September 19, 2019

Parents Claim Denial of Autism Care Coverage Violates ERISA

Parents in Seattle have filed a class action suit against a union’s medical plan alleging that the plan administered by the National Electrical Contractors Association (NECA) and the International Brotherhood of Electrical Workers (IBEW) was in violation of federal law because it does not cover certain treatments for mental health conditions listed in the Diagnostic and Statistical Manual of Mental Disorders at the same level it does medical or surgical conditions.

The suit stemmed from the denial of coverage by the NECA/IBEW Family Medical Care Plan of an applied behavioral analysis for treating autism disorder spectrum under the plain language of the plan. In the original proceedings, the plaintiffs allege that the denial of the treatment violated the federal Mental Health Parity Act. Discovery in this case is still ongoing.