is estimated that 60 percent of employers are self-insured in the United States. Many state laws also provide exemptions for small businesses. However, it depends on the states definition of “small” on how many people actually benefit from state parity laws. Several problems present themselves concerning state parity laws. This is because state parity laws differ in what is covered, the minimum benefit requirements, approved providers, the use of managed care, exemptions and populations covered and specificity of parity. Coverage seems to be the most troublesome aspect of state parity laws. Parity laws only require that mental health benefits be equal to physical and surgical benefits. If a company has poor physical or surgical benefits then they will have poor mental health benefits. Parity laws also have no control over the quality of care that is given. This proves troublesome in regards to bad managed healthcare organizations. One other coverage problem is that of benefits only related to “biologically based” mental illnesses. Schizophrenia, major depression autism, OCD and bipolar disorders are considered biologically based. This proves to be problematic in regards to only covering severe mental illnesses. Many states followed in the federal laws footsteps and used a broad definition of mental illness. However, this too poses a problem according to some employers, insurance companies and HMO’s. These groups believe that a broad definition of mental illness will promote abuse of benefits. Specifically, the abuse from people who are “worriers”. The majority of these people have do not exhibit symptoms of mental disorder but seek out help for day-to-day problems. May employers are worried that people from this particular group may cause premiums and costs to rise. Vermont’s mental healt...
