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Open Enrollment 2027

A Message from our CEO

As we prepare for Open Enrollment and the 2027 plan year, I want to personally thank you for everything you do to support our members, clients, and communities. Your dedication, compassion, and commitment are what make MTM successful, and we remain dedicated to providing benefits that support you and your family.

Like many organizations across the country, MTM continues to face significant increases in healthcare costs. Rising prescription drug expenses, increased utilization of high-cost specialty medications, large medical claims, and ongoing inflation continue to place pressure on employer-sponsored health plans. Despite these challenges, we have worked diligently to balance the rising cost of healthcare with our commitment to offering comprehensive, competitive benefits.

Alaina Macia

For 2027, we are introducing several enhancements to our benefits program, including a new wellness program through H&H Health Associates that rewards employees and covered spouses for completing simple preventive health activities with reduced medical plan premiums. We are also enhancing our vision and voluntary benefit offerings, adding a new home infusion therapy benefit, and implementing an innovative approach that allows us to continue providing access to GLP-1 medications for weight management for eligible participants enrolled in the Select EPO plan.

These changes are designed to support your health and well-being while helping MTM maintain a sustainable benefits program for years to come. I encourage you to take time during Open Enrollment to review all available resources, understand the changes for 2027, and select the coverage that best meets the needs of you and your family.

Thank you for being part of MTM. We recognize and value the important contributions our employees make every day and remain committed to providing benefits that support your health, well-being, and financial security. We hope the enhancements and changes to our 2027 benefits program provide meaningful value to you and your family, and we encourage you to take full advantage of the resources available to help you live a healthier life.

Sincerely,

Alaina Maciá
President & Chief Executive Officer
MTM, Inc.

Open Enrollment 2027 Overview

Open Enrollment for 2027 will be held November 2, 2026, through November 13, 2026.

During Open Enrollment, all benefit elections and changes must be completed through Workday. All changes made during Open Enrollment will become effective on January 1, 2027.

Important Enrollment Reminders

  • Current elections for most benefit plans will automatically carry forward into 2027 if no changes are made.
  • Flexible Spending Accounts (FSAs) and Health Savings Account (HSA) contributions do not carry over and require annual enrollment.
  • Open Enrollment is generally the only opportunity each year to make changes to your benefits unless you experience a qualified life event.
  • We strongly encourage you to review all benefit options, costs, and plan changes before making your elections.
  • Verify your beneficiaries! This is the perfect time to either add a beneficiary to your company provided life insurance plan or make changes! You can change your beneficiaries throughout the year, but Open Enrollment is the perfect time to make sure your beneficiaries are up-to-date.
  • You can view your benefit premiums in Workday during the enrollment event. Since costs vary based on the plan, your coverage level, and who you enroll, your premium will be tailored to your specific selections. Search “Employee Premiums” in the Workday search bar. Be sure to review your elections to see your exact cost.

 

Take Time to Review Your Benefits

Your benefit elections affect both your healthcare coverage and your financial well-being. We encourage you to carefully review all plan information, compare your options, and evaluate your family’s needs before Open Enrollment ends on November 13, 2026.

All changes outlined on this site become effective January 1, 2027.

 

Ready to review Workday?

Click the Workday link here or in the upper right of the website to be directed into Workday. Follow the Open Enrollment link in your Workday inbox to start the process.

Thank you for being part of MTM and for taking an active role in your health and well-being.

Medical Premium Adjustments

Healthcare costs continue to rise across the country, and MTM has experienced significant increases driven by:

  • Higher prescription drug costs
  • Increased utilization of specialty medications
  • Large medical claims within our health plans
  • Ongoing inflation and rising healthcare expenses

 

While MTM continues to absorb a substantial portion of these costs, medical contribution rates have been updated for 2027 to help ensure the long-term sustainability of our health plans.

Employees can review their 2027 medical plan contribution rates by searching for the 2027 Employee Premium article in Workday or by reviewing plan costs during the Open Enrollment process.

Looking for ways to lower your monthly contributions? Be sure to learn more about MTM’s new wellness program through H&H Health. Employees who complete the program requirements can earn reduced monthly medical contributions of up to $40 per month for employee-only coverage and $80 per month when covering a spouse who also completes the requirements.

