Mental Health Parity Did Not Go Away. The DOL Just Told Us Where It Is Looking.

There has been a lot of noise this year about the mental health parity rules being rolled back. Some of it is true. The part that matters for employers is not.

What actually happened

The departments announced last year that they would not enforce the new provisions of the 2024 parity regulation while they reconsidered it. In March they told a federal court they would not defend the 2024 rule and would propose a replacement by the end of 2026. So the 2024 rule, as written, is effectively on hold.

What is not on hold is the Mental Health Parity and Addiction Equity Act itself, the regulations that have been in place since 2013, and the requirement from the Consolidated Appropriations Act of 2021 that every plan prepare and keep a comparative analysis of its non-quantitative treatment limitations. If the DOL asks for your comparative analysis, you still have to produce it.

The new bulletin

On September 8, the DOL issued a Field Assistance Bulletin that lays out three enforcement priorities for the current rules. First, blanket exclusions of mental health or substance use disorder treatment, like excluding all residential care or all treatment for a particular diagnosis. Second, whether prior authorization and medical necessity reviews are applied to mental health claims more strictly than to medical claims. Third, network adequacy and provider reimbursement, meaning whether the plan pays mental health providers at rates that keep them in network.

The bulletin also lists what it calls red flags, and if you read it, you will recognize some of them from your own plan.

What a plan sponsor should have on file

Three things. A copy of the current comparative analysis, prepared by your carrier or TPA, that covers the plan you actually offer and not a generic template. Written confirmation of which NQTLs apply to mental health benefits and that they are comparable to the medical side. And, if you are self-funded and have ever carved out behavioral health to a separate vendor, evidence that someone compared the two vendors' practices. Carve-outs are where parity problems hide.

Why I care

In 2026, employee demand for mental health benefits is not a trend. It is a baseline expectation. A plan that quietly makes it harder to get mental health care than physical care is not just a compliance problem; it is a retention problem. Every one of our clients has had an employee leave over access to care in the last few years, whether they know it or not.

This is general guidance, not legal advice, and parity is one of the areas where I would want counsel involved if the DOL calls. But if you have never asked your carrier for the comparative analysis, ask this week. It should not take them long to find.