Mental Health & Substance Abuse
90/10 Coinsurance Plan
Find solutions to personal problems so that you and your family can lead healthy, active and productive lives. Individual & Family Counseling, Mental & Nervous Conditions, and Substance Abuse Benefits are administered by Mental Health Consultants (MHC).
When participants visit providers who are in-network with Mental Health Consultants, the Fund pays 90% of the total Mental Health allowance leaving the participant with a coinsurance of only 10%. Participants are responsible for coinsurance until they have met their out-of-pocket maximum (see graphic below). Once an individual or family has reached their OOP Max, the Fund will pay 100% for all further In-Network claims for the duration of the Plan Year (May 1 through April 30).
Covered Behavioral Health Benefits include:
- Psychiatrists & Psychologists
- Social Workers & Licensed Counselors
- Substance Abuse
- In-Patient & Out-Patient Treatment Facilities
- Individual & Family Counseling
- Mental & Nervous Conditions
*The $2,000 annual out-of-pocket maximum is a combined total between medical and mental health claims.
All mental health services are administered through Mental Health Consultants (MHC). Call or visit their website for more information or to find a participating provider.
Helpful Benefit Coverage Info
Mental Health FAQs
If you visit a Psychologist, Psychiatrist, or Counselor from Mental Health Consultants (MHC) Network of Participating Providers, you will be responsible for 10% of the charges. However, if you visit a Non-Participating Provider, you will be responsible for all charges until you reach your annual $10,000 (Individual) or $20,000 (Family) Deductible.
Mental Health Consultants (MHC) offers an extensive list of Participating Behavioral Health Providers, and Treatment Facilities for Mental Health & Substance Abuse. If you are considering obtaining any type of Behavioral Health Services, including in-patient facility stays, it is imperative you contact MHC at 1-800-255-3081 to discuss which facilities and locations are best for your course of treatment. Failing to choose an in-network facility will result in a $10,000 (Individual) or $20,000 (Family) Deductible, in addition to a 90/10% Coinsurance.
Any out of network treatment / counseling has a $10,000 deductible per individual or $20,000 deductible per family before payment is made. If you have chosen a provider who is out of network, please contact Mental Health Consultants (MHC) for more assistance