Open Enrollment

Beginning in 2026, the EPO Plan will introduce a two-tier network structure:

• Tier 1 will include FMOL Health providers and select partner organizations. This tier has the lowest out-of-pocket costs for team members.
• Tier 2 will consist of all other preferred providers within the FMOL Health customized network.

Please note: The EPO Plan will continue to offer no coverage for out-of-network services.

New Medical Plan Comparison Tool

Choosing the right medical plan can be challenging, so we’ve provided the Medical Plan Comparison Tool to help. This interactive online tool allows team members to compare estimated costs for different plans based on coverage tier and healthcare usage. Accessible from any device, the tool offers a guided experience or direct access to cost calculations. It also features a tax savings calculator for HSA or FSA contributions and educational videos about your benefits.

Updates to Medical Plan Premiums

Team member contributions for some medical plans will change slightly. FMOL Health continues to cover most health insurance costs so you can focus on your care.

New Pharmacy Benefit Manager

Effective January 1, 2026, Capital Rx will be the new administrator for FMOL Health prescription plans, replacing Express Scripts. Similar to how the medical plan covers doctor visits, the prescription plan includes coverage for eligible prescribed medications.

Prescription Benefit Updates

Coverage for GLP-1 weight management medications and lower cost alternatives is available January 1, 2026, under the FMOL medical plans. Certain criteria must be met to be eligible for coverage. Contact Healthy Lives for more information at (855) 426-4325 or healthylives@fmolhs.org. Team members can begin this process now, ahead of the 2026 benefit year. For more information on eligibility criteria, you can review the FAQs or contact a Healthy Lives coach today.

Network Updates

The FMOL Health customized network is expanding as new providers are added over the year to increase access to primary care and various specialties for team members. Additionally, more specialty options will be added in Tier 1 of the EPO and PPO networks in 2026.

Updated Just Premium Income Limits

The income limits for Just Premium medical plan contributions have been updated to align with adjustments made by the Department of Health & Human Services to the Federal Poverty Level guidelines. This adjustment reflects current inflation rates.

New Time Off Benefits

Memorial Day is being included as a paid holiday for all team members who are eligible for benefits. Additionally, benefit-eligible team members will have access to up to four weeks of paid parental leave every 12 months after completing six months of employment.

Retirement Plan Changes

Effective January 1, 2026,

• FMOL Health will allow team members aged 60-63 to make super catch-up contributions to their 403(b) retirement accounts, permitting up to $11,250. This limit is an increase from the standard catch-up limit of $7,500 for those aged 50 and older.
• The Secure 2.0 Act requires retirement plan participants aged 50 or older with prior year wages of $145,000 or more to make catch-up contributions as after-tax Roth contributions.
  
  

Student Debt Solutions

FMOL Health is partnering with Candidly to provide comprehensive student debt solutions, including support for Public Student Loan Forgiveness (PSLF). Candidly offers a flexible, easy-to-use platform, expert coaching services, and up-to-date guidance on student loan policies and repayment strategies. This partnership is designed to help employees better understand their options and take control of their student loan journey.

Growing Our Network 

FMOL Health has invested time in growing our employed primary care and specialty network, as well as our preferred partners, to provide you with convenient access to care. The FMOL Health customized EPO Tier 1 and Tier 2 networks include the same providers as PPO Tier 1 and Tier 2.

To search for providers in the EPO or PPO Network, please visit My Health Tool Kit.

Medication Copay Savings and Personal Services Available through RxONE

RxONE is our FMOL Health-owned, in-house pharmacy that offers reduced copays for mail-order/ 90-day supply prescriptions and for specialty medications from preferred providers. In addition to discounts, RxONE offers team members personal service through their in-store or curbside delivery options, faster fill times, immunizations and ease of access to our pharmacists. Select an RxONE location as your pharmacy of choice and start taking advantage of these savings and personalized service options for your medications.

Reduced Health Premium Available Through Our Just Premium Program

We recognize that health insurance can be a significant expense, which is why we offer a discounted premium opportunity called Just Premium. Team members must apply to be considered for the program, which is based on total household income (adjusted gross income), the number of dependents you claim on your Income Tax Return and your hourly base rate. To apply complete this application and submit your 2024 Federal Income Tax Return by October 30.

New Service Provider for the Employee Assistance Program

Your health and well-being are a top priority for us. That’s why we continually seek the best services to provide a comprehensive range of benefits to meet all your needs.
Starting January 1, 2025, your Employee Assistance Program (EAP) will now be serviced through Supportlinc.

Expanded Coverage for the EPO Plan

We are expanding coverage to our EPO Plan to offer you greater benefits. Starting January 1, 2025, if you are enrolled in the EPO plan and you or your covered dependents need emergent care services while traveling outside of our service markets, you will be able to access urgent care with a copay of $60.

Updates to Medical Plan Premiums

There will be minimal changes to the team member contributions for some of the medical plans. As always, FMOLHS covers most of the cost of your health insurance so that you can focus on receiving the care that fits your needs.

Dental Buy-Up Plan Enhancement

For the 2025 plan year, FMOLHS is enhancing the Buy-Up Dental Plan. While there will be a minimal increase in dental contributions, team members who elect the Buy-Up Plan will have increased annual plan maximums and lifetime orthodontic maximums.

Prescription Benefit Updates

For 2025, the copay for generic and preferred diabetes prescriptions and supplies will change. These drugs and supplies will now be subject to the standard copay based on their tier and will no longer be offered at a $0 copay.
Additionally, we are introducing Encircle RX, a clinical program for GLP1 medications for diabetes (which is the only indication for these medications covered under our Medical Plans).

Network Updates

The FMOLHS primary care and specialty network continues to grow and offer even more convenient access to care including extended hours and video visits. New providers and locations have also been added to ensure that team members have access to more primary care, and virtually every specialty. It’s important to review the updated online provider directory to confirm your provider(s) are in network.

Updated Just Premium Income Limits

We’ve updated the income limits for our Just Premium health plan contributions to match the Federal Poverty Level guidelines set by Health & Human Services. This change keeps up with inflation.

Voluntary Employee Life Insurance Update

We are enhancing the voluntary employee life insurance options for the 2025 plan year. During Open Enrollment, you now have the flexibility if currently enrolled to increase or decrease your coverage by $10,000 or $20,000 increments, allowing you to better meet the needs of you and your family.