Priority Health puts behavioral health access in every plan, so the employer question is what extra support is worth communicating.
Priority Health says all members have free 24/7 access to licensed behavioral health clinicians. Several virtual partners add specialized services on top.
What the program is and what members do.
Core access
Priority Health’s provider manual says all members’ benefits include free, 24/7 access to licensed behavioral health clinicians. They can help with emotional distress and substance use concerns and connect members with a therapist. Priority Health says it is continually expanding its network of virtual providers.
Self-care and specialty partners
Teladoc Health Mental Health is an online tool with coping tools, community support and one-on-one coaching for depression, anxiety, substance abuse, stress and chronic pain, listed for all members. Backpack Healthcare offers pediatric (ages 4 and up) and family mental health care virtually. Folx Health offers virtual care for LGBTQIA+ members.
Substance use and community care
Boulder Care is a virtual platform offering telehealth treatment for substance use disorder, particularly opioid and alcohol addiction and co-occurring conditions. Priority Health also lists Community Care Management for non-Medicaid members at risk of rehospitalization after a mental health stay.
Eligibility, funding and plan design.
Who can use what
Priority Health lists core clinician access, Teladoc Mental Health and Backpack Healthcare for all members. Folx Health is listed for all commercial members, group and individual. Boulder Care is listed for commercial group members 18 or older. Dependents and members on individual or Medicaid plans may be treated differently, so confirm who is covered.
Funding and opt-out
The manual notes some self-funded employer groups may opt out of Boulder Care, which it calls a core benefit. For fully insured groups the access features are part of the plan. Self-funded employers should confirm exactly which services are active.
Plan design fit
Access alone does not create use. Behavioral health programs work when employees know where to go and trust privacy. They complement, but do not replace, an employee assistance program, and the two should point to each other rather than compete.
What to settle before relying on it.
Have we opted out of anything, and do employees know?
If you are self-funded, ask whether Boulder Care or other core behavioral services were declined. Compare the answer with your benefits communications. Employees should not be pointed to a service the group does not have. Ask Priority Health to confirm in writing which services are active, and update your benefits guide to match.
How do these services work with our EAP?
Ask how Priority Health’s behavioral access, Teladoc coaching and your employee assistance program divide the work. Overlap is not harmful, but unclear routing is. We would want a single, simple message about who to call first. Clear routing reduces wasted calls and gets people to the right level of care sooner.
What reporting do we get, and how is privacy handled?
Behavioral health data is highly sensitive. Ask what Priority Health reports to employers, confirm it is aggregate only, and confirm no individual information is shared. If any reward is tied to participation, have employment counsel review it for HIPAA, ADA and GINA issues.
Common questions about this program.
Is behavioral health access free to members?
Priority Health says all members’ benefits include free, 24/7 access to licensed behavioral health clinicians. Cost sharing for treatment such as ongoing therapy depends on the plan.
Can an employer decline Boulder Care?
Priority Health’s manual notes some self-funded employer groups may opt out of this core benefit. Fully insured groups should confirm their status with Priority Health.
Are these programs employer products?
The core access and partner programs listed apply to commercial members, with Priority Health noting some are for all members. Medicaid and individual plans are separate lines of business, so confirm which one a given member is on.
Programs and vendors named on this page
Official pages for the services mentioned above. Availability, cost and eligibility vary by plan and employer group, so confirm what applies to your group with the carrier.
Where these details come from.
This page summarizes what Priority Health publishes. Programs change, so confirm current details with the carrier before relying on them.
Send us your renewal.
We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.
The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier
Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.
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