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HomeMy WebLinkAbout1993-09-28; City Council; 12412; APPROVAL OF A NEW EMPLOYEE ASSISTANCE PROGRAM PROVIDERI.. 1 .. - % 6 Q m > z o I= 0 a e z 3 0 0 A*<(/ * ’i WOOF CARLSBAD - AGENB~ BILL 4:: [ AB # 12, Y/b TITLE: DEI MTG. 9-28-93 APPROVAL OF A NEW EMPLOYEE CIT CIT DEPT. HR ASSISTANCE PROGRAM PWMDER RECOMMENDED ACTION: Adopt Resolution No. 93-236 approving National Resource Consultants i the City’s new Employee Assistance Program (EAP) provider. ITEM EXPLANATION: The intent of an Employee Assistance Program is to resolve employee problems that are affecting job performance and to provide counseling ai treatment when necessary for emotional, occupational, substance abuse, marital/relationship and medical problems. In addition, an EAP provider can provide employee and management training, critical incident debriefings, twenty-four hour crisis telephone contact and referral services to screened, professional community resources. For the last ten years the City has contracted with an outside firm to provide employee assistance services to City employees and their dependents. In October of 1992, the City solicited proposals from other companies interested in bidding for the City’s EAP contract. In conjunction with the Human Resources Department, a group of managers from various City departments interviewed and evaluated five EAP providers in July 1993. National Resource Consultants, or NRC, is a well respected employee assistance provider based in San Diego. The company has experience wit’ both public sector and private sector clients with large, medium and sm sized employee populations. NRC is headquartered in Mission Valley, wit offices in numerous San Diego communities including Carlsbad, Del Mar, Rancho Bernardo, Chula Vista, Encinitas and others. It is staff’s recommendation that, effective October 1, 1993, the City contract with National Resource Consultants (NRC) for provision of employee assistance services. NRC will provide (1) short term counselin services at no cost to the employee, (2) referral services to community resources who are part of the City’s health insurance programs, (3) training of City managers and supervisors on how to effectively utilize the EAP to facilitate early detection and intervention, (4) consultation a e *7 - PAGE 2 OF A8 # )1,’-i/L 1. with managers and supervisors concerning specific work-related personnel problems, and (5) 24 hour telephone availability for use in crisis situations. The Human Resources Department will receive periodic updates on the level of participation in the Employee Assistance Program, including measures of user satisfaction with the service provided. This contract will be in effect for a one (1) year period and is renewable on an annual basis for a period not to exceed three (3) years. FISCAL IMPACT: The contract with National Resource Consultants will cost approximatel) $15,000 per year. This figure includes $13,000 for the basic EAP and an additional $2,000 for supervisory training costs. Funds for these service have been included in the Human Resources Department fiscal year 1993- 94 operating budget. EXHIBITS: 1. Resolution No. ~43- 276 2. Signed contract with National Resource Consultants .- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 *’ 22 23 24 25 26 27 28 a W XESOLUTION NO. 93-276 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF CARLSBAD, CALIFORNIA, APPROVING THE SELECTION OF NATIONAL RESOURCE CONSULTANTS (NRC) AS THE CITY’S EMPLOYEE ASSISTANCE PROGRAM PROVIDER. WHEREAS, since January 1984, the City of Carlsbad has offered an Employee Assistance Program (EAP) to its employees anc their dependents; and WHEREAS, the City is interested in offering this service in th future using an alternate EAP provider; and WHEREAS, staff has interviewed and evaluated five separate EAP providers and is recommending that National Resource Consultants (NRC) be awarded the City’s EAP contract. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Carlsbad, California, as follows: 1. That the above recitations are true and correct. 2. That the City Council approves National Resource Consultants as the City’s Employee Assistance Program provider effective October 1, 1993. 3. That the City Council authorizes the attached contract with National Resource Consultants to provide EAP services for th employees of the City of Carlsbad and their dependents. . 1 2 3 4 5 6 7 8 9 lo 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 e e PASSED, APPROVED, AND ADOPTED at a regular meeting of the SEPTEMBER , Carlsbad City Council held on the 28th day of 1993, by the following vote, to wit: AYES: Council Members Lewis, Stanton, Kulchin NOES: None ABSENT: Council Members Nygaard , ATTEST: #& AQd-2- ALETHA L. RAUTENKRANZ, City Clerk (SEAL) 0 e NATIONAL RESOURCE CONSULTANTS, INC. GROUP SUBSCRIBER CONTRACT Agreement made and executed as of the 1st day of October, 1993 by and betwc National Resource Consultants, Inc., hereinafter referred to as "NRC," and CITY ( CARLSBAD, hereinafter referred to as "Group," is made with reference to the following fa( NRC is a California corporation, licensed as a specialized Knox-Keene health c service plan, whose primary purpose is to operate a specialized health care service plan offer Employee Assistance Programs (EAPs). A. B. Group desires to obtain the services herein specified for and on behalf of Subscribers and Enrollees as defined herein. THEREFORE, the parties agree: ARTICLE I DEFINITIONS The following terms, when used in this Agreement or any amendments hereof are defii as follows: 1.1 Act means the box-Keene Health Care Service Plan Act of 1975 (Califor Health and SafeFCode Sections 1340 et seq.). 