Eastern Atlantic States Carpenters Funds
The Boards of Trustees recently voted to merge the Carpenters Benefit Funds of Philadelphia & Vicinity and the Northeast Carpenters Funds to become the Eastern Atlantic States Carpenters Funds (“EASCF”) effective January 1, 2023. All behavioral health (mental health & substance use) services for Eastern Atlantic States Carpenters Funds will continue to be administered by MHC who has been proudly serving its members since 2009. Please refer to the Behavioral Health Benefit Overview below for more information on your new benefit structure.
If you need assistance locating a provider or have questions regarding your benefits, please contact an MHC Care Manager who can help you navigate your benefits and review treatment options with you. If you have been seeing an out-of-network outpatient provider and are unsure how this benefit change will affect you, MHC can help. Please contact us by phone at 800.255.3081 option 1 or by e-mail at firstname.lastname@example.org.
Behavioral Health Benefit Overview
|Gold Level||Silver Level|
|(MHC) In-Network Benefit||10% Coinsurance||30% Coinsurance|
|(MHC) Out of Pocket Maximum||
|(MHC) Out-of-Network Benefit||
$15,000 Out of Pocket Max
$30,000 Out of Pocket Max
Behavioral Health FAQ
How do I find a treatment provider?
MHC takes the guesswork out of finding a treatment provider and simplifies the referral process by providing you or your family member resources based on your unique needs. We will explain your benefits, answer your questions, and coordinate the best course of treatment. You can contact a Care Manager by phone at 800.255.3081 option 1, by e-mail at email@example.com or by searching the online provider directory.
What types of treatment providers are available under the MHC Behavioral Health benefit?
The Behavioral Health benefit includes licensed professionals who specialize in mental illness and addiction, such as anxiety, depression, and alcohol use disorders. Traditional outpatient treatment is performed by psychologists, social workers, professional counselors, addictions counselors, and marriage and family therapists who specialize in the prevention, diagnosis, and treatment of mental health and addiction. Psychiatrists and psychiatric nurses are medical professionals who can evaluate for and prescribe medication. The Behavioral Health benefit also includes psychiatric and substance use facilities whose programs (Intensive Outpatient Program (IOP), Partial Hospitalization Program (PHP), and Inpatient treatment) treat those needing a higher level of care beyond traditional outpatient treatment. An MHC Care Manager can guide you as to which type of provider best suits your needs. You can contact a Care Manager by phone at 800.255.3081 option 1, by e-mail at firstname.lastname@example.org or by searching the online provider directory.
Do my services require authorization?
General outpatient treatment (counseling and medication evaluation and monitoring) does not require authorization. The following types of higher level of care treatment require prior authorization: Intensive Outpatient Program (IOP), Partial Hospitalization Program (PHP), and Inpatient treatment. Specialty outpatient services such as ABA, ECT, TMS, and psychological testing also require prior authorization. It is the treating facility’s responsibility to contact MHC to receive prior authorization for higher level of care treatment and specialty outpatient services. If you are unsure what level of care you need, please contact an MHC Care Manager by phone at 800.255.3081 option 1, by e-mail at email@example.com or by searching the online provider directory.
What does individual counseling cost?
If you visit a Psychiatrist, Psychologist, Social Worker, Counselor, or other outpatient professional from MHC’s Network of Participating Providers, you will be responsible for a co-insurance of 10% of the charges (if you have the Gold Level plan) or 30% of the charges (if you have the Silver Level plan). However, if you visit a Non-Participating Provider, you will be responsible for all charges until you reach your annual $10,000 (Gold Level plan) or $20,000 (Silver Level plan) deductible.
Are there options for in-person and telehealth therapy?
Yes, you can choose to see a therapist face to face in their office or by telehealth. Most providers provide both options. An MHC Care Manager can assist you with locating a therapist that best suits your scheduling needs. You can contact a Care Manager by phone at 800.255.3081 option 1, by e-mail at firstname.lastname@example.org or by searching the online provider directory.
I am a member of the Northeast Carpenters Fund. What if I have been seeing an out-of-network therapist prior to the merger?
As of 1/1/23 the Out-of-Network (OON) benefit will change. For members who have been in treatment prior to 1/1/23, your OON deductible is being waived to support continuity of care. You will be responsible for a 10% coinsurance (Gold Level) or a 30% coinsurance (Silver Level). If you would like to speak with a Care Manager about these changes or explore a referral to an in-network provider, please contact us by phone at 800.255.3081 option 1 or by e-mail at email@example.com.
What if I want to go out of state for inpatient treatment?
Mental Health Consultants (MHC) offers an extensive list of Participating Behavioral Health Providers, and Treatment Facilities for Mental Health & Substance Use. If you are considering obtaining any type of Behavioral Health Services, including treatment at an in-patient facility, it is imperative you contact MHC at 1-800-255-3081 to discuss which facilities and locations are best for your course of treatment. Please be advised that treatment at an out-of-network facility requires the member to pay for the stay in full and then submit for reimbursement. Also, the cost for treatment is only covered at 50% of the allowable rate after your out-of-network deductible is met. The out-of-network deductibles are $10,000 for the Gold Level plan or $20,000 for the Silver Level Plan. For more details about your financial responsibilities when choosing an out -of-network facility, you can contact an MHC Care Manager by phone at 800.255.3081 option 1 or by e-mail at firstname.lastname@example.org for assistance.
What is the out-of-network deductible?
Any out of network treatment / counseling is subject to a deductible ($10,000- Gold Level plan or $20,000- Silver Level Plan) before payment is made. If you have chosen a provider who is out-of-network, please contact an MHC Care Manager by phone at 800.255.3081 option 1 or by e-mail at email@example.com for more assistance.