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Inside This Edition
“Serving Those that Serve Others”
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Plan Your Power Play
Your YouTube Success Series Why a Powerful Retention Strategy Leads to Better Business The Business Benefits of Cross-Selling Maximize Value, Multiply Loyalty
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Stay Ahead of 2026 ACA Changes
ACA MARKETPLACE UPDATE: Key Changes Agents Must Know for Plan Year 2026
With 2026 here at last, Agents need to be on their toes to stay on top of the market. Here are six things we believe all Agents should be aware of in the new year. 1. Subsidy Changes for 2026 Enhanced APTCs are scheduled to expire after 2025, meaning many clients may face higher premiums. Prepare clients early and run multiple cost scenarios to ensure optimal results. 2. Higher Out-of-Pocket Maximums: Federal limits will increase to about $10,600 for individuals in 2026, raising client exposure. 3. Marketplace Integrity Rules are changing: stricter income checks, pre- enrollment SEP documentation, and updated reenrollment workflows will apply. Carriers may require past-due premium payments before activating new coverage. 4. SEP & Enrollment Changes: The ≤150% FPL Low-Income SEP is being eliminated. Navigator funding will drastically decline, resulting in an increased reliance on licensed agents. 5. Risk Adjustment & Plan Transparency Updates in risk scoring and public quality metric reporting may influence plan pricing and availability. 6. Agent Licensing Requirements Agents must have an active state health LOA and complete the 2026 certification to maintain system access.
AGENT ACTION ITEMS:
Verify LOA and NIPR status
Prepare 2026 client outreach
Strengthen SEP workflows
Complete Marketplace training
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