November 4, 2026
Daybright Digest: November 2026
New mental health parity priorities and price transparency rules: What employers need to know
November 2026 compliance update
The short version: On Sept. 8, 2026, the U.S. Department of Labor (DOL) said which mental health parity issues it will focus on first when it enforces the rules. On Oct. 6, 2026, federal agencies also published a final rule that expands health plan price transparency requirements. If you sponsor a group health plan, both changes affect how you work with your carriers and service providers.
DOL names three mental health parity enforcement priorities
On Sept. 8, 2026, the DOL issued Field Assistance Bulletin No. 2026-03. It explains how the department will enforce the parity rules for nonquantitative treatment limitations (NQTLs) under the Mental Health Parity and Addiction Equity Act (MHPAEA).
What is MHPAEA?
MHPAEA generally prevents health plans and insurers from putting barriers on mental health and substance use disorder (MH/SUD) benefits that don’t also apply to medical and surgical benefits. Its parity rules cover:
- Financial requirements, like copays and deductibles
- Quantitative treatment limitations, like visit limits
- NQTLs, which limit the scope or length of benefits in ways that aren’t purely numerical
Where the DOL will focus
The bulletin says the DOL will focus NQTL enforcement on three areas where participants and beneficiaries face the most potential harm:
- Separate treatment limits for MH/SUD conditions, including blanket exclusions
- Medical necessity standards and review processes, including prior authorization, concurrent review, and retrospective review
- Network adequacy standards, especially how providers are admitted to networks and how they’re reimbursed
New tools for employers
The DOL also launched a companion webpage on spotting possible MHPAEA compliance problems. It includes:
- Warning signs that often point to compliance problems
- Examples of how health plans have fixed issues during NQTL investigations
- Questions that health plan fiduciaries should ask service providers about MHPAEA compliance
Final rule expands health care price transparency
On Oct. 6, 2026, the Departments of Labor, Health and Human Services, and the Treasury (the Departments) published a final rule on Transparency in Coverage. It applies to non-grandfathered group health plans and health insurance issuers. It updates the 2020 Transparency in Coverage (TiC) rules and carries out Executive Order 14221 on health care price transparency. For a quick overview, see the CMS fact sheet.
The biggest changes affect two requirements: the online price comparison tool for plan members and the machine-readable files (MRFs) that plans must post on a public website.
Cost estimates by phone
Plans and issuers already have to share cost estimates through a free online tool and on paper when asked. The final rule adds a third option: they must also give the same cost information over the phone on request. This change takes effect for plan years beginning on or after Jan. 1, 2027.
More files and an accuracy attestation
The final rule also requires plans and issuers to post more MRFs and to attest that their MRFs are accurate and complete. These changes roll out in phases starting April 1, 2027.
The Departments also released implementation FAQs (ACA FAQs Part 75). They set out the timeline for the updated MRFs, the required file format, and the timeline for the Prescription Drug File.
What employers should do now
Most employers rely on their insurers, third-party administrators (TPAs), and other service providers to meet these requirements. That’s fine, but the responsibility doesn’t go away. Employers should:
- Make sure these arrangements are in writing.
- Ask service providers how they’ll meet the new MRF, attestation, and phone-estimate requirements.
- Use the DOL’s MHPAEA questions to check how your plan applies prior authorization, exclusions, and network standards in practice, not just on paper.
- Keep records of your oversight so you can show it if the DOL asks.
Frequently asked questions
What are the DOL’s 2026 mental health parity enforcement priorities? Under Field Assistance Bulletin No. 2026-03, the DOL will focus on three areas: separate treatment limits for MH/SUD conditions, medical necessity and review processes, and network adequacy standards.
What is an NQTL? A nonquantitative treatment limitation (NQTL) limits the scope or length of benefits without a number attached. Examples include prior authorization rules, medical necessity criteria, and network admission standards.
When do the new price transparency requirements take effect? The phone requirement applies to plan years beginning on or after Jan. 1, 2027. The expanded MRF and attestation requirements roll out in phases starting April 1, 2027.
Can employers rely on their carrier or TPA for compliance? Most do, but employers should put these arrangements in writing and monitor their providers’ compliance.
The Bright Side
New rules can feel like more work, but this round brings more clarity. The DOL has said exactly where it will look first and published the checklists and questions it uses. That gives employers a clear view of what “good” looks like. On the transparency side, more cost information (now by phone, too) helps your people make smarter health care decisions. That’s good for them and for your plan.
Not sure where to start? Daybright Financial helps employers make sense of changing compliance rules, from checking vendor contracts to asking the right questions about parity and transparency. Connect with the Daybright team to make sure your plan is ready for 2027.
This post is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice. Content sourced from Zywave.