March 09, 2026

Employee assistance programs (EAPs) have long been a foundational component of employer-sponsored health and well-being strategies, offering confidential counseling and referral services to employees and their families. While EAPs were historically positioned as stand-alone tools to support an employee in the event of an acute crisis, many employers have embraced a broader role for their EAPs as workforce needs and vendor capabilities have evolved. As part of this change, many EAPs have become a front door for employees to access broader mental health care and specialty support. Moreover, some EAP models now offer artificial intelligence (AI)-enabled digital tools to provide timely access to mental health care directly, outside of crises, along with connections to third-party clinical and community-based care.

Deploying a high-quality EAP experience for all employees is not easy; employers face layers of complexity in navigating legal compliance, cultural norms, variance in vendor capabilities and data regulations across regions and countries. Still, a well-run and communicated EAP can have both significant tangible (e.g., reduced absences and improved health outcomes) and intangible effects (e.g., fostering a culture of well-being and support).¹

This FAQ aims to help benefit and well-being leaders assess the current landscape of EAPs, vendor capabilities and key performance metrics to make well-informed decisions to meet their workforce needs.

1. How many EAP counseling sessions/visits do employers generally offer?

Many companies around the world use a maximum-per-incident limit for EAP counseling sessions. Among U.S. and global employers surveyed with a maximum EAP limit, there is a high degree of variability, with an average of 9 maximum visits and a range of maximum numbers of visits between 3 and 25 in 2024.² To set that number, employers usually consider regional goals, employee mental health needs, local and global vendor capabilities and cost. Between 2022 and 2026, some surveyed employers changed or planned to change the maximum number of visits available through their company’s EAP offering.²

2. How does a traditional EAP compare to an enhanced EAP model?

According to Business Group on Health’s 2025 Employer Well-being Strategy Survey, in 2025, 83% of employers offer a “traditional” EAP in some or all of the countries where they operate, while 44% offer an “enhanced” EAP in some or all of the countries where they operate.³ This change is an increase of 7 percentage points in the number of surveyed employers who offered an enhanced EAP in 2024.⁴

For both types of EAP models, gaps remain in global capability, including resources defaulting to English vs. the local language, limited in-person access in rural areas and limited access to specialty care for individuals who are neurodiverse and have eating disorders or substance use disorders (SUDs).

3. How do employers approach EAP contracting across multiple countries?

Employers with geographically dispersed workforces must decide whether to work with one EAP vendor that can provide services across their global population or a set of EAP vendors that have region- or country-specific areas of focus.

Using a single EAP vendor with broad geographical coverage can streamline contracting, account management, employee communications and standardized reporting. This approach also makes it easier to create consistency of benefits across countries. Survey data indicates that use of a single EAP vendor is common among global employers, particularly those with a globally consistent approach to mental health support.² On the other hand, some may find that a single EAP vendor globally may not have sufficient knowledge of country-specific languages, legal issues, cultural norms and/or local providers to be effective everywhere they operate. For employers adopting a single global vendor, it can sometimes make sense for that vendor to cover the U.S. as well as other regions. However, for many other employers, it may be most advantageous to use a hybrid approach, with a dedicated U.S. strategy and local vendors outside the U.S. to ensure compliance and cultural relevancy. A multivendor approach can create more effective experiences for employees in their home countries, but it creates more burden behind the scenes for those managing vendor contracting and employee communications.

4. What are the key capabilities employers are looking for when implementing an EAP globally (i.e. in multiple countries)?

Global capabilities of EAPs vary considerably, including:

• How the EAP delivers a comprehensive scope of contracted services: Whether a global EAP delivers services in-house or through subcontracted vendors matters; services that are subcontracted to regional providers may be more culturally appropriate or tailored to a region’s sensitivities but give employers less control over the structure of the contract, data privacy/security and terms of services.
• Language and cultural accuracy: Effective global EAPs must provide language options and culturally accurate services factoring in regional nuance and dialect variety. Additionally, employers should ask vendors how their services are translated into local languages; ideally, translations should account for the context of a country or region’s common language use rather than literal translations that might not resonate from one country to another.
• Local referrals and transitions: Transitions from an EAP service to local health and well-being services outside the EAP are difficult to manage in many parts of the world. Employers need to push their partners to become more sophisticated in how they use and leverage technology, communications and relationships to improve the user experience, especially as it relates to transitions of care. Global EAP vendors generally rely on local clinicians to make referrals to services outside the provider company, which can improve speed but reduce influence and oversight by the global EAP vendor.

5. What legal or compliance considerations should employers keep in mind when crafting a global EAP strategy?

Employers need to consider several things to ensure legal compliance for their EAP:

• The number, duration and objectives of any mental health counseling sessions covered;
• The scope of other medical and/or health-related benefits available through the EAP;
• Any substantiation, assurances and/or guarantees the vendor will provide relating to the EAP’s status as an excepted benefit (applicable in the U.S.);
• The EAP’s adherence to psychosocial risk guidelines in specific markets;
• Vendor and employer data security protocols alignment and compliance; and
• Compliance with AI guardrails set by the employer and/or by law.

