• Most companies are requesting rate increases averaging around 25% to 30%. (The National Average is 15%)

• Due to one company only requesting a 3.16% increase, subsidies may appear lower than in 2026.

• Cigna is exiting the ACA/Obamacare market. 

• Max Out of Pocket going up to $12,000 per individual and $24,000 for families. 

• More Provider Disruption and New Plans & Provider Networks. 

• Renewal letters will have accurate premiums, but may not show accurate subsidies. 

• Identity Proofing may be triggered for several new “High Risk” situations which may include:

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- New to the Marketplace

- Moving to a new state

- Change of address, phone or email 

- Changing from one broker to another broker

- Net Premium of $30 or less after subsidy

 

Also, reporting Income changes of 50% or more, or $12,000 or more may trigger a requirement for you to submit proof of income when applying for subsidies.  Acceptable Proof

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The Full amount of subsidies over paid due to estimating too low of an income will now be recovered. Previously there was a limit on how much the government would recoup. So Be Careful and Be Accurate in your prediction!

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Lastly, the government issued a Moratorium on New Agents and Brokers. This means far fewer people will be available to assist consumers with the Marketplace this Open Enrollment. 

 

• As you can imagine, all this may dramatically increase the time and effort required for some to enroll or change plans this Open Enrollment. Please be patient and understanding of this.

 

Good News - I also offer several types of Private Insurance options completely separate and devoid from all of this. Many if not all will be far less expensive than a full premium ACA/Obamacare plan. However, none will be as comprehensive of coverage. If you are "generally healthy" these may be a good option to consider. 

 

For more information - Individual and Family page