Mental Health Plan For Comprehensive (PPO) and Catastrophic Participants

United Behavioral Health
P.O. Box 23250
Oakland, CA 94623-0250
(800) 888-2998
www.liveandworkwell.com

New in 2010

All plans will be updated to comply with the federal Mental Health Parity Act. Therefore, qualified mental health and substance abuse treatment will be considered the same as physical illness relative to coinsurance, copays, out-of-pocket maximums and day/visit limitations will no longer apply.

New 2010 Mental Health coverage

Services	Network Provider	Non-Network Provider
Deductible	None	None
Out-of-Pocket Max (per calendar year)	$1,500/person $3,000/family	$3,000/person $6,000/family
Inpatient	90%	70% after a $200 copay
Outpatient	90%	70%

Current in 2009

-Employees and dependents covered by the Comprehensive (PPO) and Catastrophic medical plans have access to the mental health program administered by United Behavioral Health. Participants may have up to 40 outpatient mental health visits per calendar year. Outpatient visits to an in-network provider require pre-authorization and a $20 co-payment per session. Outpatient visits to a non-network provider require a 50% co-payment and no pre-authorization is required. Inpatient services include psychiatric and chemical dependency treatment.

All Comprehensive (PPO) and Catastrophic Medical Plan Participants are eligible for the schedule of services below:

Services	Network Provider	Non-Network Provider
Office Visit Co-payment	$20 Per visit for individual sessions	Not Applicable
Percentage Payable after Co-Payments are Satisfied
Mental Health Inpatient	100%	50%
Mental Health Outpatient	100% After office visit co-payment	50%
Chemical Dependency Inpatient	100%	50%
Chemical Dependency Outpatient	100% After office visit co-payment	50%
Maximum Benefits
Mental Health/Chemical Dependency Calendar Year Maximum Outpatient	40 Days
Mental Health/Chemical Dependency Calendar Year Maximum Inpatient	30 Visits
Chemical Dependency Lifetime Maximum	2 Episodes of Treatment

Live and Work Well Website

www.liveandworkwell.com - This site provides many tools and resources that can help improve life at work and at home such as health and wellness articles, educational resources, chats with experts, financial fitness tools such as retirement calculators and much more.

TSRI participants may access the site by logging in with the Institute’s UBH group plan number 10730 (this group plan number is also listed on the back of the benefits card). If you would like to access mental health services through a UBH network provider, please call UBH at 800-888-2998, their 24-hour hotline for a pre-authorization. Services provided by a non-network provider do not require pre-authorization.

ADDITIONAL LINKS

On-Line Reimbursement for Claims with a Non-UBH provider

Summary Plan Description

Health Insurance Claim Form

FAQs (Frequently Asked Questions)

TSRI On-Site Counseling Services (available in California only)

Employee Assistance Program (available in Florida only)

UBH Wellness Monthly - "Stress-free Family Vacations"