Healthcare trends

SHARE Updates: Health Insurance Changes & Open Enrollment

SHARE organizers have recently heard concerns about upcoming changes to health insurance, especially regarding increases to health insurance costs, UMass Memorial’s negotiations with BCBSMA and audit of dependents, and the fact that insurers are significantly restricting coverage of GLP-1s.  

Please note also that Open Enrollment takes place this year from October 20-November 7. As a cost-saving measure, the hospital will not mail open enrollment booklets to your home this year. Instead, you will get emails with a link, and a postcard at home with a QR code that take to you the information on-line. If you don’t want to change anything, or sign up for a flexible spending plan, then you don’t need to do anything for open enrollment this year.

Here are some answers to Frequently Asked Questions from SHARE members . . .


Q: Can I continue to receive my care at UMass Memorial next year if I have Blue Cross Blue Shield insurance?

 

A: YES! SHARE members and their families who get their insurance through UMass Memorial will still have the same access to health care at UMass Memorial locations.

 

A recent memo to UMass Memorial caregivers, dated October 9, clarifies: “UMass Memorial employees and dependents with coverage through the UMass Memorial Health BCBSMA plan will still have access to all UMass Memorial facilities and physicians at their in-network benefit level.” That is regardless of the outcome of current negotiations with the between UMass Memorial and Blue Cross.

 


 

Q: What’s happening in negotiations with Blue Cross?

 

A: UMass Memorial and Blue Cross are negotiating about reimbursement rates for next year. SHARE hopes that they will be able to agree, but doesn’t have additional information.

 

The hospital also describes in the memo to caregivers, “We want to make you aware that our agreement with Blue Cross Blue Shield of Massachusetts (BCBSMA) for their commercial products expires on December 31, 2025. Although we continue to negotiate in good faith for a successor contract, there is the potential that UMass Memorial providers and hospitals will be out-of-network for 2026.” (Again, this does not apply to employees and their families who get their health insurance through UMass Memorial.)

 

SHARE is optimistic that these institutions can resolve their differences and come to an agreement that’s good for our patients: failure to renew the contract would have substantial impacts for our healthcare system. Regardless the outcome, however, it’s again important to note that that coverage won’t change for UMass Memorial employees as a result.


 Q: Are health insurance premiums going up more than usual this year?

 

A: Yes, health insurance rates are increasing more than in recent years.


A recent memo sent to hospital employees from UMass Memorial names that, effective January 1, 2026, “Caregivers will see an increase in premiums related to medical and dental plans.” Although it is standard each year that the insurers increase the rates, we do anticipate that the rates will go up more this year than has been typical. What does NOT change in January are plan details such as co-pay amounts, and importantly, our Contract Agreement regarding the “premium split” for SHARE members. In other words, UMass Memorial pays 85% of the cost of the premiums, including any 85% of the upcoming increases. While we all hate to see the costs going up, the upshot is that you’ll be responsible to pay for only 15% of that increase.

The chart below shows the increases for SHARE members.


Q: Is my husband getting kicked off of my health insurance plan?

 

A: No

 

Some SHARE members have raised concerns about the recent announcement that UMass Memorial will undertake a “verification of dependents” in order to remove ineligible participants. Please note that the eligibility requirements themselves are not changing: current spouses, dependent children under the age of 26, etc. will continue to remain covered.


Q: Where can I buy union-made Halloween candy?

 

A: Check Out this List from the AFL-CIO

 

Okay, maybe that’s not exactly a frequently-asked question, but it’s a good idea to support union businesses and help make sure that American workers have a say in their workplace.


Q: Is my health insurance going to stop covering my GLP-1 prescription?

 

A: Maybe.

 

Insurers, including Blue Cross Blue Shield of Massachusetts, are cutting back their coverage of GLP-1 drugs like Ozempic and Wegovy for weight loss, and UMass Memorial says it’s doing the same. However, some medical conditions, such as diabetes, will still typically qualify for the coverage. This article from WBUR explains why the insurers say they are doing this. SHARE has asked HR a bunch of questions to understand this more because we know it matters a lot to many SHARE members. We will continue to share with you what we learn.


Q: What else do I need to know about Open Enrollment this year?

