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Your New Mental Health Benefit

Providing excellent mental health and substance use disorder benefits for our participants is a top priority for the Health Benefit Plan. The struggle for many of our participants is real, and we want to make sure we’re doing all we can to make access to the right care as easy as possible for you and your family.

Plan changes effective July 1, 2022

Here’s a quick overview of what’s changing on July 1.

  • Lyra Health (Lyra) is replacing Beacon Health as the Member Assistance Program (MAP) provider.
  • You and your eligible family members will have up to 16 sessions per year in 2022. Starting in 2023, you and your covered family members will have coverage for up to 16 sessions (up from eight per episode) per calendar year, per person under the new Lyra MAP.
  • We will move to the Blue Cross Blue Shield BlueCard PPO provider network for the care and treatment of mental health and substance use disorders—giving you and your family greater access to care and treatment for inpatient and outpatient mental health and substance use disorders.
  • The Benefits Office will administer mental health and substance use disorder claims, bringing the same care and dedication that they already provide for other benefit claims.
  • Kepro will provide precertification and robust care management for serious behavioral health conditions.

New Member Assistance Program (MAP) provider

Based on some of the feedback we received from the survey and focus groups we conducted last year, we decided to make a change to our Member Assistance Program (MAP) provider to offer more resources, a stronger network of providers and even more free-to-you, confidential therapy sessions. As of July 1, Beacon Health will no longer administer the MAP. Instead, we’re introducing a top-tier provider—Lyra.

New network for additional support

Beacon Health currently administers the mental health and substance use disorder treatment benefits available to participants who need assistance beyond what the MAP offers. Beginning July 1, 2022, the Blue Cross Blue Shield BlueCard PPO network will become the new network for the Health Benefit Plan’s mental health and substance use disorder treatment benefits, and these benefits will be administered by the NEI Health Benefit Plan Benefits Office.

This network change should have a positive impact on our participants. The Blue Cross Blue Shield network is much larger than Beacon Health’s, with most Beacon Health providers participating. In other words, if you’re happy with your current provider, most participants will be able to continue working with that provider. Check to see if your provider participates.

Meet Lyra

Lyra offers convenient resources to help you, whether you’re exploring ways to improve your resilience, worried about someone you care for, facing depression, dealing with substance use issues, or struggling with everyday obligations. The Lyra mental health benefit is available to all active participants, retirees, and their covered dependents. Benefits include:

  • Personalized guidance by licensed professionals on evidence-based treatment for stress, anxiety, depression, and other mental health issues encountered by our member families
  • 24/7 access to Lyra Essentials, a dedicated hub for self-care and mindfulness content
  • Access to 16 free sessions for mental health coaching and/or therapy per individual, per calendar year
  • Access to additional Lyra services like advanced concierge assistance to help identify evidence-based treatment providers using the Blue Cross Blue Shield BlueCard PPO network

Beginning July 1, visit neibenefits.lyrahealth.com to register.

If you’re working with a Beacon Health therapist

If you’re currently working with a therapist under the Beacon Health MAP (eight sessions with a therapist per issue per year)

If you’re currently working with a therapist under the Beacon Health MAP (eight sessions with a therapist per issue per year)

If you are working with a therapist through the MAP currently administered by Beacon Health, you may continue working with that therapist (for any visits scheduled before June 30) until you’ve reached your 8-session limit for calendar year 2022. As of July 1, you’re welcome to register with Lyra to search for a new therapist or to see if your current therapist participates in the Lyra network. Under the new Lyra MAP, you can use up to 16 sessions in 2022, even if you’ve already used sessions with a Beacon Health provider. If you have questions, contact Lyra’s care team at care@lyrahealth.com or 877-330-6735.

If you are in treatment in a facility or working with a provider in the Beacon Health PPO network

If you are in treatment in a facility or working with a provider in the Beacon Health PPO network

Because our arrangement with Beacon Health ends on June 30, you will need to confirm that the Beacon Health providers you are working with are also part of the Blue Cross Blue Shield BlueCard PPO network, which becomes the new mental health and substance use disorder network on July 1. The good news is that most Beacon Health providers do participate in the Blue Cross Blue Shield PPO network, so there should be very little, if any, disruption to your care.

If you want to continue with a provider who is not part of the Blue Cross Blue Shield BlueCard PPO network, just remember that you will be responsible for 25% of the Usual, Customary and Reasonable charges plus any amount that exceeds the Usual, Customary and Reasonable charge. Any treatment or services you receive after July 1, 2022 with a provider that does not participate in the Blue Cross Blue Shield BlueCard PPO network will be treated as out-of-network and you may be billed. Note that inpatient and residential stays that began before July 1 will be covered by Beacon through July 17.

The Benefits Office will replace Beacon Health as the new administrator for these benefits. If you have any questions about this transition, you can contact Patricia Nelson, the Benefit Plan’s nurse advocate, to help with any change-of-provider issues.

Prior authorization and case management through Kepro

If you need inpatient treatment or your case is more complex, you may hear from or need to contact Kepro. Kepro already handles the Health Benefit Plan’s care navigation, case management, and prior authorization for medical care, but beginning July 1, 2022, they are administering services for mental health and substance use disorder treatment.

Care Navigators can answer questions about substance use treatment and can help find an in-network provider who is qualified to provide the services you need. Dedicated Kepro Care Navigators make sure that you are getting the most from your coverage and can coordinate care with Lyra to ensure a seamless transition from the MAP program therapy.

Prior authorization (or precertification) is required for all inpatient mental health or substance use admissions, just as it is for medical and surgical care. Prior authorization ensures that the care you receive is consistent with quality-of-care standards. 

Kepro’s precertification phone number is 800-634-4832. If you or a family member is admitted to a treatment facility or hospital, let your provider know that the precertification information is on your Blue Cross Blue Shield medical ID card. They can work with Kepro to make sure your inpatient treatment is certified.

Case management is a holistic approach that supports you if you have medical and/or behavioral health conditions or needs. You’ll be assigned a clinical Case Manager when a health care need that requires intervention is identified. Your Case Manager works with your providers to coordinate in-network care and provide education on health conditions, medications, and/or treatment plans.

Resources

  • Review a list of frequently asked questions about the new MAP.
  • Review the mental health benefit in the overview brochure.
  • Contact the Health Benefit Plan’s nurse advocate, Patricia Nelson, to help coordinate your care and answer your questions 610-325-9100, extension 2603.
  • Call Kepro at 800-634-4832 to precertify medical and mental health care and substance use disorder admissions.
  • Visit SAMHSA (Substance Abuse and Mental Health Services Administration) for information and resources.
  • To register and begin using the new MAP, visit Lyra online or call 877-330-6735 anytime. You can also email Lyra at care@lyrahealth.com.
  • Visit Lyra Learn (customer code #nei771)
  • Suicide Prevention Lifeline at 800-273-8255

This website provides an overview of benefits for eligible members of National Elevator Industry Benefit Plans. Refer to the Summary Plan Description (SPD) or plan contract/certificate and plan amendments for a full description of benefits. If there is a discrepancy between the information provided on this website and the official plan documents, the information provided in the official plan documents will govern.