Page 4 - Enrollment-Guide-2026-27-Final
P. 4

Enrollment Basics                                                                                                                                                           Benefits Spotlight







        An Employee who meets all of the conditions for eligibility set by their Employer and                                      More MSK Care is on its Way With Pathwell Bone & Joint
        SchoolCare is eligible to enroll as a Subscriber. Employees must enroll within 30 days after                               Care for musculoskeletal conditions continues to be one of the largest
        first meeting their Employer's eligibility requirements or during an Open Enrollment Period.                               drivers of annual claims across all of SchoolCare’s population. If you suffer
                                                                                                                                   from chronic spine, hip, knee or shoulder pain, you are not alone. Beginning
                                                                                                                                   July 1, Cigna Pathwell Bone & Joint will become available to SchoolCare
                        Elections you make while enrolling for medical, dental, vision and                                         participants. This new condition-specific care program* offers access to
              i i       Health Care Flexible Spending Account (FSA) or during Open Enrollment                                      designated providers with personalized assistance by a care navigation team

                                                                                                                                   to support your path to alleviating joint pain.
                        are binding through June 30, 2027, unless you experience a qualifying
                        life event (examples below).                                                                                •  Get personalized support from a Cigna Clinical Care advocate to help you
                                                                                                                                       find the most appropriate treatment for your needs, with in-person and
                                                                                                                                       virtual options available
                                                                                                                                    •  Access digital tools for assessments, guidance on treatment options,
         Eligible Dependents                                   Qualifying Life Events                                                  personalized activities and more
                                                                                                                                    •  If surgery is needed, a Benefit Specialist will help you understand the
         Employees may also enroll their eligible family       Per IRS regulations, you can only change your                           program benefits and find access to designated providers within Cigna’s
         members including:                                    elections annually during the Open Enrollment period,                   preferred networks
                                                               unless you have a qualifying life event. SchoolCare                  •  Includes no-cost or low-out-of-pocket cost surgery, pre- and post-surgery
                                                                                                           th
          •  Legally married spouse                            Open Enrollment generally begins on April 15  and                       support, and a travel benefit when applicable
                                                                                   st
          •  Domestic partner and their children, if offered   runs through May 31 .  For a qualifying life event,                                                                                                 *Pathwell is being offered alongside
             by Employer                                       Subscribers must provide notice and required                        Learn more about Pathwell Bone & Joint here.                                    Hinge Health, not replacing it.
          •  Dependent children under age 26                   documentation within 30 days of the event.
                                                               Examples include:                                                  If Cigna is Calling, Picking Up the                      Fertility Coverage Changing to New

                                                               •  Marriage                 •  Divorce/legal                       Phone May be Good For Your Health                        Partnership With Progyny
                                                               •  Loss of other insurance    separation (within
                                                                  coverage                   60 days)                             When your phone rings and the caller ID says “Cigna”     Building a family can be stressful, and dealing with
                                                               •  Adoption/legal           •  Birth of a child                    there are numerous reasons why they might be calling,    fertility issues without support can not only add to
                                                                  guardianship             •  Death                               but it’s never to sell you something. In fact, picking up   the stress, but become cost-prohibitive. Beginning
                                                                                                                                  the phone may make your life just a little bit easier.   July 1, SchoolCare participants will have access to
                                                                                                                                  Cigna’s various channels of participant outreach are     fertility coverage from Cigna’s new preferred partner,
                                                                                                                                  constantly expanding, offering personalized support      Progyny. As part of your SchoolCare health benefits
                                                                                                                                  services to help you navigate your health, included at   plan, Progyny offers coverage for fertility treatment
                                                                                                                                  no extra cost to you.                                    and medications associated with approved
                                                                                                                                  If you or an eligible dependent receives a call from     treatment cycles as well as nurse support and more.
                                                                                                                                  Cigna, it may be to remind you it’s time to schedule     Participants who are currently working with WIN will
                                                                                                                                  an annual physical, a routine cancer screening or a flu   receive direct outreach from Progyny
                                                                                                                                  shot. Or one of the members of SchoolCare/Cigna’s        about this change to help make
                                                                                                                                  new Personal Health Team may be reaching out to help     the transition smooth,
                                                                                                                                  you coordinate care for complex medical diagnoses or     without interruption to
                                                                                                                                  a health coach may be reaching out to see if you have    your current journey.
                                                                                                                                  health goals they can assist you with.                   Learn more about
                                                                                      Health Benefits Booklet                                                                              Progyny and your
                                                                                                                                  All conversations with any of Cigna’s Personal Health    coverage through
                                                                               Refer to the SchoolCare                            Team, Health Coaches and Care Advocates are
                                                                               Health Benefits Booklet (HBB)                      confidential and this added layer of support is there to   Schoolcare/
                                                                               for more detailed information.                     help you on your path to good health.                    Cigna here.



   4                                                                                                                                                                                                                                               5
   1   2   3   4   5   6   7   8   9