1.2 1.3 Benefits mean those services an eligible Enrollee is entitled to receive hereunc Group means any Employer, Labor Union or labor management Trust Fund other Subscriber Group. 1.4 Enrollee is defrned as a Subscriber and any eligible dependents as defined ur the eligibility requirements of this Agreement and as determined by Group who are actu enrolled in and eligible to receive benefits under said Agreement. 1.5 Evidence of Coverage or Combined Evidence of Coverage and Disclosure Fc means the document issued to the Subscriber which summarizes the essential terms of Agreement. 1.6 Provider means a licensed California professional under contract to NRC perform assessment, brief counseling, and referral. This term also refers to outside professio who perform services upon referral from NRC. Ib\contr-ltk\carkbad bc e 1.7 Regulations means those regulations promulgated and officially adopted by tl California Department of Corporations under the box-Keene Act. 1.8 Subscriber is defined as an eligible employee, retired employee or survivil spouse who is otherwise eligible for coverage under the eligibility requirements determined I Group, and who is enrolled hereunder and for whom periodic payments are made by i Employer. ARTICLE I1 PREPAYMENT FEES 2.1 Group shall pay NRC the total sum indicated in subparagraph 2.2, per quarter F Subscriber. This rate is subject to change on an annual basis. NRC shall give Group 30 da advance notice prior to change in rate. 2.2 Group shall pay to NRC a premium for each eligible Subscriber (which sE include dependents) as follows: $6.25 per employee per quarter. 2.3 The prepayment fee is paid by Group, unless other provisions for payment agreed to in advance by NRC. 2.4 Group shall send one check covering all Subscribers to NRC at the addr indicated in paragraph 9.3, commencing on the date indicated in paragraph 6. I, and continu each month thereafter on said date for the duration of this contract. 2.5 Group acknowledges and understands that this contract provides solely i exclusively for services to be performed at NRC provider facilities. This contract provides services only, is not an insurance policy and does not indemnify nor reimburse any Subscri or Group for the cost of health care services. 2.6 Group will furnish announcement brochures, management guidebooks, and ca as required by the program. 2.7 Group agrees to pay NRC for pre-approved travel expenses outside San Di county. ARTICLE 111 PRINCIPAL BENEFITS, EXCLUSIONS, LIMITATIONS AND ADMINISTRATIVE POLICIES 3.1 NRC and Group agree that NRC shall provide services to Subscribers of GI under the Plan set forth attached as EXHIBIT ONE, except as limited in the Exclusions Limitations section. EXHIBIT ONE IS AN ESSENTIAL PART OF THIS AGREEMEN? Ib\contr-kk\carlsbad bc 2 e e 3.2 EAP Services must be obtained from NRC designated Providers by calling t NRC toll-free number 800-999-7222 or (619) 291-0330 in San Diego. 3.3 Additional services beyond the EAP may be covered by Group’s employee welfa benefit plan. ARTICLE IV HOW TO OBTAIN BENEFITS Benefits must be obtained from NRC designated EAP Providers by calli NRC. NRC provides a toll-free or local telephone number. In non-emergency situatioi Enrollees are offered an appointment within 48 hours. NRC does not reimburse Enrollees 1 any unauthorized treatment from noncontracting providers. During business hours, any Enroll calling for service outside the NRC service area or with an emergency or urgent situation immediately referred to a licensed mental health professional for a telephone assessment. ‘I telephone assessor may provide crisis intervention over the telephone, arrange a same-d appointment with the EAP Provider in the Enrollee’s area, locate an EAP Provider if necessa or assist the Enrollee in obtaining more intensive, acute care services. After business hou Enrollees are forwarded to NRC’s 24-hour phone number and receive a call from a licem mental health professional for a telephone assessment within 15 minutes. ARTICLE V ELIGIBILITY 5.1 Group shall provide a monthly count of eligible Subscribers. Group shall se an eligibility list to NRC upon NRC’s request, specifying the names and other identifying d . for each Subscriber to be covered for the succeeding month. 5.2 The determination of who is eligible to be a subscriber and who is actually subscriber in the Plan shall be determined by Group, and NRC shall have the right to rely uj that determination. Any disputes or inquiries regarding eligibility, including rights regard renewal, reinstatement and the like, if any, shall be referred by NRC to Group, which shall tl advise NRC of its determination. 