MTM applies a tobacco surcharge to employees and spouses enrolled in MTM medical plans.  If you or your spouse use tobacco, you must indicate that in Workday during your enrollment process, however only one tobacco surcharge applies.  The surcharge may be removed if all tobacco users complete a qualified tobacco cessation program and submit a signed attestation form.  Rate changes are effective on the first of the month after the acceptance of the Tobacco Affidavit.

To view the 2027 bi-weekly employee premiums, log into Workday and type in the search bar ‘2027 Employee Premium’.

Hawaii Plan Change

Healthcare costs continue to rise across the country, and MTM has experienced significant increases driven by:

  • Higher prescription drug costs
  • Increased utilization of specialty medications
  • Large medical claims within our health plans
  • Ongoing inflation and rising healthcare expenses

 

While MTM continues to absorb a substantial portion of these costs, medical contribution rates have been updated for 2027 to help ensure the long-term sustainability of our health plans.

To view the 2027 bi-weekly employee premiums, log into Workday and type in the search bar ‘2027 Employee Premium’.

A New Approach to Wellness That Helps Lower Your Premiums

The current WellRight Wellness program will end on December 31, 2026.

Beginning January 1, 2027, MTM will transition to a new wellness program administered by H&H Health Associates. This new program replaces the existing WellRight program and introduces a new premium incentive designed to reward employees and spouses for completing important preventive health activities.

To help offset rising healthcare costs while encouraging preventive care and early detection, employees enrolled in a MTM medical plan administered by UMR can earn reduced monthly medical premiums by completing a Biometric Screening.  That’s it!!

During Open Enrollment, we will offer onsite Biometric Screenings at the below locations.  Sign up for a time slot here.  See your location for additional details.  If you are unable to attend an onsite screening, you can receive your screening at a participating lab in your area by following the instructions in the H&H Wellness Screening Flyer.

  • Lake St Louis, MO – November 3 & 4
  • Austin North, TX – November 5
  • Austin South, TX – November 6
  • Tucson, AZ (West Silverlake Rd) – November 9
  • Gilbert, AZ – November 10
  • Phoenix, AZ (AAA) – November 11

**Union Employees: We are pleased to offer the biometric screening to our union employees as part of our commitment to supporting health and well-being at no cost. Because employee premium contributions for represented employees are negotiated through the collective bargaining agreement (CBA), premium rates are determined by the terms of the agreement and are not affected by participation in this program.**

Click below to learn more!

Employees who complete the program requirements will receive:

  • $40 per month reduction if either the employee or covered spouse complete the requirements
  • $80 per month reduction if both the employee and covered spouse complete the requirements

 

To receive the premium reduction, the biometric screening must be completed by the employee and covered spouse, if enrolled.  An example:

  • Employee is enrolled in Employee Only coverage and completes the requirements – $40 per month reduction
  • Employee’s spouse is enrolled in Employee’s coverage and completed the requirements but the Employee does not complete the requirements – $40 per month reduction
  • Employee and spouse are enrolled in coverage and both complete the requirements – $80 per month reduction

MTM will be offering onsite biometric screening clinics at select company locations during Open Enrollment for employees and covered spouses.

If you are unable to attend an onsite clinic or do not live near an MTM location offering the onsite clinic, you may complete your biometric screening at a LabCorp location in your area.

Instructions for scheduling and completing your biometric screening can be found in the H&H Wellness FAQ.

To receive the reduced premium rates for the entire 2027 calendar year, the employee and covered spouse (if enrolled) must complete the biometric screening by December 31, 2026.

If the requirements are not completed by December 31, 2026, they may still be completed at any time during the year. However, the reduced premium rates will not become effective until the first day of the next calendar quarter following completion.

For example:

  • Complete requirements by December 31, 2026 → Reduced premiums effective January 1, 2027
  • Complete requirements by March 31, 2027 → Reduced premiums effective April 1, 2027
  • Complete requirements by June 30, 2027 → Reduced premiums effective July 1, 2027
  • Complete requirements by September 30, 2027 → Reduced premiums effective October 1, 2027

The wellness program is designed to be simple, convenient, and rewarding. The biometric screening measures important health indicators such as blood pressure, cholesterol, glucose levels, and other potential risk factors. This tool can help you better understand your health, identify concerns early, and take proactive steps toward improving your long-term well-being.

