November 1st, 2025 • January 31st, 2026
As always, we are so grateful for all of our clients - thank you for choosing Peters & Milam as your broker! We look forward to assisting you this year, and we thank you in advance for your patience during this Open Enrollment season.
Federal Changes to Your Health Insurance
The federal government has acted to make these changes to health insurance starting this year and beyond. The year they are set to take effect and their possible impacts are described below. This information (including effective dates) may change based on future court decisions.
The Enhanced Premium Tax Credit is scheduled to end December 31, 2025:
Financial help will still be available next year, but many enrollees could receive less than they did before.
In 2021, the federal government increased financial help for some people through Enhanced Premium Tax Credits.
Earlier this year, Congress passed and President Trump signed House Resolution 1 (the “One Big Beautiful Bill”). House Resolution 1 could have but did not extend the Enhanced Premium Tax Credit.
Unless Congress acts, the increased help will end on Dec. 31, 2025.
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Effective Date: 2027
Open enrollment for plan year 2026 will be from Nov. 1, 2025, to Jan. 31, 2026, as it has been in previous years.
It’s possible that the federal government will shorten open enrollment for plan year 2027, however — from Nov. 1, 2026, to Dec. 31, 2026.
Current enrollees will be automatically re-enrolled in 2026 with the health plan you had in 2025, as long as your plan is still available and you are still eligible.
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Effective Date: 2026
The federal government has made changes that will affect eligibility and benefits, however most Medi-Cal members won’t see any changes. Visit Medi-Cal’s website for more information.
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Effective Date: 2025
Deferred Action for Childhood Arrivals recipients are no longer eligible for health or dental insurance. The federal government ended their insurance on Aug. 31.
Effective Date: 2027
In 2027, only certain immigrant groups will be eligible for financial help to help pay for their insurance: lawful permanent residents (green card holders), Cuban and Haitian entrants and Compact of Free Association (COFA) migrants.
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Effective Date: 2025
The federal government ended the special-enrollment period for people with low incomes (individuals earning up to $22,590 per year or a family of four earning up to $46,800 per year).
These individuals will have to enroll during open enrollment, or through special enrollment if they experience certain life changes.
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Effective Date: 2025
Starting in September 2025, the automatic 60-day extension to fix income inconsistencies will no longer be available.
People will have the standard 95 days to resolve it instead.
People who need more time can call Covered California.
Effective Date: 2027
Some people end up receiving too much financial help to lower their monthly premiums because their household income is listed incorrectly on their application. While filing 2026 federal taxes in 2027, people who receive too much financial help will now have to pay back the full amount they owe.
Before, the amount they had to pay back was capped based on their incomes.
Remember to update your account whenever your income changes. It’s the best way to make sure you get the correct amount of financial help.
Effective Date: 2028
In 2028, you will need to prove that you qualify for financial help before receiving it. Unlike before, financial help won’t be given during the time it takes to fix any data issues (in most cases).
In 2028, people who don’t confirm or update their information for the next year will no longer be automatically re-enrolled in health insurance with financial help.
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Effective Date: 2026
In 2026, Bronze and minimum coverage (catastrophic) plans through Covered California will count as high-deductible health plans (HDHPs) that let you contribute to a Health Savings Account (HSA).
Before, some of these plans didn’t qualify because of how they were designed.
In 2026, you can use money from your HSA to pay for direct primary care fees, which is a monthly membership fee that lets you get a range of primary care services. Individuals can use up to $150 a month and families can use up to $300 a month.
However, free preventive care is available to all Covered California enrollees and covers most screenings and vaccinations.
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Effective Date: 2025
Health insurance companies in California still must provide gender-affirming care because of state rules that protect against discrimination.
COVERED CALIFORNIA
BLUE SHIELD + ANTHEM BLUE CROSS
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Covered California’s renewal period (annual re-determination process), November 1 – January 1, is intended to help individuals and families retain health coverage for 2026.
If you have no changes and wish to passively renew, there is no action needed or required. When the date on the Renewal Notice is reached, Covered California will automatically renew you into your same plan with updated premiums.
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This tool will allow you to research your options for 2026 coverage.
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Covered California consumers who are new to our brokerage can choose to delegate our office as their broker through their CalHEERS account in order for us to assist them with their application and enrollment process.
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You will receive a renewal packet via mail from Blue Shield. This renewal packet will include information regarding your 2026 plan information and rates. PLEASE NOTE: If you are receiving premium assistance, your renewal packet from BS will reflect the full rate without assistance. Renewal packet from Covered Ca will reflect net rate.
If you would like to make changes, please reach out to our office at tarah@petersmilam.com or you can call the Member Services number on the back of your ID card.
If you do nothing, you will be automatically renewed and mapped to the most similar plan with 2026 benefit changes and rates.
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You will receive a renewal packet via mail from Anthem. This renewal packet will include information regarding your 2026 plan information and rates. PLEASE NOTE: If you are receiving premium assistance, your renewal packet from Anthem will reflect the full rate without assistance. Renewal packet from Covered Ca will reflect net rate.
If you would like to make changes, please reach out to our office at tarah@petersmilam.com or you can call the Member Services number on the back of your ID card.
If you do nothing, you will be automatically renewed and mapped to the most similar plan with 2026 benefit changes and rates.
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2026 COVERED CALIFORNIA INCOME GUIDELINES
2026 COVERED CALIFORNIA BENEFIT CHART
The buttons below will help you apply directly for a Blue Shield or Anthem Plan (not through Covered California)
