The 6% Problem: How High-Acuity Mental Health Needs Drive Your Fund's Biggest Claims

Union members do hard, physical work—but the toll isn't always physical. An injury on leave turns into depression. Chronic pain turns into substance use. A child's mental health crisis pulls a working parent off the job. These cases are rare, but they're rarely simple: They cut across medical, behavioral and disability benefits at once, and most plan designs aren't built to handle them. When that happens, members and their families are left to navigate detox programs, treatment centers and out-of-network care largely on their own, often at the worst possible moment, and often at significant cost to the fund. Join clinical leaders from Lyra Health and Carelon, alongside a trustee from the Arizona Pipe Trades, for a conversation on protecting members and plan dollars.

• The complex conditions behind the highest-cost claims, including substance use, suicidality, pediatric and family crises, and neurodiverse needs
• The leading indicators that a member or family is headed toward the ER, extended leave or out-of-network care, and how to intervene earlier
• What trustees and administrators can do now to build care pathways that get members the right level of care from day one, keep them in-network and contain costs