Some states have been trying for years to get health insurers tocover mental health services in a way above and beyondwhat federal law requires.

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Washington state regulators are about to take the fightover mental health services parity to the mail.

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Mike Kreidler, the state's insurance commissioner, has toldinsurers in his state to identify any policyholders whohave mental health claims denied because of blanket orcategorical coverage exclusions since Jan. 1, 2006, for large-groupplan enrollees, and since Jan. 1, 2008, for other enrollees, andtell those consumers that they have a right to have their claimsre-evaluated.

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"The Office of Insurance Commissioner will independently informconsumers that each carrier must implement a process for allowingimproperly denied claims to be re-evaluated, and will encourageconsumers to contract our insurance consumer hotline should theyhave complaints, questions or concerns," Kreidler says in theletter.

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Kreidler is acting in response to a Washington State SupremeCourt ruling on the state's own mental health parity law. The 2006law bans coverage exclusions for medically necessary mental healthservices.

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See also: Mentalillness takes toll on businesses

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The U.S. Department of Health and Human Services has nowincluded access to mental health services in what it defines as thebasic package of essential health benefits that a major medicalplan that complies with the Patient Protection and Affordable CareAct ought to cover.

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Determining just what the HHS rules really mean and how theywill really work may take years.

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The two major federal mental health parity laws -- the MentalHealth Parity Act of 1996 and its successor, the Mental HealthParity and Addiction Equity Act of 2008, have required large-grouppolicies that offer behavioral health benefits to make the benefitscomparable to the other benefits. Neither law requires a plan tooffer behavioral health benefits.

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Washington state's top court ruled that insurance regulators canapply the stricter state parity law to individual and small-groupcoverage going back to Jan. 1, 2008, and to Jan. 1, 2006, forconsumers who were enrolled in large-group plans.

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What could Kreidler's move mean for agents and brokers? Here arefour possibilities.

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See also: 6tools you need in your health toolbox

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1. This may be one of those increasing commonopportunities for the solution creators in the health insurance andbenefits business to stand out from the order takers.

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The insurers in Washington state are going to be tellingconsumers to communicate with them.

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The insurance commissioner is going to be telling consumers tocommunicate.

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If you're in that state -- or in another state with a similarsituation -- maybe it would be useful to the consumers, and to you,if you encourage the consumers to call you first.

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2. The insurers may come to value any agents, brokers orother benefits professionals who can help them deal with thissituation.

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Health insurers may find that they rely more on producers tofind the affected consumers, reach them, and manage communicationswith them in an efficient and mutually satisfactory fashion.

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3. Health agents and brokers can use a situation likethis to explain how they earn their commissions.

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Eventually, exchange Web sites are supposed to give consumerssome clue as to how carriers actually pay claims. Experiencedagents and brokers can use their experience and information sourcesto give customers an idea of how coverage might actually work inthe real world where they really live.

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4. Eventually, prices might rise or market competitionmight decrease.

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Regulators like to get consumers important protections andbenefits "for free" by creating laws and regulations requiringthose protections and benefits be provided, through the magic ofthe government telling the insurers to do that.

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In some cases, insurers may find that meeting a requirement likemental health parity benefits may cost them little, or even savethem money. Some have suggested that adding solid mental healthbenefits to a benefits package might ultimately save money, byreducing overall claims.

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But, if that prediction proves to be optimistic, and parity ismore expensive than advocates think, insurers might increase thecost of the coverage to pay for the benefits, cut the benefits theyoffer, or leave the market.

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See also: Healthyminds, healthy profits

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Allison Bell

Allison Bell, ThinkAdvisor's insurance editor, previously was LifeHealthPro's health insurance editor. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached at [email protected] or on Twitter at @Think_Allison.