Most importantly, completing these requirements allows you to earn lower medical plan premiums while investing in your health and future well-being.

The goal of the program is not only to reward healthy behaviors but also to help you identify potential health risks before they become more serious concerns.

The biometric screening provides valuable information about key health indicators such as blood pressure, cholesterol, blood sugar, and other risk factors. Understanding these results can help you take proactive steps to improve your health and access support resources when needed.

The new wellness requirements are designed to be simple, convenient, and beneficial to you and your family. By investing a small amount of time in your health, you can earn meaningful savings on your monthly premiums while gaining insights that may help you stay healthier in the future.

Thank you for being an active partner in maintaining your health and helping us manage healthcare costs for everyone covered under the MTM health plan.

Express Scripts Pharmacy Program Changes

Beginning January 1, 2027, brand-name prescription medications for the Basic EPO and Select EPO medical plans will be subject to a new coinsurance requirement. There are no changes to the prescription medication coinsurance for the HDHP medical plan.

Examples of how coinsurance works:

Choosing generic medications whenever available continues to be one of the most effective ways to manage out-of-pocket prescription costs while maintaining quality care.

Changes to GLP-1 Coverage for Weight Loss

Why Is Coverage Changing?

The cost of GLP-1 medications used for weight loss has increased significantly and continues to be one of the fastest-growing expenses in employer-sponsored health plans nationwide.

MTM recognizes that these medications can provide important health benefits and has made the decision to continue offering access to GLP-1 medications for eligible employees and covered spouses. To help make this coverage sustainable for the long term, MTM is changing how these medications are provided.

Beginning January 1, 2027, GLP-1 medications prescribed for weight loss will no longer be covered through the Express Scripts pharmacy benefit.

Instead, eligible employees and covered spouses enrolled in the Select EPO medical plan will have access to GLP-1 medications through a new program administered by RxSaveCard. 

 

What You’ll Pay

Eligible participants may receive one fill of an approved GLP-1 medication each month for a $150 copay.

MTM will cover the remaining cost of the medication, regardless of dosage.

Covered GLP-1 medications are Foundayo, Wegovy, and Zepbound.

If you are enrolled in the Select EPO medical plan and meet the eligibility requirements, follow these steps:

  1. Talk with your physician to determine whether a GLP-1 medication is right for you and confirm that you meet the program requirements.  Covered GLP-1 medications are Foundayo, Wegovy, and Zepbound.
  2. Receive your prescription. If prescribed, your physician will send the prescription directly to the participating manufacturer’s pharmacy program or to Amazon Pharmacy.
  3. Create your RxSaveCard account and upload documentation from your physician showing that you meet the BMI and comorbidity requirements. A screenshot from MyChart is acceptable.
  4. Complete the approval process. Once approved, RxSaveCard will provide you with a virtual payment card.
  5. Add your personal payment method to your RxSaveCard account.
  6. Purchase your medication. When ordering through the manufacturer’s pharmacy or Amazon Pharmacy, use your RxSaveCard. Your personal payment method will automatically be charged the $150 copay, and MTM will pay the remaining eligible cost.

To participate in the program, you must:

  • Be enrolled in the Select EPO medical plan, and
  • Meet one of the following criteria:
    • BMI of 35 or higher, or
    • BMI of 27 or higher with at least two weight-related comorbidities

 

Eligibility will be reviewed by RxSaveCard. Participants must provide physician documentation showing their current BMI and any applicable comorbidities.

Documentation must be dated within the previous 12 months.

Covered GLP-1 medications are Foundayo, Wegovy, and Zepbound.

MTM understands that many employees and covered spouses currently using GLP-1 medications have made significant progress toward their health goals.

To support those individuals, participants who are actively receiving GLP-1 medications for weight loss at the end of 2026 will be grandfathered into the program for 2027.

This means they will not be required to submit BMI documentation when enrolling in RxSaveCard because they have already been approved through Express Scripts’ prior authorization process.

Please note: Grandfathering applies only for 2027.

Review the RxSaveCard Program Overview for more information.

New Home Infusion Therapy Benefit

MTM is pleased to introduce Leap Health Home Infusion Services to offer an in-home infusion benefit to eligible members*.

