An internal company employee assistance program (EAP) was compared to an externally delivered comprehensive program featuring telephonic 24-hour 7-day access to counselors and nurses and in-person counselor services. Self-report surveys were completed at the start of the service and again at 9 months later. The baseline sample included 1,165 employees and 183 managers. The sample included 800 employees and 123 managers. The Optum Care24 service had significantly higher program utilization and better work and health outcomes than the internal EAP service. Implications for future trends in EAP delivery are discussed.