2026 Q3 Hot Topics

Selling Highlights:

Simple Savings with Small Group: Save automatically with credits for new groups. Different savings offers for Aetna fully insured or Aetna Funding Advantage.
Small Group Producer Program – Earn More, Grow your Business: Producers can earn more for new groups with effective dates from January 1, 2026, through December 31, 2026. Check out the flyer for more information.
Aetna Funding Advantage (AFA) Transition Credit: Groups with effective dates through 9/1/26, Aetna is offering $400/employee transition credit. Check out the flyer for more information.

Underwriting:

No DE9C required for 5+ enrolling for groups with current coverage.

Rates:

Quarterly Rate Change Average: PPO 2.8% and HMO 2.9%
*Average rates only – rate actions vary by plan and rating region

Selling Highlights:

Sales Promotion: New groups submitted to Anthem from now through December 2026 will be allowed to select any combination of networks with no restrictions for the life of the group.
Union Carve Out Groups: For groups with total employees exceeding 100, but have a union population that has coverage, we can now offer coverage to the non-union employees.
PEO sub/hybrid groups are now eligible (groups that stay in the PEO) to enroll with Anthem.
Anthem may consider employers with out-of-state employees on a case-by-case basis.
Virtual Access Plus: Prioritizes virtual care and offer copays for all services, resulting in transparent, predictable costs for employees.

Underwriting:

The CA Enrollment Compliance Form can be used in lieu of a Reconciled DE9C/payroll or Reconciled Prior Carrier Billing Statement

Selling Highlights:

Why BBSI? Gain access to competitive plans and rates. Experienced professionals partner with you to make decisions as easy as possible and guide you through enrollment.
Comprehensive Benefits Package: Dental, Life, AD&D, Long and Short Term Disability, Group Legal, FSA, EAP, Accident, Vision, Identity protection, Pet Insurance, HSA, Critical Illness.
Regional plans and networks are also available!

Rates:

Quarterly Rate Change Average: PPO 3.8% and HMO 2.7%
*Average rates only – view full rate tables and rate books for medical and specialty here.

Selling Highlights:

Enhanced PPO plans with Virtual Blue: Starting January 2026 all Small Group Off-Exchange PPO plans will now have virtual health care through the Virtual Blue℠ program benefits, replacing Teladoc and NurseHelp 24/7℠ upon renewal.
Life Insurance Highlights - Guaranteed Issue, no additional underwriting for all small business groups 10+.
Wellness Discount Program – Discounts on: Gym memberships, Acupuncture, Chiropractic services, Massage therapy, and Vision care.
Sell more, Earn more – Earn points when you enroll members in Blue Shield that can be redeemed for gift cards and rewards. Points apply to groups with effective dates beginning 2/1/26 through 1/31/27. See full details here

Underwriting:

DE9C not required with 3 or more subscribers enrolling! Owners are not included in the count of eligible employees.
Relaxed Participation requirements through 12/31/26: 25% participation for groups with 5+ enrolled employees!

NEW for 2026:
- CalCPA Health is introducing a suite of alternative health plans that access the same Anthem PPO network as traditional plans. The new CalCPA Health tiered copay plans are powered by Coupe Health and offers a more simplified plan designed to connect members with the highest quality, best value providers of their choice.
- New tiered copay plans are being offered for 2026
  - PPO HSA PRx 1900-C
  - PPO HSA PRx 2900-C
  - PPO 30/0-C
  - PPO 50/0-C
  - PPO 60/0-C

Selling Highlights:

CaliforniaChoice is now quoting for Q3 2026.
Additional Anthem Out-of-State Options for 7/1:
o 2 Anthem Select Gold PPO Plans for out-of-state employees

Underwriting:

Simplify Existing Business Process: Expanded Census Enrollment
- Census Enrollment is now available for existing business
- Adds, terminations, and changes available via census

ChoiceBuilder is now quoting for Q3 2026.

Selling Highlights:

No Participation requirements between carriers
Simple administration – one enrollment, one renewal
Dental, Vision, and Life in one program

Selling Highlights:

Multi-Carrier Portfolio: Kaiser (Rate and Benefit Parity), Blue Shield Access+ HMO (Full Network), Blue Shield Trio HMO (Cost-effective Limited Network), Blue Shield Full PPO (including the Blue Card nationwide network), Sharp Health Plan (HMO Premier / HMO Performance Networks in S.D.)

Out-of-State Employees (Blue Shield PPO):
- Group must be based in California with verifiable Principal Address OR 51% of eligible employees in California, with CA business location
IRS Employer Tax Credit: Sliding scale for employers with average annual wages under $67,000 and less than 25 Full-Time Equivalent Employees
Broker Bonus Program: Earn more with a partnership that pays! Sell new small group coverage with effective dates from July 1, 2026 – January 1, 2027 and earn extra. Check out the flyer for more information.