As a trusted national coordinator of home infusion treatments, Leap offers:

  • Convenient home infusions: A licensed, experienced infusion nurse administers treatment in the comfort and privacy of your own home, or at a preferred clinic nearby – helping you avoid long drives and hospital visits.
  • Fast, flexible scheduling: Choose times that work best for you, including evenings and weekends. Leap can typically schedule your treatment within one week.
  • Dedicated support: Your Leap Care Guide handles all the logistics – including scheduling, authorizations, and coordinating with your doctor and pharmacy – so you have less to worry about.

 

Leap supports infusion treatments for many conditions, including (but not limited to): multiple sclerosis, lupus, chronic inflammatory disorders, Crohn’s disease, chronic kidney disease, bleeding disorders, hematology, immunoglobulins, and some oncology treatments.

Click here to learn more or speak with a Leap Care Guide at (929) 998-8932.

We are thrilled for Leap to be joining MTM’s portfolio of benefits and look forward to hearing your feedback.

*Eligible members include employees and dependents, and COBRA members who are enrolled in a UMR administered medical plan.

Vision Plan Enhancements

MTM is excited to offer enhanced vision benefits through VSP for 2027.

These improvements provide additional value and expanded coverage to help support your vision and eye health needs.

We are pleased to offer an increased frame and contact lense allowance under the plan. The new allowance is increasing to $200 from $175. If you select a featured frame, the allowance is increases to $220.

We are also pleased to offer an additional computer glasses benefit for employees only. This benefit allows you to purchase an additional pair of computer glasses with a $130 frame allowance for a $10 copayment.

Click on the VSP flyer for more information about the 2027 program.

Enhanced Voluntary Benefits Through The Standard

Beginning January 1, 2027, MTM is enhancing our voluntary Accident Insurance, Critical Illness, and Hospital Indemnity Insurance plans through The Standard. These enhancements provide additional financial protection when unexpected health events occur, while also delivering lower premiums for many employees and families.

We reviewed these programs carefully to ensure they continue to provide meaningful value and support when you need it most. The updated plans include expanded benefits, additional covered conditions, and increased benefit payouts in several key areas. Many coverage tiers will also see reduced employee contributions.

Accidents, illnesses, and hospital stays can create unexpected expenses that aren’t always covered by medical insurance. These voluntary plans pay cash benefits directly to you, providing additional financial support that can be used however you choose, including for deductibles, coinsurance, travel expenses, household bills, childcare, or other out-of-pocket costs.

For 2027, MTM is pleased to offer enhanced coverage across all three programs while reducing premiums for many employees, helping you gain greater financial protection at a lower cost.

The Accident plan continues to provide cash benefits for covered injuries resulting from on- or off-the-job accidents. Several benefits have been increased, including:

  • Higher benefits for hospital admissions and hospital stays.
  • Increased payments for emergency room visits, urgent care visits, physician visits, follow-up care, and physical therapy.
  • Enhanced benefits for fractures and dislocations.
  • New sports activity coverage enhancement for eligible accident claims.
  • Reduced premium rates for many coverage tiers, including employee-only, employee plus spouse, employee plus children, and family coverage.

The Critical Illness plan has been expanded to provide protection for additional covered conditions and increased support services. Enhancements include:

  • New covered conditions, including Sudden Cardiac Arrest, Crohn’s Disease, Pulmonary Embolism, Idiopathic Pulmonary Fibrosis, and other specified illnesses.
  • Expanded childhood condition coverage for serious diagnoses such as Cerebral Palsy, Cleft Lip/Palate, Congenital Heart Disease, Down Syndrome, Muscular Dystrophy, Spina Bifida, and additional congenital conditions.
  • Increased Health Screening benefits that reward preventive care participation.
  • Enhanced travel, lodging, transportation, and second-opinion benefits when treatment requires care away from home.
  • Lower premium rates across many age bands and coverage levels.

The Hospital Indemnity plan has been enhanced to provide additional financial support during hospital stays and recovery periods. New and improved benefits include:

  • Increased hospital admission and daily confinement benefits.
  • New Intensive Care Unit (ICU) admission benefits and higher ICU confinement benefits.
  • New newborn admission and newborn confinement benefits.
  • New rehabilitation facility benefits following a hospital stay.
  • Coverage for substance abuse and mental health inpatient treatment.
  • Wellness screening benefits to encourage preventive care.  
  • Reduced employee premium contributions for many coverage levels.

Learn More

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