Employee Assistance Program (EAP)

Employee Assistance Program (EAP) services are a separate and distinct benefit from an individual's behavioral health benefit plan. EAP is pre-purchased by employers for their employees and their employees’ household members. As part of the program, employees and their household members have access to a pre-determined number of counseling visits per issue, per individual, per plan year, at no cost to the individual. The number of sessions varies depending on the program model purchased by the employer. The goal of the program is, in part, to help employees and their household members address personal issues and bring balance to their lives.

What kinds of issues are discussed during an EAP visit?

EAP services may include assessments or short-term counseling. Customers may come to you for assistance with a broad range of issues, including but not limited, to:

  • Relationship and marital concerns
  • Parenting challenges
  • Substance use
  • Workplace stressors
  • Depression and anxiety
  • Ways to better manage stress and life’s daily challenges
  • Loss and grief

Does the EAP have any exclusions?

The EAP benefit excludes coverage for:

  • Psychiatric evaluations
  • Medication management
  • Psychological testing
  • Court-ordered treatment
  • Workers' Compensation/disability management/Family Medical Leave Act (FMLA)
  • Fitness for duty/return to work determinations
  • Employment law

How do you administer EAP?

Below are some tips to help familiarize you with administration for all EAP offerings.

Providing EAP services

  • EAP sessions are separate from the behavioral health benefits plan, and no copayment is required from the customer.
  • The EAP is not meant for long-term treatment/therapy.
  • EAP benefits and eligibility are not available on this website. If you have questions about administering EAP benefits, call the number on back of the customer’s ID card. If the customer does not have an ID card, they should contact the employer.
  • If a customer would like to utilize their EAP benefit, they must obtain an EAP code and provide it to you prior to their first counseling session.
  • If the individual does not have an EAP code, please call Provider Services at 800.926.2273 to secure the code on behalf of the individual.
  • You should not provide EAP services unless you have an EAP code.

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Claims and payment

Closing the EAP case

EAP Forms

Why is employment law excluded from the EAP?

Coverage for employment law is excluded due to the dual nature of the EAP client relationship — the individual employee (or family participant) and the employer who sponsors the program. Any legal information or advice given by a practitioner to an individual client concerning employment law can have potentially detrimental consequences for the employer client. To avoid this conflict of interest, employment law services are excluded from the program.

In the course of providing EAP services, practitioners shall refrain from discussing legal recourse as a potential action in resolving workplace concerns or disputes. Employees with concerns about workplace practices should be referred to their Human Resources department for further assistance.

Examples of excluded employment law questions or concerns are:

  • Workplace safety, accidents, injuries, or illnesses
  • Coworker liability (including workplace assaults or threats)
  • Employee benefits issues/disputes or disputes concerning the agents of company-sponsored benefits or services
  • Pension rights, employment termination, retirement questions, or disputes
  • Employer-based civil rights violations (including workplace sexual harassment allegations)
  • All other alleged employer liability issues