Not everyone follows the same path to building a family. And not every journey follows the expectation of ‘want a baby, get pregnant, have a baby, return to work’. Physical, emotional and financial well-being can be impacted when navigating the complexities of trying to build a family. In addition to comprehensive health plan coverage for pregnancy, benefits for fertility and infertility as well as adoption and surrogacy are available through the Franklin County Cooperative health plan. Download the brochure, view the FAQ or read the following information to learn more about each of the available programs and resources.
The health plan provides comprehensive coverage for maternity services and most members pay no more than the annual deductible for a traditional pregnancy. Coverage is available at both in and out-of-network providers.
Several support programs are available for expectant families, including the Maternity Support Program and Maven. Learn more about each of these programs below.
Fertility & Infertility
If infertility is caused by an underlying medical condition, the health plan covers treatment of the medical condition the same as it covers any other medical condition. Applicable annual deductibles, coinsurance, and annual out-of-pocket maximums apply at both in or out-of-network providers.
Effective January 1, 2023, the health plan covers fertility treatments and fertility medication. Coverage is only available if services are received from in-network
providers. Applicable annual deductibles, coinsurance, and annual out-of-pocket maximums apply and the combined lifetime maximum benefit for all medical and pharmacy expenses is $30,000
Services covered under the medical and pharmacy benefits include:
- Medical: IUI/IVF and egg retrieval/storage.
- Pharmacy: Infertility medication.
While not mandatory, it is strongly recommended
that Maven is engaged when utilizing these services. Learn more about Maven and the Maternity Support Program below.
Adoption & Surrogacy: Maven Wallet
Effective January 1, 2023, employees enrolled in the health plan are provided a $30,000 lifetime maximum benefit for adoption and surrogacy services. (This is a separate benefit than the $30,000 provided for fertility and infertility services.) This is not a United Healthcare program. Maven Wallet administers this program and enrollment in Maven is mandatory.
Maven Wallet is a reimbursement program. Qualified adoption or surrogacy expenses are paid by the member and paperwork (receipts, etc.) are submitted to Maven Wallet for reimbursement. Reimbursement is made through employee payroll. Surrogacy reimbursements are treated as taxable income. Certain adoption reimbursements may receive more favorable tax treatment.
: Maven Wallet cannot provide tax advice. It is strongly recommended
that you consult with your personal tax advisor to discuss your personal tax implications related to this benefit.
Maternity Support Program
A healthy pregnancy is the first step to a healthy baby and mother. The Maternity Support Program is available through United Healthcare and provides personalized support from maternity nurses. The nurses discuss healthy pregnancy habits and provide educational resources throughout the pregnancy. There is no cost to join and a $200 incentive is available to anyone who enrolls in and completes the program. For more information about the Maternity Support Program, call the number on the back of your United Healthcare id card (1-877-440-5983).
Maven is a new program available in 2023. It is not a United Healthcare program, but does compliment the maternity, fertility and infertility benefits available through your health plan.
Maven provides end-to-end support for every path to parenthood and offers services, resources and coverage not previously offered. It helps navigate preconception, pregnancy and postpartum with content tailored to your individual experience and needs. It is also your path to Maven Wallet, which offers support and reimbursement for adoption and surrogacy services.
You are assigned a dedicated Care Advocate to help you understand your benefits and all Maven can offer including access, education and referrals to in-network fertility clinics and doctors, IUI/IVF/egg freezing, reproductive endocrinologists, male fertility specialists, doulas, lactation consultants, sleep coaches, nutritionists, adoption and surrogacy coaching and much more.
Enrollment in Maven is 100% voluntary (with the exception of those using Maven Wallet), however, is strongly encouraged for those facing difficult or non-traditional paths to parenthood. The plan pays all Maven enrollment / membership costs.
Neonatal Resource Services
United Healthcare's Neonatal Resource Services connects you with a neonatal nurse who will answer your questions and help you work with the NICU to provide information and support. They'll assist in making a plan to bring baby home and lining up any needed services and equipment as well as putting you in touch with local services and resources. For more information about this program, please contact United Healthcare at the number on the back of your United Healthcare identification card (1-877-440-5983).
Starting or growing your family can present unique challenges. Your Franklin County Cooperative has programs and resources in place to help you navigate many of these needs and support you along your family forming journey.
- Lactation support and counseling: This coverage is through United Healthcare and in addition to any guidance or education received through Maven. Services are covered 100% by the health plan when performed by an in-network doctor or health care professional. Various in-network clinics and other providers, including many OB/GYNs and pediatricians, may provide lactation support and counseling. For more information about these benefits, call the number on the back of your United Healthcare id card (1-877-440-5983).
- Breast pumps: Purchases of personal electric breast pumps are covered by the health plan. Contact an in-network doctor or approved breast pump supplier up to 30 days before your delivery date or 365 days after your delivery date. For a list of in-network breast pump suppliers call the number on the back of your United Healthcare id card (1-877-440-5983).
- Employee Assistance Program (EAP): Contact your EAP 24/7 at 1-800-354-3950 to speak with a Masters-level clinician about all of life's challenges. Virtual and in-person support is available. 8 visits per problem per year.
- WorkLife: Available through your EAP, WorkLife services can help you navigate all the demands of life. Whether you're looking for childcare, have house repairs, or need help finding a new apartment, WorkLife can help you find something that meets your needs. Call 1-800-354-3950 to get started.
- Enrich Financial Wellness: Growing your family can cause financial stress, but Enrich Financial Wellness is here to help. You can work one-on-one with a financial coach for free. Call 888-801-1451 to get started today.
Contact the Franklin County Cooperative Benefits & Wellness Office if you need additional information.