A: Open Enrollment takes place from October 20-November 7

The hospital will not mail open enrollment booklets to your home this year, as a cost-saving measure. Instead you will get emails with a link, and a postcard at home with a QR code that take to you the information on-line. If you don’t want to change anything, or sign up for a flexible spending plan, then you don’t need to do anything for open enrollment this year. Find more details in the memo from UMass Memorial, copied below.



Open Enrollment Details from UMass Memorial

If you missed the email from Adriana Florez, UMass Memorial VP for Human Resources, describing this year’s Open Enrollment process, it’s copied below. You can also check your inbox for this message with the subject heading “Open Enrollment Is Coming!” dated October 29.

 

To: UMass Memorial Health Benefits Eligible Non-Union Caregivers

From: Adriana Florez, Vice President, Human Resources Business Partnering and Service Delivery, UMass Memorial Health    
Diane Sarkisian, Senior Director, Benefits, UMass Memorial Health

Date: October 9, 2025

Subject:    Open Enrollment Is Coming!

Open enrollment is coming for benefits-eligible employees at all UMass Memorial Health entities.
 
This year’s open enrollment period will run from Monday, October 20 through Friday, November 7 and will be completed in Workday. Postcards with information on how to access the 2026 Benefits Guide are being mailed to homes.
 
What’s in store for 2026:

Open enrollment will be “passive” this year. This means that UMass Memorial benefits-eligible employees do not have to re-enroll in benefits for 2026 (with the exception of Flexible Spending Accounts (FSA)). Your current, 2025 benefit selections will carry over into 2026. However, if you wish to make changes to your current benefit selections, you will need to make those changes in Workday between Monday, October 20 and Friday, November 7.

Flexible Spending Accounts (FSA) require re-enrollment every year.

If you are making changes for 2026, those must be completed in Workday during the open enrollment period. View this job aid or visit the Open Enrollment Hub page for more information and instructions.

 
Additional changes:
As part of the organization’s ongoing financial sustainability efforts, some additional changes will be in effect for benefits and wellness offerings in fiscal year 2026. Visit the Financial Sustainability Hub page to learn more about these and other changes.
 
Questions about this year’s open enrollment?
Should you have questions, please call the HR Solution Center Monday to Friday 8 am to 5 pm at 508-334-8800 and select option 2.

 

Nationwide Changes in Healthcare, and How We're Adapting Here

Many SHARE members have been talking about UMass Memorial’s increasing focus on cost-savings, with questions about the hospital’s finances and why we need to cut costs. SHARE members are also implementing ideas which are already having a real impact on the hospital’s bottom line.

What’s Happening?

You may have seen the recent Financial Sustainability update from Dr. Eric Dickson, CEO of UMass Memorial Health, providing an overview the financial challenges faced by our hospital system, including a $25M loss at UMass Memorial Health in FY25.

Federal cuts to Medicaid are expected to have a substantial impact on our hospital’s budget, beginning in Fiscal Year 2027

Dr. Dickson’s message (from “The Thread” on October 9th), outlines measures to further address these issues in FY26, and to stem the projected impacts of the One Big Beautiful Bill Act on safety net hospitals like our own. Dr. Dickson also praised the work of UMass Memorial employees toward those cost savings through the Find the 4% initiative, an effort to re-calibrate hospital finances by enhancing revenue and decreasing spending throughout the system.

The federal government is currently shutdown over disagreement about Medicaid cuts for this year and their effect on Medicaid patients. Medicaid cuts planned for 2027 will have an even bigger impact on the UMass Memorial’s budget. Estimates vary on the impact of those cuts – one estimate is that the hospital would lose $100+ million.

For a more in-depth analysis, you can also listen to this interview with Dr. Dickson in The Commonwealth Beacon’s podcast, “The Codcast.”