Employers should consider working with consultants and legal counsel to help ensure that their EAP design complies with applicable regulations governing EAPs. Outside the U.S., employers can lean on the expertise of global consultant or broker partners to understand region- and country-specific compliance considerations. Globally, there are legal considerations for specific health issues (e.g., suicide ideation, substance use) and employee groups (e.g., women, LGBTQ+) in certain markets.

6. What key performance indicators do employers use to measure the success of EAP offerings, and how are vendors held accountable?

As employee mental health care has become a growing cost driver and health burden, employers have increased expectations of EAP vendors to deliver positive, measurable outcomes. Employers need to continue to evaluate what metrics and outcomes define success for their company.

While abiding by country-specific regulations, employers should consider key performance metrics that typically include, but aren’t limited to:

• EAP utilization rates;
• Access to a diverse array of providers;
• Average wait time to appointment;
• Number of one-on-one counseling sessions;
• Impact on other claims costs;
• Aggregate mental health categories (e.g., depression, anxiety);
• Health outcomes assessment (Harvard’s Flourishing Index, PHQ-9, GAD-7, etc.);
• Absenteeism; and
• Employee satisfaction (e.g., net promoter score, employee experience surveys).

Holding vendors accountable for these metrics requires comprehensive data; employers should include specific data-reporting requirements in contracts and regular reports that go beyond basic metrics such as email open/click rates or service sign-up rates. This data should be made available regularly, with check-ins from EAP vendors on areas of opportunity and insights on employee needs across markets. Unfortunately, access to meaningful data, even simple utilization, varies widely in different countries. Limited access also is often the case in locations with smaller employee headcounts.

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7. What are the advantages and drawbacks of incorporating EAP services on-site?

On-site EAP services provide access to care that otherwise may be geographically limited. In fact, in 2026, 55% of surveyed employers offer on-site EAPs as part of their health and well-being clinic services.⁷ Bringing the EAP on-site can improve utilization by increasing convenience, particularly in locations or job types where accessing care outside work hours is challenging. On-site services also allow employers to align the EAP with their organizational culture by having the EAP hire counselors that fit in and educating them on company policies, practices and norms, along with available benefits and programs. On that note, an on-site EAP may enable greater coordination and/or referrals to other services that are also on-site or co-located. Potential drawbacks to bringing the EAP on-site include cost, scalability and potential dissatisfaction among those without access as well as the potential for misperception among employees regarding privacy.

8. What technological capabilities do EAPs offer?

EAPs have evolved quite a bit from a technological standpoint in recent years. Examples of recent technological developments for employers to consider include:

• Apps: Many EAP providers have the ability to deliver live and virtual therapy through an app. Apps may also include asynchronous tools for people to use outside the standard therapy visit, such as videos and self-guided exercises. Apps also generally include messaging with providers in between sessions, provider directories and digital questionnaires that triage care or offer recommendations.
• AI: AI is sometimes used for intake triage and identification of services or providers most helpful to a new or current user, but capabilities are evolving quickly. Some EAPs use AI-enabled ambient-listening during counseling services to capture notes and track outcomes. As with other vendors, employers should know how EAP vendors are using AI in patient care or navigation; the mechanisms in place to ensure appropriateness of use, including human oversight; and its impact on utilization and mental health outcomes. New AI tools show a lot of promise but also require careful scrutiny, especially in light of AI health care regulation compliance.⁸ For more information on this topic, check out Artificial Intelligence in Health Care and Employee Benefits: What Employers Need to Know.

9. What capabilities do EAPs make available for employees with substance use disorders (SUDs) and other specialty care (e.g., eating disorders, neurodiversity)?

Some EAPs offer specialty care for conditions like SUD and eating disorders. For conditions like these that require long-term support, employees will need to rely on their medical plan for many or most mental health services. However, EAPs can provide tailored services in support of that care, including:

• Curated networks of specialty mental health providers and facilities that provide evidence-based treatments;
• Virtual visits with specialty providers that otherwise can take months to access via the health plan;
• Coordinators to help employees navigate the health system to meet employee and dependents’ health needs, including crisis support when seeking treatment for serious substance use episodes;
• AI tools to help employees access the right care for themselves or their dependents when it is necessary; and
• A monitoring process for employees who are on a job performance-related treatment program as part of “first offense forgiveness” policies.

For more information on these topics, please see these resources:

• Substance Use Disorder: An Employer’s Strategy Resource
• Podcast: Finding Strength in the Middle Place: Between Acute Sickness and Full Eating Disorder Recovery
• A Spectrum of Benefits for Neurodiverse Employees

10. Should my communication strategy emphasize the mental health components of an EAP or focus on work/life support to drive utilization? What have other employers done to bolster their partnerships with their EAP providers?