5.3 Dependents shall include: a. The lawful spouse who shares the same household of the subscriber, i all newborn infants whose coverage shall commence from and after moment of birth. Adopted children shall be covered from and after date of placement. Except as stated above, dependents shall be eligible coverage on the day the Subscriber acquires such dependent. Ib\contrXk\carkbad bc 3 e e .. b. Dependents shall also include all unmarried children under the age nineteen (19) years who are chiefly dependent on the Subscriber f support and maintenance. Extension of eligibility may be made up to t age of twenty-three (23) years for unmarried children who are principal dependent upon the Subscriber and are registered students in regular, fu time attendance at an accredited school, college or university. Coverage shall not terminate while a dependent child is and continues be (1) incapable of self-sustaining employment by reason of men disability or physical handicap; and (2) chiefly dependent upon t Subscriber for support and maintenance. Upon request, NRC may choose to extend the definition of dependent include a significant other who shares the same household, parents in I subscriber’s household who are chiefly dependent on the subscriber support and maintenance, or other person whose impact on the subscril might adversely affect the subscriber’s well-being or work performan If such a person is not covered under the Group’s definition of eligibili the referral may be limited to specific community resources. c. d. ARTICLE VI COMMENCEMENT AND DURATION OF THIS CONTRACT TERMINATION - RENEWAL 6.1 Coverage shall commence at 12:Ol A.M. on October 1, 1993 for all Subscrib enrolled on the day when the Plan starts. Coverage for new subscribers shall commence at 12 A.M. on the first day of employment or at the end of any Group designated probationary peril Coverage terminates at 1159 P.M. on the last day of eligibility for participation in the Gro whether the last day of employment or the last day of eligibility for any continuation of coveri period. 6.2 This contract shall be effective on the date indicated in paragraph 6.1 above, i shall continue until the end of the month of September, 1994. NRC shall not increase the am0 of prepaid payment, except upon at least 30 days written notice, nor shall NRC decrease bene in this agreement except upon 30 days written notice. Renewal Provisions: The term of this contract shall be one year beginning the effective date of this contract at which time it may automatically be extended for tl- additional one-year periods or part thereof. Contract extension will be based upon satisfact performance and the Group’s needs. Or, the parties may renew this contract at the end of term hereof, and by mutual consent modify or alter this contract; provided, however, that ! modifications, amendments, alterations or renewals shall be in writing, duly executed by t parties hereto, and attached to this contract. There is no individual right of renewal. Only gra are eligible to enter into or renew subscriber agreements with NRC. I bkontr-k kkarisbad bc 4 6.3 0 e .’ 6.4 Termination Provisions: Should either party be in defaklt by the failure reasonably perform any of the covenants and conditions contained herein, the non-defaulting pa shall have the right to give the defaulting party thirty (30) days written notice, specifying t default. If the default is not cured, the contract will be terminated, excepting therefrom GrouI failure to remit the monthly prepayment fees, or provide eligibility list as required, in which cs fifteen (1 5) days written notice shall apply. The defaulting party shall then have the thirty (3 days, or fifteen (1 5) days in the case of the failure to remit the appropriate prepayment fees, eligibility list when due, from receipt of notice, in which to remedy the default or failure perform. Both parties agree that NRC shall have the absolute right to terminate ti contract should Group fail to remit the monthly prepayment fees or eligibility list, within I fifteen (1 5) day period after notice. Receipt by the plan of the proper prepaid or periodic payment after cancellati of the contract for nonpayment shall reinstate the contract as though it had never been cancel if such payment is received on or before the due date of the succeeding prepaid or perioc payment. The Plan may, if such payment is received more than 15 days after the issuance oft notice of cancellation, refund such payment within 20 business days and there will be reinstatement of the contract. NRC will not terminate or fail to renew the eligibility of any individi subscriber or enrollee because of health status or use of the EAP. If any person believes that tl agreement has been terminated or any enrollee or subscriber has been denied services under tl agreement because of health status or requirements for health services, the enrollee may requ a review by the Commissioner of Corporations of the State of California. Both parties may terminate this Agreement immediately if the other party shoi engage in fraudulent conduct with respect to this Agreement. This Agreement may be terminated at any time without cause by Group upon days written notice. 