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Medical Mutual Small Group, Life and Disability, and MLR Updates
Learn about Medical Mutual's updates to their small group plan portfolio, updates to the Life and Disability Census Template to improve onboarding efficiency, and information regarding MLR rebate checks.
Humana’s Group Dental Benefits Lead with Wellness
Humana understands the importance of dental health on our overall wellbeing. This is why Humana's dental plans provide enhanced preventive benefits for your clients.
Take Advantage of Allstate’s 2026 Open Enrollment Individual Bonus Programs!
Allstate recently announced several Open Enrollment bonus opportunities for individual health insurance agents for plans with effective dates beginning October 1, 2025, until January 15, 2026.
Important Update About Ohio Farm Bureau Membership Dues
Effective December 1, 2025, the Ohio Farm Bureau Health Benefits Plan membership dues will increase from the current rate of $7.50 per employee per month (PEPM) to $9.00 PEPM.
Plan Year 2026 Marketplace Registration and Training is Now LIVE
Plan Year 2026 Marketplace registration and training is now available for returning agents and brokers who were registered for Plan Year 2025! The Small Business Health Options Program (SHOP) agreement and optional SHOP training are also available.
Updates to Anthem’s Employer Access Portal (with Informational Video)
Anthem is introducing a new feature allowing brokers and employers to pull ID cards at the group level on the Employer Access. This feature will only be available for small group new sales with July 1 effective dates and will be rolled out for all small groups in the future.
Update From Medical Mutual: DispatchHealth Closed Ohio Operations August 1
Medical Mutual has just been notified that DispatchHealth, a mobile urgent care provider, closed Ohio operations on August 1, 2025, impacting all Ohio health plans. This change is a result of a broader business realignment for DispatchHealth, who is planning no other market exits at this time.
The MedMutual Employer Dashboard, a New Employer Platform, Set For Release
Medical Mutual recently announced the release of the MedMutual Employer Dashboard, their new primary platform for employer group administration, and will soon reach out to small group (1 to 50), Single Bill Group customers to offer them an opportunity to participate in a beta test. The new tool will replace EmployerLink.
Kentucky State-Based Marketplace KYNECT Important Plan Year 2026 Training Updates
Due to the need to make numerous updates to Kentucky’s Agent Certification and Refresher Trainings for Agents for Plan Year 2026, the availability of these trainings is delayed and the window to complete the training will be extended.
Updates to Ameritas’ Dental Network Effective November 1
Ameritas recently announced a new dental network-sharing arrangement takes effect November 1, 2025. It is expected to increase some Ameritas dental networks by 4,000 to 6,000 access points.
Employer Action Required: Distribute Medicare Part D Notices by October 15, 2025
Group health plan sponsors must provide Medicare Part D “creditable coverage” notices prior to October 15, the start date of the Medicare annual enrollment period for Part D, Prescription Drug coverage.
Upcoming Webinar: Plan Year 2026 Health Insurance Marketplace Registration & Training for Returning Agents and Brokers
Learn more about Plan Year 2026 registration and training requirements for returning agents and brokers as you prepare to assist consumers during Open Enrollment.
Medical Mutual’s Negotiations Ongoing with Licking Memorial Health System
Medical Mutual is currently in active contract discussions with Licking Memorial Health System, working diligently to negotiate in good faith to keep providing their members and employer groups with affordable care.
Ambetter Health Will Exit Detroit for Plan Year 2026
Beginning January 1, 2026, Ambetter Health will not be offering plans in Detroit, Michigan. As a result, Ambetter Health will be exiting Macomb, Monroe, Oakland, and Wayne counties for plan year 2026.
Updates Regarding Anthem KY MLR for ACA and Grandmothered Groups
Anthem pays annual rebates to fully insured groups when their medical loss ratio (MLR) is less than 85 percent for large groups or 80 percent for small groups. Anthem KY will be sending out its MLR checks by September 12 to ACA and Grandmothered business only.
Upcoming Webinar: Learn More About UnitedHealthcare’s Restaurant Association Plan
As the only endorsed health benefit carrier of the National Restaurant Association, UnitedHealthcare offers exclusive solutions tailored for the restaurant and service industry.
Update to Anthem Ohio’s Health Plan Network
Anthem's contracts with Allen Emergency Physicians, LLC and Lorain Emergency Physicians, LLC, are ending August 31, 2025. This means your client’s employees may pay more for non-emergency care received from these providers after August 30.
Extended Coverage for Short-Term Plans Now Available!
The Centers for Medicare and Medicaid Services (CMS) recently released a statement regarding the 2024 final rule on short-term, limited duration health insurance that effectively frees insurers to potentially offer longer-term policies (e.g., 6, 12, or even up to 36 months) without fear of federal penalties.
Anthem KY Group Administrator Manuals
These manuals are crafted to provide quick answers and step-by-step directions for managing day-to-day administrative responsibilities efficiently.
Register for UnitedHealthOne’s August Product Training Webinars
These webinars are designed to help you gain an even better understanding of UnitedHealthcare products, services, and best practices.
