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TREATMENT FOR ALCOHOL OR DRUG PROBLEMS
EMPLOYEE ASSISTANCE PROGRAM (EAP): (916) 922-1099
(OUT OF THE SACRAMENTO AREA): (877) 881-7877
The Employee Assistance Program (EAP) is self-funded by the Plan and is available for all participants. This benefit
offers free, confidential help to eligible employees and their eligible family members with alcohol or drug problems
(illegal or prescription).
It is the intent of the Trustees to provide all participants and their family members with benefits for the treatment of alcohol
and/or drug problems. The sole purpose of the Employee Assistance Program is to provide medically specific and
medically supervised treatment for chemical dependency.
The EAP benefits are separate from the Pipe Trades PPO Plus Self-Funded Indemnity Medical Plan or HMO medical
benefits. The EAP program is intended to address drug and alcohol problems in a cost-effective manner by matching participants with existing community resources such as A.A. and other free counseling and support services and organizations
and EAP approved drug and alcohol facilities. Some of the EAP benefits may be provided in conjunction with the
pain management program (see page 32).
Description of Benefits
Most EAP services are provided via referral to free community resources. In addition, the EAP pays for the following
services:
- 24-hour hotline (916) 922-1099 or (877) 881-7877 outside of Sacramento to seek assistance with drug and alcohol
related problems and an EAP contact person to schedule initial screening and follow-up;
- Screening, referral and follow-up by the EAP’s medical team;
- Following screening and referral, full cost of approved medically necessary inpatient or outpatient detoxification
program provided the patient complies with program rules.
- Following screening and referral, full cost of one course of treatment at an approved residential recovery facility,
provided the patient complies with program rules and the treatment is medically necessary.
Course of Treatment
A course of treatment may not exceed a six month time period. A course of treatment can include:
- Screening;
- Referral;
- Detoxification;
- Residential recovery facility; and
- Follow-up visits (maximum of 5 per lifetime).
For tobacco users wishing to quit, nicotine replacement therapy is covered at 50% of charges up to a lifetime maximum
benefit of $150.
Follow-Up
After completion of one course of therapy, the EAP will provide follow-up care. After treatment, you will be contacted at
least once a month for the next six months. Thereafter, you will be contacted on a quarterly basis.
EXCLUSIONS
The EAP does not pay for:
- Any services which are not for the treatment of drug or alcohol problems;
- Any services for the treatment of drug or alcohol problems except as pre-approved;
- Drug or alcohol treatment required by court order, unless the treatment is determined to be medically necessary;
- Transitional housing, rent, transportation, meals or other living expenses;
- Medical treatment except pre-approved detoxification (medical benefits may be payable under other provisions of
the Pipe Trades PPO Plus Self-Funded Indemnity Medical Plan or HMO medical plan);
- Psychiatric treatment or counseling (psychiatric treatment and/or counseling benefits may be payable under other
provisions of the Pipe Trades PPO Plus Self-Funded Indemnity Medical Plan or HMO medical plan);
- Preventive care;
- Routine or random drug testing;
- Claims not submitted within 12 months after services were received, except in the absence of legal capacity;
- Treatment in excess of the $10,000 lifetime maximum; and
- More than two courses of treatment in a lifetime.
Participants who use the EAP are expected to follow the recommended treatment program. Those who fail to comply
with program rules may be denied any further EAP benefits.
