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Life Health > Health Insurance > Life Insurance Strategies

PPACA: EAP Seller Wants Slot in Exchange System

By Allison Bell

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Current visions of the Affordable Care Act health insurance exchange system do not seem to make room for employee assistance plans (EAP), an EAP vendor says.

Dr. Rene Lerer, chairman of Magellan Health Services Inc., Avon, Conn. (NYSE:MGL), has written about the lack of an EAP slot in a comment letter to the Exchanges Subgroup at the National Association of Insurance Commissioners (NAIC), Kansas City, Mo.

Lerer was responding to a draft of the NAIC’s American Health Benefit Exchange Model Act.

The NAIC is developing the model in an effort to help implement provisions in the Affordable Care Act, the package that includes the Patient Protection and Affordable Care Act (PPACA), that require states to create a system of state-based health insurance exchanges in 2014.

The exchanges are supposed to help individuals and small groups buy standardized, federally subsidized health insurance packages that meet exchange program quality standards.

Magellan provides a variety of services, including management of behavioral health care

and diagnostic imaging, and it also runs EAPs, which can help workers with matters such as getting immediate, telephone-based emotional counseling and find out whether they need professional help with substance abuse problems.

Today, there seem to be no provisions for the exchange system to offer EAPs to small groups, Lerer says.

“This oversight could effectively deny small employers access to an affordable additional resource and tool to help them to contain the costs of the mental health and substance abuse benefits they must offer employees,” Lerer says.

EAPs can lower employers’ costs, improve productivity and improve the employees’ quality of life, but, “despite the obvious value of EAPs, small employers may not consider purchasing this benefit if it is not an easily available option,” Lerer says.

State health exchanges can solve that problem by providing information about and links to EAPs, Lerer says.

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