You can cover your spouse or domestic partner, your child(ren) and your domestic partner's child(ren) under the age of 26 or your child(ren) and your domestic partner's child(ren) age 26 and older if physically or mentally disabled.

If you are covering a spouse or domestic partner in a Cotality medical plan, and that spouse or domestic partner has access to medical coverage through another employer, you will be subject to a $1,200 annual working spouse surcharge. Be sure to complete the enrollment process and your working spouse certification during Open Enrollment this year.

Yes, you are required to provide documentation of dependent status by December 1, 2025 through the Cotality Benefits Center. You will receive email reminders with examples of acceptable documentation after enrollment. Failure to provide sufficient documentation by the deadline will result in your dependent(s) being removed from coverage.

On the Anthem Consumer Choice HDHP, the deductibles and out-of-pocket maximums are both increasing by $150/$300 depending on tier. On the Anthem Basic HDHP, the deductibles are increasing by $200/$400 and the out-of-pocket maximums by $400/$800 depending on tier. See more here. Copays and coinsurance will remain the same for all plans.

There are no plan design changes to the Kaiser medical plans for 2026 with the exception of the IRS-required increase to the deductibles on the Kaiser High Deductible HMO plans. See more here. Copays, coinsurance and out-of-pocket maximums will remain the same for all plans.

Annual Contribution - The annual cost to purchase health insurance is spread across the year, so you pay a portion of the cost over the course of 24 pay periods. Amounts differ based on the plan you select and the number of people you cover

Annual Deductible - This is the amount you will pay before the plan starts to pay.  

Coinsurance - After you meet the annual deductible, generally, you will continue to pay a percentage of the cost for covered medical services until you meet the out-of-pocket maximum.

Out-of-Pocket Maximum - This is the most you’d pay for covered medical services in a calendar year. Think of it as your financial safety net. Once you meet it, the plan covers the full cost of additional covered care

The Anthem Exclusive Care EPO Plan uses the SaveOn SP program through ESI. Through the SaveOn SP program, you and your covered dependents can save money on certain identified specialty drugs. If you are using or are prescribed an eligible drug, you’ll receive more information from ESI directly with action items. Be sure you take the required action within the specified timeline or you will pay more for your prescriptions.

As part of your prescription benefit managed by Express Scripts, the Smart90 program offers two ways to get up to a 90-day supply of your long-term maintenance medication (those drugs you take regularly for ongoing conditions such as high blood pressure, diabetes, or high cholesterol). You can conveniently fill those prescriptions either through home delivery from the Express Scripts Pharmacy or at a CVS retail pharmacy. If you do not use the Smart90 program, you will pay the full cost of your maintenance medications after the second fill at a retail pharmacy.

When you choose to get a 90-day supply of your maintenance medication through home delivery from the Express Scripts Pharmacy, Express Scripts will contact your doctor to get a new prescription.

If you choose to get up to a 90-day supply at a CVS retail pharmacy, you can ask the pharmacist to contact your doctor to get a new 90-day prescription for you, or to transfer your current 90-day prescriptions from another pharmacy.

No. Your copayment for your 90-day supply will be the same whether you fill your prescriptions through Express Scripts home delivery or at a CVS retail pharmacy.

You must order a 90-day supply of your prescription medication either through the Express Scripts Pharmacy or at a CVS retail pharmacy after the second fill. You will pay the full cost of any maintenance prescriptions at a retail pharmacy other than a CVS after the second fill.

Getting started with Smart90 is easy. Visit www.express-scripts.com/90day or by calling the toll-free number on the back of your member ID card.

No, there are no changes to the dental or vision plan provisions for 2026. 

A health savings account (HSA) is like a 401(k) for your medical expenses. If you enroll in the Anthem Consumer Choice HDHP, Anthem Basic HDHP or the Kaiser High Deductible HMO, you can contribute to your account each year. If you enroll in the Consumer Choice HDHP or Kaiser High Deductible HMO and you earn less than $150,000 per year in base salary, you have the added benefit of a company contribution to your account. You can use the money in your account for eligible medical expenses, including deductibles and coinsurance.

Once money goes into your HSA, it's yours to keep - whether you stay with Cotality or not. That means that it's a great tool to help you save for future medical expenses. For more information about the HSA, watch the video or click here.

There are three easy ways to access money in your HSA:

1 - HSA Debit Card – When you experience an eligible expense, pay directly with your HSA debit card

2 - Online bill payment – Pay providers directly from your HSA through NetBenefits.com or the NetBenefits mobile app

3 - Reimbursement – Reimburse yourself from your HSA for eligible expenses paid for out-of-pocket

With an HSA, you can make pre-tax contributions to pay for eligible expenses. If you enroll in the Consumer Choice HDHP or Kaiser High Deductible HMO and you earn less than $150,000 per year in base salary, Cotality makes an automatic contribution to your account as well. The account is owned by you and follows you if you leave Cotality or retire. Unused money in your account rolls forward from year to year.

With an FSA, only you make pre-tax contributions to your account. Up to $660 of unused funds can be rolled over each plan year. Per IRS rules, unused money in your account at the end of the year above the $660 limit is forfeited.