6.5 In the event of termination of this contract, each NRC participating provider 1 agreed to complete all assessment, brief counseling, and referral services which have been start prior to the date of termination, pursuant to the terms of this contract. 6.6 Pursuant to Section 1365(b) of the Knox-Keene Act, any Subscriber who alleg his enrollment has been canceled or not renewed because of his health status or requirement . services, may request review by the California Department of Corporations. Ib\confr-kk\carisbad bc 5 0 m .. ARTICLE VI1 ADMINISTRATION 7.1 With regard to the distribution of all materials, such as Combined Evidence of Coverage and Disclosure Form and other materials required to be distributed pursuant to the box-Keene Act or any regulation issued pursuant thereto, Group shall be responsible to distribute such materials to the Subscribers andor eligible participants. 7.2 NRC shall also provide telephone or in-person emergency service twenty-foul hours a day, seven days a week, to all Enrollees. If the Enrollee’s provider office is unavailable the Enrollee shall call NRC’s offices during normal business hours, or in the case of an after hours emergency. 7.3 NRC agrees to duly investigate and resolve any and all complaints received fron Enrollees with regard to the nature of professional services rendered. Any inquiries or complaint shall be made to NRC by writing or calling NRC at the address and telephone number indicate1 herein. NRC shall maintain a grievance system in compliance with the Knox-Keene Act. Grievance Report Forms and copies of the Grievance Procedures are availab at each facility of the plan. Enrollees may send a written cornplaint or call NRC directly 1 resolve their complaint. NRC will acknowledge receipt of the complaint and provide notice 1 the complainant of whom may be contacted with respect to the complaint within 20 days. If the enrollee is not satisfied with the resolution offered at the first level, t€ grievance is directed to the next management level. If the grievance is not resolved to the Enrollee’s satisfaction at the second levi it will be directed to the Quality Management Committee in the case of a quality of care issL or the Vice President, Operations or designee in the case of an administrative issue. The Qualj Management Committee or the Vice President, Operations or hidher designee will review I applicable data within 15 days. The enrollee will be advised in writing of the findings and recommendatic within 30 days of the receipt of the Grievance Report. Enrollees file a complaint or grievance by calling (619) 291-0330 in San Dit or 1-800-999-7222 in all other areas regarding the complaint. Ib\contrkk\cadsbad bC 6 0 w .. ARTICLE VI11 QUALITY CONTROL AND PROFESSIONAL-PATIENT RELATIONSHIP 8.1 NRC is responsible for and agrees to arrange for services and care as herr provided in accordance with the prevailing professional standards. 8.2 It is expressly understood that the relationship between the Enrollee and N1 participating professionals shall be subject to the rules, limitations, and privileges incident to doctor-patient relationship. NRC shall be solely responsible, without interference from Grc or any of its agents, to the Enrollee for arranging counseling and treatment. 8.3 It is understood by Group that the operation and maintenance of the participat offices, and the rendition of all services shall be solely and exclusively under the control 2 supervision of the NRC provider, including all authority and control over the selection of st supervision of personnel, and operation of the professional practice, and/or the rendition of particular professional service or treatment. 8.4 NRC will undertake to see that the services provided to Enrollees by provic shall be performed in accordance with nationally accepted professional standards of reasoni competence and skill of providers as applicable prevailing at the time of service. 8.5 If NRC shall subcontract any of the work to be performed under this contracj NRC, NRC shall be fully responsible to Group for the acts and omissions of NRC’s subcontra and of the persons either directly or indirectly employed by the subcontractor, as NRC is foi acts and omissions of persons directly employed by NRC. Nothing contained in this coni shall create any contractual relationship between any subcontractor of NRC and Group. E shall bind every subcontractor and every subcontractor of a subcontractor by the terms of contract applicable to NRC’s work unless specifically noted to the contrary in the subcontra1 question approved in writing by Group. ARTICLE IX GENERAL PROVISIONS 9.1 If a dispute should arise regarding the performance of work under this agreer the following procedure shall be used to resolve any question of fact or interpretatior otherwise settled by agreement between parties. Such questions, if they become identified a: of a dispute among