How Blue Cross Blue Shield of Massachusetts works to implement gender-friendly initiatives
BY NONA TEPPER
The tight labor market and a shifting regulatory and legal landscape are driving more employers and members to ask Blue Cross Blue Shield of Massachusetts about women’s health benefits.
For answers, the nonprofit carrier is looking within its organization. Leaders consider employee input on gender and other social issues when creating targeted benefits for the insurer’s 2.9 million members, particularly those who receive coverage from their employer, said Dr. Monica Ruehli, an OB-GYN and the health plan’s clinical director of reproductive health and gender-affirming services.
The organization is broadly reviewing some of its medical coverage, along with workplace policies. Most recently, under the guidance of its CEO, the company has focused on the effects menopause stigma can have on inequality and health issues. It has created a menopause support group and launched an online reproductive health resource. In an interview, Ruehli spoke about how BCBSMA seeks to support all members of the workplace and what the future looks like for gender-friendly initiatives at the organization and beyond. The interview has been edited for length and clarity.
How did the idea of being a “menopause-friendly” workplace come about?
We were getting a lot of inquiries from our members and our accounts about menopause.
When our CEO Sarah Islein came in in August 2022, one of her priorities was to spread awareness about menopause. With her direction, we created a webinar for our employees about menopause in July and we had over 400 people attend, which was really exciting. A lot of people commented on how important that was—that people in leadership recognized this to be a topic.
[During the webinar], the associate clinical director for reproductive health, Kate Watson, and I went through some education on menopause—when is menopause, what are symptoms people commonly experience and [what are] some of the treatments that people are able to take to treat the different symptoms of menopause. Then we answered questions from employees.
What came next after the webinar in terms of employee-facing support regarding menopause and other women’s health issues?
Last month, we finished creating an online employee resource, where employees can access information related to the topic of menopause and other women’s health issues. We’re also in the process of forming a support group where employees can come together and ask questions about menopause. We already have 10 other support groups for things like women in tech, LGBTQ employees, Black professionals and more.
We offer a lot of neat benefits through our company as well.
We have telephonic wellness coaching, where we have certified wellness coaches who will talk to our employees about their health risks and help them work on their wellness goals. We offer wellness time, allowing people to have paid off time if they need some time to care for their own health. We also have a hybrid work model. If people need some flexible time, and they need to work from home to help them balance their professional needs and goals, we have that. The model allows for flexibility with childcare or eldercare arrangements, and paid wellness days ensure that women have the time they need to manage menopause symptoms and seek treatment.
At Blue Cross, over 70% of our employees are women, and the average age is 45. It’s really important for us to be a leading employer of choice for women who are looking for a company that values and prioritizes women’s health.
How do you know these efforts are successful?
We’re constantly asking our employees to provide feedback on the resources and benefits that are available to them, via pulse surveys and other measurement tools. Our new menopause support group will be a great forum to collect feedback from employees and improve our offerings to ensure we’re giving our employees what they need to feel supported at work and home.
What should men know about menopause in the workplace?
Men should have a basic knowledge of menopause. That would allow them to support their female colleagues and their own partners if their partners are female.
Menopause has come up more since we started talking about it. It seems like people just feel more comfortable talking about it.
Why is it important to have these conversations now?
As you get older, menopause is part of life. It’s a topic that’s typically had a lot of stigma around it, and people have been embarrassed to talk about it. We felt it was really important to make it a part of our dialogue and a normal part of our lives.
It was probably always important to have these conversations. But given everything that’s going on in the field of reproductive health, and how important it is for us to be a leading health plan for women’s health, we had to start with our own company and make sure that we were a friendly workplace for women of all ages.
The entire reproductive landscape around the country has had a lot of upheaval. There’s a lot of attention on Roe v. Wade, and maternal health inequities. I think there’s just a heightened awareness of issues related to women’s health in general. I’ve never seen anything like it as an OB-GYN.
You mentioned you’d also been getting a lot of inquiries from your members and your accounts about the reproductive landscape. What kinds of questions are your members asking?
Initially, a lot of the requests we were getting were in the field of fertility services. As there are more fertility services available, we get a lot more requests to cover those types of things.
Similarly, we recognized that menopause was a topic of interest. There are more women in the workplace and more women in executive positions. More people realize that menopause itself is part of life and aging, and people have more questions about it.
A lot of our [employer] accounts are more focused on women’s health in general right now because they want to attract and retain employees. Women make up half of our membership, and they often make a lot of the healthcare decisions for their families. If [companies] support employees in these different areas, they’re more satisfied at work. The goal is for everyone to feel good about their work, and their role at the company.
What does the future look like for gender-friendly initiatives at BCBSMA?
One of the big projects that we’ve recently started is a reproductive healthcare program, in which we have a team that helps support members who are navigating the fertility landscape. They can call in through our member service program and ask questions. If their questions can’t be answered through our member service program, then they’re referred to a specialty team, and we try to help them negotiate their benefits because they are complicated.
We’re always reviewing things. Things change so quickly in this area. We really try to look at our benefits and our medical policies in terms of the medical literature. I can’t say that the legal piece of it isn’t important but, primarily, we try to look at the medical literature for how we structure our benefits.
The most important thing you can do [about reproductive health] is just educate people. The more people know about it, the more comfortable they feel about it and the more they understand this is just a natural part of your life.
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