YNS Health Insurance Membership Guide

YNS Health Insurance Memberships

Lead Admin Contact: Sara Marshall, marshalls@northshoreymca.org 

Lead Membership Contact: Caroline McDonnell, mcdonnellc@northshoreymca.org 

What are Health Insurance Memberships?

• Memberships paid for by participants’ health insurance* coverage.

• Typically, members must scan in for us to be paid by the insurance company. Each provider has different rules, see below.

• Health Insurance Memberships are managed via third party billing with our central admin team, contact: Sara Marshall, marshalls@northshoreymca.org 
  
  

*Many insurers are now allowing Health Savings (HSA) or Flex Spending (FSA) Accounts to pay for fitness club memberships with pre-tax dollars. This is not 3rd party billing, rather, the member should remain on a normal membership and the billing method should be switched to their HSA or FSA debit card. Alternatively, the member could submit receipts to their HSA/FSA for reimbursement.

How do I help a new or existing member enroll?

• Check for a Daxko record, and add a non-member account if none exists yet.

• Enroll the prospect in a complimentary 1 week pass.

• Click here to request set-up of a new Health Insurance membership or send this link to an interested prospective member.
  NOTE: Not all insurers will cover YMCA membership, and sometimes coverage differs between MA and NH… feel free to submit a request and our team will follow up to let you know if your plan is included. If not, we have senior membership rates and Flexible Pricing as options.

• The Admin Team will confirm the enrollee’s eligibility with the insurance company and set up 3rd party billing.

• The Admin team will send a confirmation email to the member and CC the local Membership Sales Director once the membership and insurance billing has been set up.

• The Local Membership Director will send a welcoming email clarifying that the member must scan in monthly for the membership to remain active (see sample email below).

• Daxko Engage will send automated reminders to scan in each time the member goes 14 consecutive days without scanning.

• The Admin team will track usage for monthly billing purposes, and will terminate memberships that have not scanned in 1 full month.

Which Insurers do we work with? 

*MEDICARE VS. MEDICAID: As of January 2023, we are currently contracted with three Medicare Advantage plans: ASH/Tufts Senior Whole Health, UHC’s Renew Active, and Tufts SCO Silver Sneakers. We, along with the MA Alliance, are open to investigating new Medicare Advantage partnerships, which must be individually contracted. The MA Alliance is separately investigating a much larger Medicaid partnership similar to what is being piloted in 10 states this year, beginning January 1, 2023. Y-USA intends to learn best practices, especially around billing and contracts, from those pilots throughout the year in order to scale the partnership more broadly.

Ensuring Usage & Payment

1. Upfront communication around the “use it or lose it” nature of this member type. Example:

Hi, [Member name] -

Welcome to the Y! I’m so glad you’re ready to get started taking advantage of all the Y has to offer for your physical and mental wellbeing. Let me know how I can help you get started!

I want to also reiterate that your health insurance membership is a “use it or lose it” benefit, meaning that if you don’t scan in at least once each month, the membership will deactivate. So, please make sure to stop at the welcome center and scan in when you arrive so you get credit for coming!

I hope we’ll see you much more often than once a month so we can help you get connected and meet your goals. We’ll do our best to send you reminders if you fall out of the habit.

See you soon!

[Staff name]

2. An ongoing Daxko Engage Initiative will send an auto email reminder to any health insurance members who have not scanned in for 14 consecutive days.
    

Check in and Stay Active at the Y!

*|preferred_name|*,

We noticed you haven't scanned in a couple weeks! As a Y member with one of our health insurance partners, this is a friendly reminder that a monthly check-in is needed to keep your membership active. We are here for all your wellness needs, and want to keep you healthy and connected at the Y!

For group exercise, pool, pickleball, and other schedules, visit our website.

Not sure how to get started? Book an orientation! Click here for our schedules page, then filter to your preferred Y and “Fitness Center Orientations” to see available options. If there’s nothing that fits your schedule, we’re happy to book something that works better for you – just reach out to Chelsea at halec@northshoreymca.org

 Thank you for being a part of the Y, and we hope to see you here soon!

Gratefully,

[Membership Sales Director]

3. (If needed) Termination Notice to Health Insurance Members who have 0 scans after one full month, sent by central admin team:
   
   

Subject:  Y Membership Deactivated [Date]

Hi [Member Name] -

Your Y membership was deactivated on [DATE] as you had not scanned in for 30 days.

If you would like to reactivate your health insurance membership in the future, please submit this request form with up to date insurance information so our team can re-enroll you.

Hope we’ll see you again,

[Staff name]

The Association Admin team will terminate any Health Insurance Membership that has not been used in 1 month, and will send a confirmation email to the member.

Holds & Cancellation

Holds - Due to the manual nature of 3rd party billing, we will not process typical holds for Health Insurance memberships. Instead, members should request a cancellation and simply reactivate when they’re ready. This is less of an administrative burden to the central admin team. 

Cancellations - When a cancellation comes in and the Membership Admin sees a health insurance discount group on the account, please be sure to notify the admin team so that they can deactivate 3rd party billing and cancel the membership: Sara Marshall, marshalls@northshoreymca.org