We know open enrollment is an important time of the year to learn more about your family friendly benefits and Progyny is here to help. The second webinar in our three-part Open Enrollment Webinar Series focuses on how to successfully plan for the options that may be presented to you during open enrollment season. Read on to learn more about the Progyny benefit, how it works, and what to consider for next year.
This webinar featured:
- Melissa Maldonado, VP of Client Operations at Progyny
- NajaMia Phillips, Patient Care Advocate (PCA) Supervisor at Progyny
- Cynthia McEwen, VP of People at Progyny
In case you missed our first webinar within the Open Enrollment Webinar Series, Financial Wellness and Your Progyny Benefit, check out the recap here.
Open Enrollment Planning
Open enrollment is the time of year when you can make changes to your chosen benefits through your employer. This period typically only happens once a year, so it is important to know your organization’s open enrollment dates.
Once open enrollment begins, there are a number of things to consider, including understanding if any changes will be made to your current benefit offerings. There are almost always changes, whether a minor change (such as an increase to the flexible spending account contribution maximum), or a major change (such as a shift in medical plan carrier).
Progyny is a benefit offered through your employer, and may work alongside your health insurance plan. If you have an employer that offers more than one plan for medical coverage, confirm which plan or plans you must be enrolled in to access the Progyny benefit.
To make the benefit easier to understand, we have broken it down into the Progyny Smart Cycle. A Smart Cycle is a unit of measurement and includes all of the standard of care services needed to support your intended treatment cycle, such as office visits, lab tests, ultrasounds, and the applicable medical services for your treatment. It is important to know that members will have financial responsibility based on their health plan, and can expect those responsibilities to coincide with their eligible medical plan’s deductible, co-insurance, and maximum out-of-pocket amount. If you have more questions regarding your financial responsibility, refer back to our Financial Wellness and Your Progyny Benefit webinar recap here or contact your PCA.
Open Enrollment Action Items
Once you know your employer’s open enrollment dates, it’s important to understand if it is an active or passive open enrollment period, which will help you determine what actions you may need to take:
- An active open enrollment means that you must re-confirm all of your benefits elections, even if your elections aren’t changing. This often happens if your employer has made substantial changes in their benefit offerings to help ensure you have all of the information you need.
- A passive open enrollment means that you only have to confirm enrollment elections with your employer if you would like to make changes in your coverage.
To make open enrollment season easy for you to navigate, we’ve made a checklist of the top things to keep in mind:
- Explore the changes to your benefit to understand how they may affect your elections.
- Find out the dates of your open enrollment period so you can prepare to make changes as needed.
- Look into any tax-savings account options, like HSAs and FSAs, and determine what may be a best fit for you.
- Involve your family in any election decisions. If your spouse or domestic partner has other coverage that is also available to you, compare the two plans to choose what is best for you.
Questions from the audience
1. What if both my partner and I have access to the Progyny benefit?
For most, if you and your partner have access to the Progyny benefit, you would utilize your Progyny benefit first. Once your Progyny benefit is exhausted, and if enrolled in your partner’s medical plan, you can then access your partner’s Progyny benefit. Be sure to contact your Patient Care Advocate to understand the specific coverage and options available to you.
2. My partner and I have primary and secondary insurance. Only our secondary insurance is eligible for Progyny. Can we still utilize that benefit?
If your primary insurance does not offer fertility coverage, your PCA can help coordinate steps to grant you access to Progyny via your secondary insurance. Call your PCA to learn more about the additional steps involved in coordinating benefits.
3. What questions can I ask my benefit team to better understand my options?
Here are a few prompting questions to help inform your decision-making:
- Where can I find key changes to my benefit elections?
- How can I better understand what financial implications may look like under each medical plan?
- Can you further explain what is include in my coverage options? Are there any limitations?
4. What if I newly select a plan that is eligible for Progyny coverage, but I am already mid-treatment?
Contact your Patient Care Advocate to discuss what your options are for a smooth transition. Your PCA will help you understand the best next steps according to your benefit effective date.
If you are looking for more information around benefits planning, check out our frequently asked questions page. If you have any other questions related to this webinar, please don’t hesitate to reach out to education@progyny.com. If you are a Progyny member and have any questions about your fertility benefit or coverage, please call 888.597.5065.
Register here for our next webinar in this series, Emotional Wellness and Support, on Thursday, October 19, 2023 at 3 PM ET.