What the DOL’s New Mental Health Parity Enforcement Policy Means for Your Health Plan

Mental health coverage rules for group health plans shifted again this fall, and the change is worth understanding whether you already offer a plan or are weighing one. On September 8, 2026, the U.S. Department of Labor issued new guidance that narrows where it will focus its mental health parity enforcement. The headline is simpler than the regulation behind it: the core protections for your employees stay in place, and the government has told plans exactly where it is looking first.

Here is what that means in plain terms.

A quick refresher on parity

The Mental Health Parity and Addiction Equity Act, or MHPAEA, is the federal law that says a group health plan cannot treat mental health and substance use care worse than medical and surgical care. That covers more than dollar limits. It also covers how a plan manages care, things like prior authorization, how medical necessity is decided, and whether the mental health provider network is as accessible as the medical one. Those management rules are the piece regulators have spent the last two years fighting over.

What actually changed

In September 2024, the Departments of Labor, Health and Human Services, and Treasury finalized new rules that added detailed analysis requirements to the parity law. In May 2025, those same agencies said they would not enforce the brand new pieces of that 2024 rule while the rule was reconsidered and while a federal court challenge played out.

The September 2026 guidance, Field Assistance Bulletin 2026-03, builds on that. The Department of Labor confirmed it will not pursue enforcement on four of the newest 2024 requirements, including the new meaningful benefits standard, the added restrictions on how plans use certain factors and data, and the expanded content rules for parity analyses. That pause holds until the court challenge is resolved, plus another 18 months after that.

Where the DOL is focusing instead

The guidance names three areas the Department considers most likely to actually harm employees. These are worth a look for any employer:

• Blanket exclusions. A plan that flatly excludes a mental health or substance use treatment while covering comparable medical treatment.
• Medical necessity and review. How prior authorization, concurrent review, and after the fact review are applied to mental health care versus medical care.
• Network access. Whether employees can actually find and reach in network mental health providers, and how those providers are paid.

What still applies to your plan

Here is the important part. The older parity rules from 2013 and the underlying law did not go away. Plans are still required to cover mental health and substance use care on par with medical care, and plans subject to the requirement still need to keep a comparative analysis on file showing they do. The 2026 guidance changed the enforcement focus, not the obligation. If you sponsor a plan, this is general information and not legal advice, so keep your documentation current and ask questions before you assume anything about your specific arrangement.

How NARFA supports access to care

NARFA offers an Employee Assistance Program that gives employees and their families confidential access to licensed counselors for stress, anxiety, depression, family issues, financial pressure, and substance use support, by phone, telehealth, or in person. It is 100% confidential and covered under federal privacy law. For more on why that benefit matters, see our post on the growing focus on mental health and EAPs.

Strong mental health coverage has become an important part of any benefits offering. It is what keeps people healthy, on the job, and able to do the work.

Contact the NARFA Benefit Center today. We will walk you through what parity means for your coverage and how the medical plan and EAP work together to support your team.

Read the DOL’s current guidance: EBSA Field Assistance Bulletin No. 2026-03.