How SHARE Members Are Responding

Recently, SHARE Unit Based Teams have turned some attention to the hospital’s “Finding 4%” campaign. UBTs give SHARE members opportunities to design the work in their own departments, and put SHARE members at the center of the decision-making about things that matter to them. The purpose of UBTs is to make it feel better to come to work, and to make it easier to be able to do work we can feel proud of. Here’s a glimpse of some of the UBT projects to “Find 4%”:

The above list names a number of UBT projects aimed at cutting costs, especially through cutting wasteful practices

Making the Difference in Your Department

A commonsense way to make things more efficient in your workplace is to look for things that are redundant or wasteful. Smoothing things out can make work feel better, too. To get the ideas going, here’s the guide that the SHARE-UMass Memorial Continuous Improvement Coaches use with their Unit Based Teams

SHARE Members Information Meeting: About MGB

Why SHARE Opposes Mass General Brigham Expansion in Westborough

Wednesday, March 31, 2021

Noon-12:30 & 12:30-1:00

Zoom link: https://us02web.zoom.us/j/85231547713

Or dial-in: 301-715-8592 and enter meeting ID: 85231547713

“I hope people get fired up about this. A big new shiny building isn’t going to necessarily be better or give you good care. A sparkling waiting room isn't going to give you good care. Marlborough Hospital is a small community hospital. We don't hav…

“I hope people get fired up about this. A big new shiny building isn’t going to necessarily be better or give you good care. A sparkling waiting room isn't going to give you good care. Marlborough Hospital is a small community hospital. We don't have big parking garages, you don’t have to pay to park. You’re greeted at the door when you come in, even before COVID. We play a vital role in the community, and we serve an under-served part of the community. It would be a shame if MGB came into town, because I worry that we would have to close eventually.” — Melissa Green, Surgical Technologist & Member of the SHARE Executive Board at Marlborough Hospital

Join us to talk about why SHARE Executive Boards at both Marlborough Hospital and the Medical Center voted to oppose the huge clinic complex that Mass General Brigham (MBG) is proposing to build in Westborough. The MGB complex could threaten SHARE jobs, increase the cost of our health insurance, and hurt the finances of our safety net hospitals. Read more here.

SHARE leaders will be among many to testify at the DPH hearing against the proposal on April 6th and provide written testimony after. UMass Memorial and numerous local mayors, city councilors, community groups, state reps, healthcare providers and chambers of commerce are testifying against the proposal because they don’t think it would be good for healthcare and citizens in Central Mass.

Join us Wednesday during your lunch break to hear more, and to find out how you can put in your two cents to help stop the new MGB clinics in Westborough.

p.s., In case you missed it, check out SHARE’s post and links to the Chronicle episode on WCBV Channel 5 that was dedicated entirely to UMass Memorial caregivers’ work during the pandemic

Mass General Is Coming this Way

What does Mass General Brigham Expansion West

Mean for SHARE Members? 

If you’ve seen the news lately, you may have seen the articles (here and here) about Mass General Brigham’s plans to build at new outpatient center in Westborough. Mass General Brigham (formerly “Partners”, now known as “MGB”) announced it plans to spend $400 million to build new ambulatory centers in 3 towns along the outer suburban ring of Boston -- Westborough, Woburn, and Salem, NH – as well as to expand their clinics in Westwood.

Competition for UMass Memorial

The SHARE Executive Board at Marlborough Hospital is particularly concerned about MGB taking away UMass Memorial patients since they would be close by. If patients decide to get their outpatient care there, they may drive into Boston when they need inpatient care too. If a substantial number of patients choose MGB, that could threaten jobs at Marlborough Hospital.

MGB is the largest provider of healthcare in Massachusetts, with notoriously deep pockets. They are locating these clinics in relatively wealthy towns, where there are more patients with private insurance. Hospitals get paid more for the care we provide by private insurance than by from Medicare, and especially by MassHealth (Medicaid). Some say that MGB is intentionally trying to attract the better-paying patients, while leaving safety net hospitals like UMass Memorial to care for the Medicare and Medicaid patients. That’s not good for the bottom line at UMass Memorial.

Making the Cost of Care Go Up?

The cost of care at Mass General Brigham is higher than at other providers in the state. Data from the Massachusetts Health Policy Commission showed that “As more outpatient procedures shift to Partners hospitals, costs overall go up.” These proposed new clinics could accelerate that trend. If UMass Memorial employees choose to get their care at the new MGB locations, it could increase the cost of health insurance for all of us.

DPH Approval Needed

MGB has to get approval from the Massachusetts Department of Public Health before building these new ambulatory centers. UMass Memorial and other health systems will probably want their voices to be heard in that process. SHARE plans to pay close attention to the proceedings, and to make SHARE members’ point of view heard.