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Administering Generous Mental Health Benefits:
Opinions of Employers
III. Approach to the Study
Representatives from seven employers attended a full-day meeting in which they shared their experiences in mental health benefit design and management. These employers all provided and administered comprehensive mental health benefits in their employee health plans. Meeting participants included representatives of Bank One, Delta Air Lines, Eli Lilly and Company, Fannie Mae, Motorola, and Puget Sound Energy (see Appendix A). The meeting also included one representative from a company that wished to remain anonymous because of concerns about pending union negotiations.
In selecting these employers, "comprehensive" benefits were defined broadly to include such elements as Employee Assistance Programs (EAPs) as well as access to and flexibility of mental health services. The selected employers
- provide benefits that extend beyond the traditional limits of 30 inpatient days and 20 outpatient days per year,
- place a high priority on mental health,
- provide a range of innovative and flexible benefits (e.g., offer multiple levels of care beyond inpatient and outpatient treatment) and integrate these benefits with other company programs such as an EAP,
- encourage employees to access mental health care,
- represent a geographically diverse group, and
- operate in a variety of industry sectors.
The participants had a diverse set of professional backgrounds. In addition to human resources professionals and health benefit administrators were two physicians and one psychiatrist. All but one of the corporate groups operate under ERISA1 and are therefore free of State mandates.
The participating employers use a variety of approaches to manage and deliver health benefits, including health maintenance organizations (HMOs), preferred provider organizations (PPOs), and indemnity plans. Most of the participants are self-insured and contract with third-party administrators to manage benefits and provider networks. These contracted insurers or benefits administrators will be referred to as insurers or vendors throughout this discussion.
The characteristics of the employer participants present some limitations in using them as models for other companies. Some concepts and recommendations apply only to large self-insured companies with extensive employee populations and available resources. Nonetheless, many of the findings will prove relevant to small businesses and those that do not self-insure their health benefits. For example, interested employers can model their coverage on the designs discussed and can use management techniques such as purchasing groups to enhance their purchasing power.
This report summarizes the participants' experiences and suggestions in five key areas: rationale, contextual factors, benefit design, benefit management, and next steps. In addition to specific suggestions concerning benefit design, philosophy, and management, the meeting participants described the advantages of offering comprehensive mental health care. The focus group did not reach consensus or vote on specific recommendations, nor was a consensus sought. Rather, this report simply presents the opinions and beliefs of the meeting participants.
1 The Federal Employee Retirement Security Act (ERISA) was originally adopted in 1974 to correct problems of fraud and mismanagement in employee benefit plans. One section of the Federal law preempts almost all State regulation of employee benefit plans established by employers. As such, States cannot require ERISA employers to cover mental health benefits.
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