If you work and you have a dependent child or disabled spouse or domestic partner that needs care during the day, the Dependent Care FSA may be right for you. You can contribute up to $7,500 in pre-tax dollars each year in your Dependent Care FSA. However, $7,500 is a household maximum, so if your spouse or domestic partner participates in a Dependent Care FSA at his or her work, your combined contributions cannot be more than $7,500.

Please note: our DCFSA benefits program is governed by provisions of the Internal Revenue Code (IRC). The IRC allows for pre-tax contributions to a DCFSA for certain childcare or other dependent care expenses. In order to offer the favorable tax treatment, Cotality must comply with certain IRC "non-discrimination" requirements. A DCFSA compliance failure under the IRC non-discrimination rules results in "highly compensated" plan participants losing some or all of the favorable tax treatment of their DCFSA contributions.

You can use money in your Dependent Care FSA for eligible dependent care expenses.

Yes, however there is a $7,500 household maximum contribution each year.

When deciding how much to save in your Dependent Care FSA, it’s important to plan carefully. Any money in your account at the end of the calendar year will be forfeited. Expenses must be incurred by December 31 of each year to be reimbursed through the reimbursement accounts. All claims must be submitted for reimbursement by March 31 of the following year.

If you are covering a spouse or domestic partner in a Cotality medical plan in 2026, and your spouse or domestic partner works and is offered medical coverage through his/her place of employment, you will pay an additional $100 per month to cover your spouse or domestic partner in a Cotality plan ($1,200 per year).

If your spouse or domestic partner’s employment status changes during the year, visit the Cotality Benefits Center and update your working spouse certification.

According to section 125 this is considered a life event. It is common for Open Enrollment periods to not coincide for different employers and it is considered a HIPAA special enrollment opportunity if coverage is lost, for whatever reason, mid-plan year. If you choose to drop your spouse or domestic partner during Cotality’s OE, the spouse or domestic partner should be able to pick up coverage under their own employer’s plan. Your spouse or domestic partner should contact their employer to determine if this will permit a mid-year election under that plan. You will be able to prove the drop from coverage by requesting a detailed coverage notice from the Cotality Benefits Center which will show the end date of the coverage.

No, you will only be subject to the spousal (domestic partner) surcharge if your spouse or domestic partner has access to coverage through their employer. Government programs, such as Medicaid and Medicare, are not considered an employer program.

Cotality provides you with $400 annually, $100 at the beginning of each quarter, to support your well-being journey through the well-being account, powered by Forma. New for 2026, you’ll have two options of how you want to receive your quarterly contributions. Learn more here.

A tobacco or nicotine user is anyone that uses e-cigarettes, cigars, pipe tobacco, chewing tobacco, snuff, dip, or any other tobacco-related/nicotine materials. This includes regular tobacco usage and occasional tobacco use during social occasions. It does not include someone that uses an electronic cigarette or e-cigarette that does not contain tobacco and is designed expressly for smoking cessation.

The cost to treat the diseases caused by tobacco products is excessive and, more importantly, preventable. According to the Centers for Disease Control and Prevention, people who smoke have more lifetime medical expenses and are absent from work more days each year than those who do not smoke. According to the National Institute on Drug Abuse, smoking harms nearly every organ in the body. It's been linked to cataracts, pneumonia, and accounts for about one-third of all cancer deaths. Overall rates of death from cancer are twice as high among smokers as among nonsmokers.

The amount of nicotine absorbed from smokeless tobacco is 3-4 times greater than that delivered by a cigarette. Chewing tobacco and snuff contains 28 cancer-causing agents. Smokeless tobacco increases the risk for cancer of the lip, tongue, cheeks, gums, and the floor and roof of the mouth. Other effects include oral leukoplakia (mouth lesions that can become cancerous), gum disease, and gum recession (when the gum pulls away from the teeth).

Nicotine replacement products like gum and patches are not considered tobacco products and will not count against you for the purpose of the tobacco/nicotine surcharge.

Those employees enrolled in a Cotality medical plan who do not certify to being tobacco free will pay an additional $50 per month, for a total of $600 annually.

If you complete a Quit Plan through https://smokefree.gov/build-your-quit-plan, and submit it by opening a ticket in Help – Powered by Workday, your status will be changed and any surcharge amounts you’ve paid to date will be refunded to you as soon as administratively possible. You can also change your designation by calling the Cotality Benefits Center at (888) 259-3461. This change can be made during the year if you begin using tobacco, or if you become a non-tobacco/nicotine user.

You must change your certification status or risk penalty, fraud investigation, or termination from health insurance.

You must certify in the Cotality Benefits Center during Open Enrollment that you are not a current tobacco or nicotine user. If you are a current tobacco or nicotine user, you can remove the surcharge when you complete a Quit Plan through https://smokefree.gov/build-your-quit-plan, and submit it by opening a ticket in Help – Powered by Workday.

You can check your current tobacco/nicotine user status by visiting the Cotality Benefits Center at enroll.cotalitybenefits.com or calling (888) 259-3461.

Yes. Check with your plan provider to determine which prescription drugs are covered.