PUBLIC LAW 104-204—SEPT. 26, 1996
110 STAT. 2945
" SEC. 712. PARITY IN THE APPLICATION OF CERTAIN LIMITS TO 29 USC 1185a.
MENTAL HEALTH BENEFITS.
"(a) IN GENERAL.—
"(1) AGGREGATE LIFETIME LIMITS.— In the case of a group
health plan (or health insurance coverage offered in connection
with such a plan) that provides both medical and surgical
benefits and mental health benefits—
"(A) No LIFETIME LIMIT.— I f the plan or coverage does
not include an aggregate lifetime limit on substantially
all medical and surgical benefits, the plan or coverage
may not impose any aggregate lifetime limit on mental
health benefits.
"(B) LIFETIME LIMIT.— If the plan or coverage includes
an aggregate lifetime limit on substantially all medical
and surgical benefits (in this paragraph referred to as
the 'applicable lifetime limit'), the plan or coverage shall
either—
"(i) apply the applicable lifetime limit both to the
medical and surgical benefits to which it otherwise
would apply and to mental health benefits and not
distinguish in the application of such limit between
such medical and surgical benefits and mental health
benefits; or
"(ii) not include any aggregate lifetime limit on
mental health benefits that is less than the applicable
lifetime limit.
"(C) RULE IN CASE OF DIFFERENT LIMITS.— In the case
of a plan or coverage that is not described in subparagraph
(A) or (B) and that includes no or different aggregate lifetime limits on different categories of medical and surgical
benefits, the Secretary shall establish rules under which
subparagraph (B) is applied to such plan or coverage with
respect to mental health benefits by substituting for the
applicable lifetime limit an average aggregate lifetime limit
that is computed taking into account the weighted average
of the aggregate lifetime limits applicable to such categories.
"(2) ANNUAL LIMITS. —In the case of a group health plan
(or health insurance coverage offered in connection with such
a plan) that provides both medical and surgical benefits and
mental health benefits—
"(A) No ANNUAL LIMIT. —If the plan or coverage does
not include an annual limit on substantially all medical
and surgical benefits, the plan or coverage may not impose
any annual limit on mental health benefits.
"(B) ANNUAL LIMIT.— If the plan or coverage includes
an annual limit on substantially all medical and surgical
benefits (in this paragraph referred to as the 'applicable
annual limit'), the plan or coverage shall either—
"(i) apply the applicable annual limit both to medical and surgical benefits to which it otherwise would
apply and to mental health benefits and not distinguish
in the application of such limit between such medical
and surgical benefits and mental health benefits; or
"(ii) not include any annual limit on mental health
benefits that is less than the applicable annual limit.
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