persons operating under the provisions of this contract, shall be reducl writing by the principal of NRC or the Group’s Human Resources Department. A copy of documented dispute shall be forwarded to both parties involved along with recommended me1 of resolution which would be of benefit to both parties. The Human Resources Departme principal receiving the letter shall reply to the letter along with a recommended methi resolution within ten (10) days. If the resolution thus obtained is unsatisfactory to the aggr Ib\contr.ltk\carisbad bc 7 0 "1 party, a letter outlining the dispute shall be forwarded to the City Council for their resolutiol through the Office of the City Manager. The City Council may then opt to consider the directec solution to the problem. In such cases, the action of the City Council shall be binding upon thi Rarties involved, although nothing in this procedure shall prohibit the parties seeking remedie available to them at law. 9.2 Each party to this Agreement, together with their respective successors an assigns, agrees to defend and indemnify the other parties to this Agreement and hold the] harmless from and against all loss, cost, claims, actions, liabilities and attorneys' fees arising i connection with this Agreement as a result of or attributable to the intentional act or negligenc of such party, or such party's officers, directors, employees, agents, or independent contractor Whenever it shall become necessary for either party to serve notice on the 0th respecting this Agreement, such notice shall be in writing and shall be served by certified ma return receipt requested, addressed as follows: 9.3 a. If served on Group, it shall be addressed to: CITY OF CARLSBAD Human Resources Department 1200 Carlsbad Village Drive Carlsbad, CA 92008-1 989 (619) 434-2852 b. If served on NRC, it shall be addressed to: NATIONAL RESOURCE CONSULTANTS, INC. 2835 Camino del Rio South, Suite 300 San Diego, California 92108 (619) 291-0330 9.4 NRC is subject to the requirements of Chapter 2.2 of Division 2 of the He: and Safety Code (the "Act") and Subchapter 5.5 of Chapter 2 of Title 10 of the California C of Regulations (the "Regulations"), and any provisions required to be in the contract by eithe the above shall bind NRC whether or not provided in the contract. In the event that the Act or Regulations thereunder set forth any requirer which is not included herein or is contrary to this Agreement, it shall supersede the applic provisions of this Agreement and shall be binding unto the parties hereto. 9.5 Nothing contained herein shall preclude NRC from changing the location oj of its provider offices, as long as it retains a sufficient provider network to provide servici Group. Ib\contrhk\carlsbad be 8 e *< 9.6 In the event any of NRC’s contracted participating Providers should termina his relationship with NRC, breach his contract with NRC or be unable to render servicc hereunder, and Group andor its Subscribers will be adversely or materially affected, NRC wi give the Group and/or its Subscribers written notice thereof. 9.7 Upon termination of a provider contract, NRC shall be liable for covered servicc rendered by such provider to a Subscriber or Enrollee who retains eligibility under this contre or by operation of law under the care of such provider at the time of such termination until t services being rendered to the Subscriber or Enrollee by such provider are completed, unless NF makes reasonable and medically appropriate provision for the assumption of such services bj contracting provider. 9.8 In the event that NRC fails to pay the participating Provider for costs assessment, brief counseling, and referral, by statute the Enrollee shall not be liable to t Provider for any sums owed by the plan. In the event NRC or the employee’s full service hea plan fails to pay a non-participating Provider, the Enrollee may be liable to the non-participatj Provider for the cost of services rendered. 9.9 If any provision of this contract is held to be illegal or invalid for any reas such decision shall not affect the validity of the remaining provisions of this contract, and SI remaining provisions shall continue in full force and effect unless the illegality or invalid prevent the accomplishment of the objectives and purposes of this contract. 9.10 In the event Group is regulated under the Employee Retirement Income Secui Act of 1974 (ERISA), Group covenants and agrees that it and not NRC shall be responsible meeting all requirements of ERISA. NRC will cooperate with Group in supplying Group v any information within its possession to aid Group in meeting any ERISA reporting requireme NRC is not and shall not be designated the administrator or fiduciary of the Plan. 9.11 If the Subscriber andor Enrollees are eligible to retain coverage under contract during any Continuation of Coverage period or election period necessary for Groi compliance with requirements of the Consolidated Omnibus Budget Reconciliation Act (COBI and any regulations adopted thereunder, or any similar state law requiring the Continuatior Benefits for Subscriber andor Enrollees, the Group must continue to certify the eligibility of Subscriber andor Enrollees and pay the monthly prepayment fees for COBRA coverage for : Subscribers andor Enrollees. 