45 C.F.R. § 147.160

Parity in mental health and substance use disorder benefits

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(a) In general. The provisions of §§ 146.136 and 146.137 of this subchapter apply to individual health insurance coverage offered by a health insurance issuer in the same manner and to the same extent as such provisions apply to health insurance coverage offered by a health insurance issuer in connection with a group health plan in the large group market.

(b) Applicability date. The provisions of this section apply for policy years beginning on or after January 1, 2026. Until the applicability date in the preceding sentence, issuers are required to continue to comply with 45 CFR 147.160, incorporating 45 CFR 146.136, each revised as of October 1, 2023. This section applies to non-grandfathered and grandfathered health plans as defined in § 147.140.

[89 FR 77751, Sept. 23, 2024]

Notes of Decisions

Cited in 2 cases (2 in the last 5 years), 2021–2023 · leading case: P.E.L. v. Premera Blue Cross, 540 P.3d 105 (Wash. 2023).

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P.E.L. v. Premera Blue Cross, 540 P.3d 105 (Wash. 2023). · cites it 2× “§ 18031 (j) (parity provisions apply “in the same manner and to the same extent”); 45 C.F.R. § 147.160 (a) (same). However, it is equally clear that Congress intended 26 P.”

Smith v. Golden Rule Ins. Co. (S.D. Ind. 2021). “C § 18031(j) and 45 C.F.R. § 147.160 (a).3 [Filing No. 1 at 3; Filing No.”

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