Open Enrollment starts November 1, 2025, and runs through January 15, 2026.
Anthem will offer shopping starting November 1. Some exchanges may offer window shopping options earlier. We encourage you to check with specific exchanges for their timelines.
We’re here to help you connect your clients to a health plan that offers the savings and care they need. Benefits include $0 preventive care,1 $0 virtual care visits,2 $0 for many brand and generic prescription drugs,3 and rewards for healthy behaviors. Plus, our SydneySM Health app gives members their health information, resources, and well-being support in one convenient place.
Important updates for 2026
October 28, 2025 – Wisconsin renewal packets mail.
November 1, 2025 – Open enrollment begins.
January 15, 2026 – Open enrollment ends.
Discontinued plans for 2026
Anthem BCBS is discontinuing Blue Preferred POS & Blue Priority HMO plans for on- and off-exchange plans effective January 1, 2026, exiting from 26 select counties (see below). Members will be notified by mail of this POS/HMO product plan withdrawal and are being told to shop for a different plan during open enrollment. These members will qualify for Special Enrollment Period (SEP) 60 days from January 1, 2026, to March 1, 2026.
Rating Region Changes
There are rating region changes for 2026. Click here to view the list of exiting counties. Impacted members may choose a different medical plan during Open Enrollment or a Special Enrollment Period. Because their plan is ending on December 31, 2025, members qualify for a Special Enrollment Period and may enroll in a new plan from January 1 through March 1, 2026.
New expansion of Pathway HMO in Sheboygan, Brown, Manitowoc, Kewaunee, Shawano and Oconto counties.
Primary Care Provider
Primary Care Providers (PCPs) are mandatory for HMO/POS ACA plans in 2026. PCPs will be automatically selected during renewals for mandatory PCP benefit changes. Members can change PCPs at any time.
Pediatric embedded dental benefits
2026 plans will not have coverage for pediatric embedded dental benefits on all medical plans effective January 1, 2026. Embedded pediatric dental coverage is being removed from all 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.
Wellness Incentive Changing
Increased timeframe to receive $50 Incentive for wellness exams from 90 to 120 days.
2026 Open Enrollment Renewal & Discontinuation materials
Your clients will receive their personalized Open Enrollment renewal and discontinuation packets by mail. The cover letter includes information on how members can find out if they qualify for financial help or make sure they receive all the savings available to them. Visit Producer Toolbox, select Book of Business, then select Renewals to view the Renewal Letter link for a specific client. After enrollment, your clients can virtually access their ID cards and other plan details through the Sydney HealthSM app.
Tips & tools to help you and your clients
- Members must pay the full amount of their January bill on time to make sure their 2026 coverage begins January 1, 2026.
- If your clients are staying on their plan, they can maintain their coverage by continuing payments.
- Use E-Submit for paper applications and maintenance paperwork.
- Our Wisconsin map shows current coverage areas.
- View and generate client reports in Producer Toolbox.
- If the 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.
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.
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.