9.12 This Agreement is non-assignable by either party without the prior wr consent of the other party. NRC may, in its sole discretion, delegate administrative functioi other entities. 9.13 NRC shall perform the services provided for herein in NRC’s own way a independent contractor and in pursuit of NRC’s independent calling, and not as an employt Group. NRC shall be under control of Group only as to the result to be accomplished, but consult with Group as provided for in the request for proposal. Ib\contr-kk\carlrbad bc 9 0 NRC is an independent contractor of Group. The payment made to NR pursuant to the contract shall be the full and complete compensation to which NRC is entitle Group shall not make any federal or state tax withholdings on behalf of NRC. Group shall n be required to pay any workers’ compensation insurance on behalf of NRC. NRC agrees indemnify Group for any tax, retirement contribution, social security, overtime payment, workers’ compensation payment which Group may be required to make on behalf of NRC or a employee of NRC for work done under this agreement. NRC shall be aware of the requirements of the Immigration Reform and Cont Act of 1986 and shall comply with those requirements, including, but not limited to, verifyi the eligibility for employment of all agents, employees, subcontractors and consultants that i included in this agreement. 9.14 This contract constitutes the entire agreement of the parties. This contract n only be modified by a writing executed by the parties. IN WITNESS WHEREOF, the parties have executed this agreement on the date forth on page one (1) hereof. CLAUDE A. LEWIS (Print) NATIONAL RESOURCE CONSULTANTS, INC. By: - /$&& /@K447 Nicholas M. Krnich Presi Ib\contrXk\carlsbad bc 10 e *. EXHIBIT ONE PRINCIPAL BENEFITS, EXCLUSIONS, AND LIMITATIONS Benefits NRC agrees to provide the following services: 1. Ongoing consultation regarding the benefits provided in this Employee Assistar Program Agreement, including the overall design, development, management a implementation of such benefits. Appropriate individual case management including: Evaluation of employee and family member problems, appropriate brief counseling (c to six sessions per incident of treatment when the Enrollee’s or Enrollee’s fam member’s problem(s), in the judgement of the EAP Provider, are subject to signific improvement as a result of short-term care) andor referral to screened resources ongoing or specialized treatment or services. Consultation to Group employees and management to assist with reintegration employees who have been in alcohol or drug treatment or who have been absent duc other mental health related reasons. Follow-up on each case to determine rate of success of the rehabilitation process or n for further assistance. Liaison between Group and all counseling and helping agencies that service Gr employees and their families in matters related to the benefits available under Employee Assistance Program. Assistance with continuous and ongoing in-service training of Group supervis management, including one in-depth training session for Group personnel schedule( appropriate and consistent with business needs. Assistance in providing information about the benefits available under the Emplc Assistance Program to Group employees through pamphlets, posters and other approp means. Ongoing evaluation and reporting sufficient to enable Group to measure the effective of the Employee Assistance Program. Ongoing formal recommendations for the upgrading and improvement of the Prog including the development of an annual report of Employee Assistance Program re5 Critical incident debriefings, consultation and counseling in response to trauma a worksite, subject to the limitations stated herein. 2. 3. 4. 5. 6. 7. 8. Ib\contrkk\carlsbad be 11 0 V a, EXHIBIT ONE PRINCIPAL BENEFITS, EXCLUSIONS, AND LIMITATIONS Limitations and Exclusions 1. Benefits under this Agreement are limited to a maximum of six sessions per incident treatment when the Enrollee’s or Enrollee’s family member’s problem(s), in judgement sf the EAP Provider, are subject to significant improvement as a result short-term care. NRC’s benefits work in conjunction with the benefits provided under Group’s full-service health plan that may cover, to the extent determined by the Grc services of physicians, hospitals, mental health and substance abuse providers. NRC is not responsible for the inclusion or exclusion of any particular health care ben in the Group full-service health plan. Critical incident debriefings, consultation and counseling in response to trauma at worksite shall be limited to short term intervention within the capacity of NRC’s prov network. In the case of massive trauma caused by major disasters or other events cau massive trauma, NRC shall not be responsible for the results of circumstances beyonc control that prevent NRC from completely responding to all service requests. 2. Ib\contrkk\carlsbad bc 12