Your 2026 Healthcare: Annual Enrollment 101
October 01, 2025
CPG ConnectOctober 01, 2025
CPG ConnectIt’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:
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
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.
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.
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.
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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