Anthem Has Reached a New Multi-Year Agreement with OhioHealth
This agreement continues uninterrupted access to care at OhioHealth hospitals, facilities, and physician practices for Anthem members in all health plans, including employer-sponsored, individual, Medicare Advantage, and Medicaid health plan networks.
Medical Mutual Updates Regarding Modified Amendments Approved for ORC 3902.63 (Ohio HB 315) Cost-Sharing
Updated Certificate amendments were approved by the Ohio Department of Insurance in regards to the Ohio Revised Code section 3902.63 portion of Ohio House Bill 315 stating any cost-sharing, including copays, deductibles, and coinsurance, applicable to services rendered by occupational therapists, physical therapists, and chiropractors must be no greater than the applicable cost-sharing for a medically necessary primary care physician office visit.
MedMutual WELL Officially Launching for Group Business
Effective immediately, MedMutual WELL is available to include in sales quotes for new groups and to upsell to existing groups.
2026 Affordability Percentage Set at 9.96 Percent
Today, the IRS issued Revenue Procedure 2025-25, which significantly increases the affordability threshold for ACA employer mandate purposes to 9.96 percent for plan years beginning in 2026. The new 9.96 percent level marks by far the highest affordability percentage to date.
Anthem to Send Out Annual MLR Survey Soon to Employers
Anthem pays annual rebates to fully insured groups when their medical loss ratio (MLR) is less than 85 percent for large groups or 80 percent for small groups. Each year, they contact affected groups to verify group size. Anthem will use the information to calculate rebates. This year, they will ask for 2024 group size for distribution of MLR rebates in 2026.
Register for UnitedHealthcare’s Upcoming 2025 Summer Broker Webinar Series
These webinars are designed to help you gain an even better understanding of UnitedHealthcare products, services, and best practices.
Anthem ChamberCare Health Alliance Benefits Are Changing October 1
Recent changes proposed and implemented by the Chamber Benefit Arrangement of Indiana Trust will increase the cost and alter the administration, both making it difficult for Anthem to continue fulfilling their promise through the partnership with the ChamberCare Health Alliance (CHA) MEWA.
MedMutual WELL Launching for Groups on July 22
The MedMutual WELL program, provided to all Medical Mutual members at no additional cost, is designed to empower both employees and groups through a tailored wellness strategy.
Principal’s New STD Open Enrollment Experience
After initial eligibility, employees can add or increase STD coverage during their annual open enrollment period at their next policy anniversary, or within 31 days of a qualifying event (such as marriage, divorce, birth, or adoption), without evidence of insurability.
Humana Process Enhancements, Resources, and Reporting Information
Humana released updates regarding the enhanced EOI process, broker portal resources. and new dental and vision reporting.
Medical Mutual Premium Split Reporting Survey
Medical Mutual collects the needed employer information for the RxDC data due in June each year through use of a QR code on the group’s renewal.
U.S. Supreme Court Upholds ACA’s Mandate for Free Preventive Care
The Court’s decision requires health plans and health insurance issuers to continue covering, without cost sharing, the full range of recommended preventive care services.
Medical Mutual: ODI Updates Therapy, Chiropractic Services Cost-Sharing Related to Ohio House Bill 315
Recently, the ODI clarified the Ohio Revised Code 3902.63 portion of Ohio House Bill 315 that any cost-sharing—copays, deductibles and coinsurance—applicable to services rendered by occupational therapists, physical therapists, and chiropractors will be no greater than the applicable cost-sharing for a medically necessary PCP office visit.
New Rule Cracks Down on Improper Enrollments, Protects Patient and Taxpayer Dollars, and Restores Marketplace Integrity
CMS is finalizing a major rule that will lower individual health insurance premiums by approximately 5% on average and is projected to save taxpayers up to $12 billion in 2026.
Join Golden Rule’s July Webinar Events
Enhance your knowledge this summer with Golden Rule's webinar training events in July where you will learn how GRIC products can enhance your business portfolio and increase your income by offering cost-effective solutions.
Anthem Kentucky New Employer Portal Feature
Beginning July 1, 2025, Anthem Kentucky will introduce a new feature allowing brokers and employers to pull ID cards at the group level on the employer portal.
PCORI Fees Due to IRS No Later Than July 31, 2025
Fees to fund the Patient-Centered Outcomes Research Institute (PCORI) are due to the IRS no later than July 31, 2025, from employers who sponsor certain self-insured health plans such as level funded and HRAs that are not treated as excepted benefits.
Important Updates From Kentucky kynect
Kentucky kynect releases updates on D-SNAP for those affected by severe weather in May, CareSource leaving the individual market in Kentucky, SSP updates, and a general reminder about switching QHPs outside of Open Enrollment.
CareSource to Exit the Kentucky Individual Market
CareSource recently announced a decision to withdraw from the individual market in Kentucky beginning with the 2026 plan year. The company noted declining membership, which has led to significant financial challenges in the Kentucky market, as the reason for the decision.
Important Update About Individual Dental Plans Offered by Dental Care Plus, Inc.
Dental Care Plus, Inc. recently announced they will discontinue new DCP individual sales and will begin to non-renew existing plans. This impacts individual dental plans offered by DCP in Indiana, Ohio and Kentucky.