Federal parity legislation has altered the benefits landscape, putting mental and behavioral health coverage on par with medical/surgical benefits — at least in theory.

It’s up to employers to ensure that their health plans are in compliance, but examples of unequal benefits suggest that gaps remain.

“Plans and employers are still responding to the law,” said Clare Miller, director of the Partnership for Workplace Mental Health, a program of the American Psychiatric Foundation, in Arlington, Virginia.

Long-awaited final rules implementing the Mental Health Parity and Addiction Equity Act of 2008 were published in November 2013. The rules took effect for plan years beginning on or after July 1, 2014, affecting most employer-sponsored benefits.

The latest parity law shored up and expanded protections under a previous law, the Mental Health Parity Act of 1996.

Gone are financial and treatment limits affecting out-of-pocket costs and the number of mental health days or visits allowed under a plan. But many of the law’s parity provisions aren’t as cut and dried.

So-called “nonquantitative” treatment limits affect everything from managed care protocols, such as step therapy and prior authorization, to restrictions due to geography, facility and provider specialty.

For example, under federal rules, an employer health plan that precertifies all inpatient admissions to a psychiatric facility must also precertify all inpatient admissions for medical/surgical conditions.

The American Psychiatric Association has been fielding complaints from psychiatrists who say they sit on the phone for hours to obtain prior authorization for generic medications.

“It’s hard to imagine a scenario where that would not be a violation of the parity law,” Ms. Miller said.

While employers don’t need to be experts on the law, they should familiarize themselves with its requirements. Employers should also consult their third-party administrators or insurers about how their health plans fulfill regulatory tests under the law.

Milliman Inc. and the Partnership for Workplace Mental Health have developed a free guide to help employers navigate the law’s intricacies.

Employers may download the guide at www.workplacementalhealth.org.