Using EAP Benefits at Alma

What is an EAP?

Employee assistance programs (EAPs) are a wellness benefit that is separate from your primary health insurance plan. EAPs offer short-term engagement and support for employees around mental health — from anxiety and depression to everyday stressors like caregiving and work-life balance. 

Alma is now in-network with four different EAPs:

• Optum Live & Work Well EAP
• Optum Emotional Wellbeing Solutions Premium EAP
• Cigna Confide Enhanced EAP
• Aetna Resources for Living EAP

If you are an Optum client and you’re not sure which Optum EAP you have, you can log into Optum’s benefit website www.liveandworkwell.com to find your EAP details.

If you are a Cigna client and you’re not sure if you have Confide Enhanced EAP (in network with Alma) or another Cigna EAP (out of network with Alma), you can log into Cigna’s website https://confidenavigator.com/ to confirm your EAP information.

Why are EAPs important?

EAPs give additional mental health coverage outside of the framework of a formal insurance plan at no cost to you as a client. You can use these benefits for short-term clinical interventions (such as relationship counseling or maintaining work-life balance) without paying a copay, coinsurance, or deductible.

If you do not currently have access to health insurance, or if you are paying down a high deductible on your health plan before you can access your full health plan benefits, EAPs can provide an alternative means for receiving care quickly and affordably. 

If you have Optum or Cigna EAP benefits and are currently seeing an Alma provider either out-of-pocket or in-network with Alma’s insurance program, you may be able to apply your EAP coverage to anywhere between 3 and 10 sessions (depending on your benefit) with Alma. Note that some mental health services are not covered under EAPs, so discuss this option with your Alma provider to make sure it is a good fit for you.

How do EAPs typically work?

Session cost

A major advantage of EAP visits is that they are entirely free for you as a client. All costs are covered by the employer, and there is no copay, coinsurance, or deductible for services. 

Access to services

Unlike traditional insurance, where Alma reaches out directly to your health plan to verify that your provider is in-network with your benefits, EAPs give you the agency to verify your own eligibility for benefits. 

To apply your EAP benefits to sessions, you will need 3 things:

• A client EAP authorization code
  A  unique code that you can use to apply EAP benefits to specific provider visits.
• Eligible sessions
  The total number of visits authorized by your for EAP coverage. These range from 3-10 visits.
• Benefit effective dates:
  The active dates of your EAP eligibility. For example, you could have 5 EAP visits to use within a benefit year of July - June.

Every program has its own pathway for accessing this information. Select your program name below to find instructions for applying your EAP benefits to Alma sessions. 

• Optum Live & Work Well EAP
• Optum Emotional Wellbeing Solutions Premium EAP
• Cigna Confide Enhanced EAP

Please note that Alma cannot gather your EAP enrollment information directly or on your behalf. You will need to complete the EAP enrollment process with your health plan before starting EAP sessions with an Alma provider. 

Services covered

In general, EAPs cover a limited range of mental health services, which can include 30- and 45-minute psychotherapy appointments, couples and family therapy, and group therapy. EAPs will not cover longer therapy sessions or medication management. 

If you are new to Alma or if you already see an Alma provider, and you want to use either Cigna or OptumEAP benefits, make sure to review the following table to be sure that your EAP program covers the services you’re looking for:

Privacy

Optum Emotional Wellbeing Solutions Premium EAP ensures quality of care delivery throughout the care journey by looking at high-level summaries of data from program participants.

Alma won’t share any identifiable information without your consent (unless required by law). We will never share individualized data about you with your employer. 

Aggregated versions of your data may be shared according to HIPAA regulations for reporting purposes only. 

This means that your data (minus any identifiable information) will only be presented as part of this summary of data from program participants, without any way to connect that data back to you individually. You can read more about how we manage health data here.

Summary: Using Your EAP Benefits

Below is a quick summary of the EAPs Alma supports, along with the websites you can visit to get more information about your benefits directly from your health plan. 

Can I keep seeing my Alma provider after my EAP benefits are ended?

Yes! If you and your provider want to keep working together beyond your covered EAP sessions, you have several financial options to continue care:

• If you have an active health plan, you can share your insurance details with your provider. They can add your health plan details to the Alma portal to verify eligibility. Following the eligibility check, you and your provider will receive an email from Alma letting you know if your health plan is in- or out-of-network.
  • • If your plan is in-network with Alma’s insurance program, then you will be able to see you provider with the copay or coinsurance set by your health plan.
      
    • If your plan is out-of-network with Alma, you can see your provider at a private pay rate you agree to with them. You will receive regular invoices and superbills, which are monthly statements of care received.
      • You can also reach out to your health plan directly to  ask about out-of-network benefits. You may still be able to use your Alma superbills to get reimbursement from your health plan for some of your session costs.
• If you do not currently have insurance, then you can see your provider at their agreed-upon private rate for sessions.

You can also review your options for working with your Alma provider after EAP here: Continuing care beyond my EAP benefits.

Can I check if my insurance is in-network with Alma before I finish my EAP benefits?

Yes! To get a preliminary quote of session costs, you can use the Alma website’s cost estimator tool. Simply enter your health plan name (for example, Aetna, Cigna, or Oscar) and your member ID number, and our site will give you a general estimate of what you can expect to pay.

Once you have completed your EAP benefits, your provider can enter your health plan information into the Alma portal for a more formal verification. This eligibility check through the portal is more detailed than our cost estimator tool, so it will give an updated quote for your costs per session.

You can also use the phone number on the back of your insurance card to contact your health plan and verify your benefits and network status with Alma.