Employers’ EAP communication strategies vary based on organizational culture, workforce demographics and location. Some employers have rebranded their EAP to change employee perception, remove possible stigma and align the program with the organization’s mission and goals. As a part of this rebranding, employers are promoting the full scope of EAP benefits, from core services like mental health counseling to the often less well-known services such as financial, legal, child and elder care assistance. Some employers are marketing their EAP by communicating the positive reasons employees might use it, such as for career development. Marketing the full scope of EAP services also enables employers to integrate its promotion into other health and well-being communications or tools (i.e., well-being platforms) to help keep the EAP top of mind for employees and their families.

Return on investment (ROI) is arguably strongest when employees understand, trust and use the EAP offering - something that hinges on culturally relevant communication, local champions and integration with established systems. Common approaches to foster this understanding include partnering with employee resource groups (ERGs) to direct employees to relevant resources as well as holding personalized live events with popular C-Suite leaders at multiple time zones. For more actionable information and messaging tips, please visit the Business Group’s resources on reducing mental health stigma and delivering relevant communications.

11. Do EAPs offer peer and manager trainings?

Many EAP providers conduct peer and manager training on a variety of topics. Employers take varied approaches to training. Some offer mental health first aid (MHFA) training while others provide broader, consolidated programs delivered through internal teams or EAP vendor partners. Access to training also differs, with some employers focusing on only leaders and managers while others focus on all employees. To help employees identify those trained in MHFA or mental well-being, employers use various methods, including posters inside bathroom stall doors, email signatures, lanyards and stickers on hard hats. Employers interested in peer and manager training should ask their EAPs if they offer it and if they have outcomes data associated with both kinds of training. 

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12. What should employers consider as part of an EAP RFP?

Employers are reevaluating their RFPs to ensure that future partners are aligned with their strategic vision. Key priorities include:

• Customization;
• Technology capabilities including use of AI;
• Provider network;
• Qualifications of providers;
• Time to care;
• Employee experience;
• Integration with, and referrals to, other health and well-being offerings;
• Data sharing and reporting;
• Understanding vendor ownership vs. partnership approaches for global networks to optimize globally consistent offerings;
• Cost and cost control strategies; and
• Engagement strategies.

As this landscape evolves, employers can consider the following elements when developing their EAP RFP:

• Assess the current EAP landscape across the company’s worldwide enterprise: For multinational companies with a decentralized structure, the organization may lack a consistent way of reporting the available benefits in each of their locations. It is therefore important for HR/benefits leaders to identify where EAP programs already exist and what services are offered. Employers can use this opportunity to survey local teams and understand the location-specific drivers of absenteeism and health concerns as well as identify gaps in support.
• Determine priorities and clarify what matters most: It’s helpful to have a clear vision of what services and/or capabilities are most important before beginning the RFP process. This process involves identifying top priorities (e.g., well-being, work/life, in-country offerings, etc.). Examples of key capabilities to consider include:
• Digital capabilities (i.e., security, privacy, AI governance, etc.);
• Provider networks;
• Data and reporting;
• On-site services;
• Global consistency with local nuance; and
• Integration across employers’ benefit ecosystem.
• Decide whether to use a local, regional or global approach: Each employer must decide which approach works best for it’s corporate and in-country staff based on available financial and staffing resources, existing EAP vendor relationships and desire for global standards and services. See Question 3 for more context.
• Involve local staff from the beginning: Involving local staff in the selection of an EAP vendor can increase buy-in by providing them with a sense of ownership. Using company structure as a guide, determine in which phases local staff are involved. Having a local EAP champion can lend a hand to promoting the benefit locally.
• Understand pricing options: Understanding the pricing structure options by vendor and what is most economical given the employee footprint is key. Also, weigh cost efficiencies related to having different EAP models; for example, not having to manage or renew several local providers may be worth some added cost.
• Make sure services are delivered in a culturally sensitive manner and tailored to workforce needs: Even if an employer chooses to have global administration of an EAP, service delivery is typically done at the local or country-specific level. If employers choose to have local or regional EAP vendors, they may want to develop global minimum standards to have some sense of continuity and consistency across locations (e.g., minimum number of sessions, focus on management consultation, specific trainings available, etc.). See Question 4 for more context.
• Make sure the RFP (and resulting conversations) reflect local laws and regulations: EAP vendors must be aware of and follow relevant country-specific laws and regulations. See Question 5 for more information.
• Be aware of the providers, their specialties, where they’re located and how they’re credentialed: Ask vendors about their requirements for providers, whether they’re affiliates or employees of the company and how they’re chosen. Some employers require that the intake staff answering the phones have a mental health background along with those engaging in telephonic or face-to-face counseling.

More Topics

Resource On-site/Near Site Services Vendor Management & Accountability Culture & Strategy