Underwriting:

Relaxed Participation: 70% of employees covered by any valid coverage, No more than 30% uninsured (waiving for cost)
Minimal Payroll Requirements: Prior Carrier Bill in lieu of DE9C for groups of 3+ enrolled employees. Employment Offer Letters when payroll not available for new hires.

Rates:

Quarterly Rate Change Average: HMO: 3.9% and PPO: 6.2%
*Actual rate changes may vary by network and rating area.

Selling Highlights:

Teladoc: Virtual health care that’s convenient, with confident access to quality U.S. board-certified doctors. Teladoc is an option when members can’t see their regular doctor.
Out-of-state In-network coverage for PPO: The Cigna® PPO Network is the provider network outside of California for Health Net PPO plans with out-of-state coverage. With over 1.5 million health care providers, Cigna® PPO network offers a wide selection of doctors and hospitals, competitive discounts, and flexibility to support value-driven plan designs.
$0 Deductible HMOs: All HMOs come with no deductible.
ShareCare: All members aged 18+ can earn up to $100 annually by participating in ShareCare.

Simplified Underwriting:

Enhanced Choice (HMO & PPO) – Groups with 4-9 enrolling employees, 25% participation, or no participation requirements when 10+ employees enroll. Mix and match PPOs and all HMOs. No DE9C required. No Prior carrier bill. No ownership documents required.
Flexible Underwriting – 2 weeks payroll for a startup group of any size.
- Groups 1-4 enrolling: 70% participation
- Groups of 5-100 enrolling, 25% participation required – Not a promotion
Straightforward enrollment:
- No DE9C, payroll or ownership documents required for groups that qualify for underwriting promotions. PLUS when enrolling 10+employees, no waivers are needed for medical.

Selling Highlights:

NEW Kaiser Permanente Plus (KP Plus) Plan: Effective 1/1/26, Kaiser will offer this new plan with out-of-network flexibility. With KP Plus, not only do employees benefit from the true value-based care, they also have the flexibility to keep their favorite out-of-network doctors with up to 10 physician visits or outpatient medical services, and 5 prescription fills or refills annually, without the need for referrals or prior authorization.

Simplified Underwriting:

Beginning January 1, 2026, all new group enrollments with 5 or less subscribers must provide the following documentation:
- DE 9C or equivalent payroll report for startups
- Business-entity verification
- Waivers (if applicable)

Underwriting:

Contingent Approval: Small groups enrolling less than 5 EEs and No DE9C
New Documents Required: must submit relevant IDs, Marriage Certificate and birth certificate for matching one of the parents. For domestic partners, a CA certificate of registered domestic partnership or notarized domestic partner declaration from Mexico.
Existing Clients may be subject to random recertification at renewal
MediExcel will continue to accept 1 enrolled employee on select plans

Selling Highlights:

Provide medical coverage for employer groups that operate within the US but are owned by a foreign company or parent.
Global Coverage with Aetna International (medical and prescription coverage while traveling outside the US)
Traditional East Asian Medicine (Acupuncture, herbal supplements, cupping, hypnotherapy and tai chai covered)
Additional benefits: Active & Fit, Prenatal Program, Teladoc, ActiveHealth wellness program and Care Management.
Nippon uses the national PPO network of Aetna signature Administrators of over 1 million providers for our large group and global business opportunities
They review any 100+ large groups in CA and also in other situs states as well

Underwriting Guidelines:

1-4 subscribers enrolled: Minimum of 60% participation, excluding any valid waivers.
5+ subscribers enrolled: Minimum of 25% participation, excluding any valid waivers.

Selling Highlights:

NEW: Starting Jan. 1, 2026, small group non-grandfathered plans will switch to a 4-tier prescription benefit upon renewal. SHARP will notify employer clients affected by this change 90 days prior to their renewal.

Trinet is HR designed for for everyone: Payroll Services, Risk Mitigation, Technology Platform and HR Expertise
Trinet offers comprehensive HR solutions for your clients:
- Trinet PEO is a full-service HR solution that unifies HR, payroll, access to big-company benefits and risk mitigation.
- Trinet HR Plus is a scalable solution that combines flexible service options alongside all-in-one technology platform to simplify HR, benefits administration and payroll processing.
NEW! Enhanced onboarding experience for clients that simplifies how brokers gain Trusted Advisor Access – no extra steps required.
NEW! TriNet’s Human-Centered AI Suite is available now! The Personal Health Assistant, powered by Healthee, enables employees to accew3ss important healthcare information throughout the year.

Underwriting Guidelines:

CA Groups with 3+ enrolling can submit a participation certification form in lieu of a DE9C.
o UHC updated underwriting guidelines: See the full guide here