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Your 2026 Healthcare: Annual Enrollment 101 

October 01, 2025

CPG Connect

It’s that time again: Annual Enrollment is almost here. Are you overwhelmed by the numerous health plans available and anxious about selecting the one that will best meet your needs and those of your dependents in 2026? Well, we’ve got help for you.

These seven steps take a lot of the guesswork out of the process:

  1. Learn the terminology. The Glossary of Health Coverage and Medical Terms from the Centers for Medicare & Medicaid Services is a good resource to consult.
  2. Peruse our guide, document handbooks, and the benefits summaries of our medical and dental plans to understand what they cover—and don’t cover. You may be surprised by some of the benefits, such as membership discounts to your local gym and discounts on LASIK surgery under the EyeMed benefit.
  3. Consider a Consumer-Directed Health Plan (CDHP) paired with a Health Savings Account (HSA) if offered by your participating group. These plans have high deductibles and out-of-pocket limits, but if you’re in reasonably good health, you may end up spending less on healthcare while your HSA account value grows to help cover future medical expenses.
  4. Explore our SEE Plan if you’re 65 and over and an active employee of a small employer. Enrolling in such a plan may save both you and your employer money.
  5. Estimate your 2026 care needs. Even if you’re not expecting major events, such as having a baby or undergoing surgery, you can get a sense of your medical, dental, and vision needs by reviewing your healthcare expenses for 2025 and speaking with a doctor you know and trust.
  6. Check provider networks. If your physicians are not in our Anthem or Cigna networks, Quantum Health’s Care Finder helps you locate high-value providers who are and thus may save you money. Kaiser members can call Kaiser for information about their in-network providers.
  7. Find out whether your current plan is being offered next year. If it isn’t, you must enroll in a new plan, or you will not have Medical Trust coverage in 2026

And don’t forget that Quantum Health is available to help members enrolled—or eligible to enroll—in an Anthem or Cigna network* plan to

  • review existing benefits,
  • understand plan options, and
  • choose the right plan for 2026

Simply call 866-871-0629, Monday to Friday, 8:30 AM to 10:00 PM ET.

*Members covered by Kaiser Permanente and by the Hawaii Medical Service Association have comprehensive services as part of their plans and will not use Quantum. Neither will members enrolled only in a dental plan (through Delta Dental), a disability policy (through Aflac), and/or the standalone Employee Assistance Program.

GLP-1 Drugs and Weight Loss: What Changed?

The Episcopal Church Medical Trust, as plan sponsor, chose to continue to approve coverage of GLP-1s for certain conditions, including weight loss. The Medical Trust implemented coverage criteria to manage costs, as has become industry practice. As of January 1, 2025, to obtain coverage for weight loss, people must have either a BMI equal to or greater than 32 or a BMI equal to 27 plus documentation of two comorbid conditions. In addition, patients must enroll in and engage with Omada Health, an online program that fosters good eating, exercise, and other healthy habits for long-lasting results.

Quantum Health Update

After years of study, in January we made the services of Quantum Health available to members in Anthem and Cigna network plans with the aim of simplifying their healthcare journeys. This transition led to suboptimal service for many members, including, in particular, delays and inaccuracies in out-of-network claims reimbursements.

We worked diligently with our claims administrators and resolved all out-of-network reimbursement problems. Our plan is to restore claims processing accuracy and timing to pre-2025 levels by mid-October. In addition, we will be conducting a full audit this fall to ensure that all claims are processed correctly.

Retirees: UnitedHealthcare or Quantum

The Episcopal Church Medical Trust continues to offer medical coverage to retirees through UnitedHealthcare Group Medicare Advantage (GMA) plans. In addition, on January 1, 2025, the Medical Trust made the services of Quantum Health available to retired members to improve their experience of the healthcare system.

If you don’t know whom to contact for medical, dental, vision, or behavioral health needs, call Quantum. They’ll point you in the right direction and connect you with the resource you need. If, however, you know whose help you require, such as UnitedHealthcare or EyeMed, you can contact them directly.

Cariloop is a new resource for GMA members that replaces Health Advocate (discontinued at the end of 2024). Quantum can also put you in touch with Cariloop Care Coaches. They are doctors, nurses, social workers, occupational therapists, certified dementia practitioners, and other seasoned professionals who can help you and your caregivers with everything from obtaining a preauthorization and navigating a cancer diagnosis to finding the right nursing home and understanding an advanced directive.

Comments? Questions? Concerns? CPG is listening. Please reach out to us at corpcomm@cpg.org.

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