Open Enrollment begins November 1, 2025, and runs through January 15, 2026.
We’re here to help you connect your clients to a health plan that delivers the care and savings they need. Benefits include $0 preventive care1, $0 virtual care visits2, and prescription drug coverage including convenient home delivery. Plus, our SydneySM Health app gives members their health information, resources, and well-being support in one convenient place.
Important updates for 2026
- The time frame to receive a $50 incentive for wellness exams has increased from 90 to 120 days.
- The new out-of-pocket maximums for plans without a health savings account are $10,600 for individuals and $21,200 for families.
- Some Affordable Care Act (ACA) health insurance tax credits are scheduled to expire at the end of 2025, unless Congress takes action to extend them. This means your clients may pay more for their premiums in 2026. For more information, clients can visit Anthem.com/stayinformed.
- Embedded pediatric dental coverage is being removed from all on and off exchange medical plans. For off-exchange consumers, the ACA requires anyone up to age 19 to have coverage for pediatric dental services. We are informing members in their renewal packets that by renewing their medical plan they are agreeing to purchase pediatric dental separately for anyone up to age 19.
- Medical Discontinuation Plan Details
- Anthem has made the decision to discontinue all on and off exchange medical plans in Rating Region 16 effective December 31, 2025. Discontinuation notification will be mailed to your clients on October 15, 2025. This will impact about 2,400 members in the following counties:
- Clark
- Crawford
- Floyd
- Harrison
- Jefferson
- Scott
- Washington
2026 open enrollment renewal materials
Your clients will receive their personalized open enrollment renewal packets by mail. The cover letter explains how they can find out if they qualify for financial help and how to make sure they receive all the savings available to them. To view the renewal letter for a specific client, visit Producer Toolbox, select Book of Business, then select Renewals. After enrollment, your clients can virtually access their member ID cards and other plan details through the Sydney HealthSM app .
Helpful tips and tools
- Members must pay the full amount of their January bill on time to make sure their 2026 coverage begins January 1, 2026.
- If a client is staying on their plan, they can maintain their coverage by continuing payments.
- If the Health Insurance Marketplace® contacts your client about updating their account information, please advise them to reply quickly. We can’t complete their enrollment until the Marketplace tells us their account information is current.
- Use E-Submit for paper applications and maintenance paperwork.
- Enhanced Direct Enrollment allows you and your client to enroll, renew, or update your information for ACA plans on the exchange using anthem.com.
- Our Indiana map shows current coverage areas.3
- Generate client reports in Producer Toolbox.
We’re here to help you connect your clients to affordable Anthem health plans. If you have questions, please contact Broker Services at 833-864-0133, or IndividualBrokerServices@anthem.com.
Thank you for your partnership and dedication to your Anthem clients. Visit Anthem Broker Hub for additional online support to help your business and your clients.
1 Nationally recommended preventive care services received in-network have no copay and no deductible requirement.
2 Virtual care visits, including video visits using the Sydney Health app are at no cost to members for most plans (however, it may be subject to the deductible depending upon the terms of the plan). Virtual care visits refer to video consultations, as deemed appropriate by a licensed physician. In addition to using a telehealth service, you can receive in-person or virtual care from your own doctor or another healthcare provider in your plan’s network. If you receive care from a doctor or healthcare provider not in your plan’s network, your share of the costs may be higher. You may also receive a bill for any charges not covered by your health plan. Sydney Health is offered through an arrangement with Carelon Digital Platforms, a separate company offering mobile application services on behalf of your health plan.
3 Individual Marketing collateral for plan year 2026 is available on AnthemBrokerHub.com.