NOTICE OF PROVIDER CHANGE - DRUG AND ALCOHOL ABUSE EMPLOYEE ASSISTANCE PROGRAM
FOR ACTIVE EMPLOYEES
Starting March 1, 2011, the current Drug and Alcohol Abuse Employee Assistance Program (EAP) administered by MHN will be replaced by a new vendor, Human Behavior Associates. New brochures and wallet cards are currently being printed and will be available soon at the Union Halls. The following will give you some information about the new vendor and program effective March 1, 2011. This notice serves a summary of material modifications as required by the Employee Retirement Income Security Act of 1974 (ERISA) to the SUP WELFARE PLAN, INC (Plan). Please keep this summary of plan changes with your copy of the SPD.
Who is Human Behavior Associates?
Human Behavior Associates (HBA) is an independent firm that specializes in providing nationwide employee counseling and assistance programs. To contact HBA call (800) 937-7770 or (707) 747-0117 collect. The help line is available 24 hours per day.
What Specific Services Are Available?
Up to a maximum of three (3) counseling sessions (each 6-month period) with licensed professional counselors at no cost to you and your family members. You or your family member must first call the HBA office. During your first call, HBA will arrange for a referral to the most appropriate resource that can help you. If it is determined that you or your dependent need additional counseling beyond three visits, HBA will try to help you in working with your current medical plan provider. There may be copayments or other out of pocket expenses required by your medical plan provider.
For you, the Employee only (the following benefit is not available to your dependents):
In cases where in-patient treatment is required for drug and alcohol treatment, you may be eligible for the Trust’s self-funded alcohol/substance abuse benefit that provides for full payment of up to one rehabilitation admission during your lifetime (not to exceed 28 days). HBA will work with you and the Plan Office to arrange for appropriate treatment. If you are not eligible for the self-funded benefit, HBA will help you work with your current medical plan provider in obtaining appropriate care. There may be copayments or other out of pocket expenses required by your medical plan provider.
All contact between you and HBA is strictly confidential and all health information will be used, disclosed and maintained by HBA in accordance with the privacy and security requirements of the Health Insurance Portability and Accountability Act of 1996, as amended (HIPAA).
Please call the Plan Office if you have any questions on the change in program vendors or if you have any questions about the benefits provided through the program.
Grandfathered Group Health Plans
The Trust’s Board of Trustees has concluded that each of the health plans that the Trust offers (collectively, “the Plan”) is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that the Plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of certain lifetime limits on benefits.
Although it is a “grandfathered health plan”, you should know that the Plan provides health coverage benefits beyond the “basic” level of benefits and has long maintained many consumer protections now required under the Affordable Care Act. For example, the Plan has always prohibited rescissions of coverage due to a member’s health condition as well as exclusions for pre-existing conditions for children and adults. There is also no “waiting period” for benefit eligibility once a member attains initial coverage based on required work hours. Nor does the Plan discriminate in favor of certain members based on compensation, age, gender or health status.
Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to the plan administrator at (415) 778-5490. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at (866) 444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans.
As referenced above, this notice serves as a “summary of material modifications” (SMM) to the SUP Welfare Plan, Inc. (the “Plan”) in accordance with the requirements of ERISA. Please keep this notice and the HBA brochure with your copy of the Summary Plan Description. Such notices will be sent to you from time to time updating you and your dependents about any benefit plan changes. The Board of Trustees of the SUP Welfare Plan, Inc. has the exclusive right, in its sole and absolute discretion, to administer, amend or terminate any provisions of the Plan at any time. We note that neither this notice nor the HBA brochure attempts to cover all benefit details or plan limitations and exclusions. These are contained in official plan documents that legally govern the operation of the Plan and which control in the event of any omission or other difference between those documents and this notice.
Member Assistance Program
What is a Member Assistance Program (MAP)?
The MAP is a confidential, professional resource that is provided by your Trust Fund. With a staff of counselors, psychologists and other helping professionals, the program can help members and their family members resolve personal problems. The services are delivered by Human Behavior Associates, Inc.
What Specific Services are Available?
- No cost counseling services with licensed, professional counselors.
- Assessment, Referral and Case Management of Alcohol and Drug Treatment Services that are funded by the Trust Fund for Employees only.
- Referral services for community resources, self-help support groups, eldercare and childcare resources and other services.
- Access to a Resources Directory with 1000s of helpful national and local resources.
Is the MAP Private?
All contact between employees and the MAP is strictly confidential. All health information will be used, disclosed and maintained by HBA in accordance with the privacy and security requirements of the Health Insurance Portability and Accountability Act of 1996, as amended (HIPAA).
How Much Does it Cost?
You or your dependent may see a licensed counselor at no cost. Your Trust Fund has contracted with HBA to provide a specific number of no-cost counseling sessions. For continued treatment you will be referred to your medical plan. There may be charges for continued treatment.
Who Pays for the MAP?
The services of the MAP are 100% paid for by your Trust Fund. The organization recognizes that the member with a personal or family problem is not an effective employee. Therefore, this program is an investment in the quality of work life for all members. It is sincerely hoped that members with personal or family problems will make use of the services.
How do I Request Help?
Call 1-800-937-7770 or collect at 707-747-0117. The help line is available 24 hours per day. The program staff will refer you to the most appropriate resource for your issues. You will be referred to local counselors and treatment centers, self-help programs and other sources of immediate assistance.
What if my Co-Worker or Family Member Needs the Help?
First, strongly encourage him or her to call the MAP. It’s private and services are 100% paid for by your Trust Fund. Union representatives, family members and coworkers should call the MAP for consultation when someone you work with or who is close to you has a problem. The MAP can help you find a Solution!
Human Behavior Associates, Inc.
1350 Hayes Street, Suite B-100, Benicia CA 94510
Phone 707-747-0117 Fax 707-747-6646