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Anthem Blue Cross has released their CA Small Group HMO Guide for 2026. This convenient guide is to help you easily see which medical groups and independent practice associations are part of these Anthem Blue Cross networks: CaliforniaCare Select HMO Priority Select HMO Vivity Anthem Small Group 2026 HMO Guide Click Here For More Information or Help Quoting Anthem Blue Cross, Please Contact Your Dickerson Sales Representative.

Covered California for Small Business has shared some helpful insights when speaking with your clients about dental coverage. For example, dental is completely voluntary, no ER contribution and no minimum participation is required. CCSB has also released their Dental Plan booklet for 2026 highlighting available plans and providers. Here are some other helpful insights: • Dental can only be added to the group at inception, or renewal – not mid-year • Dental is not a stand-alone product, but an employee can waive medical and have dental. A minimum of one employee must have medical, for the group to offer dental. If a group has zero medical enrollment at renewal, the group will be termed • A reference plan is required on the portal – either the DPO or the DHMO • Rates are based per person – 18 and under use the child rate. 19 and older use the adult rate, even for a dependent ‘child’ • Non-California employees need the DPO plan only. For More Information or Help Quoting CCSB Dental, Please Contact Your Dickerson Sales Representative.

Health Net’s 2026 Large Group Dental & Vision rate guide is available now. This guide provides the approved 2026 rates and benefits for Large Group Dental and Vision plans in one document. This is the newest addition to the pool of resources available to you to help expand your business. 2026 Large Group Dental & Vision Rate Guide Click Here Health Net Forms and Resources Click Here For More Information or Help Quoting Health Net Dental & Vision, Please Contact Your Dickerson Sales Representative.

(December 30, 2025) The IRS recently released Notice 2026-5, which provides guidance and answers to common questions related to the expanded availability of health savings accounts (“HSA”) under the Reconciliation Act (previously named the One Big Beautiful Bill Act) passed into law earlier this year. Background on Qualified HDHPs and HSA Eligibility To be eligible to contribute to an HSA an individual must be enrolled in a qualified high deductible health plan (“HDHP”) and not have any disqualifying coverage. To be a qualified HDHP, the HDHP must meet certain minimum deductible and maximum out of pocket limits and, with limited exceptions, among other things, pursuant to §223(c)(2)(A), cannot provide benefits for any year until the minimum annual deductible for that year is satisfied. One exception or safe harbor to the requirements under §223(c)(2)(A), is for the receipt of preventive care without first meeting the applicable minimum deductible. In addition, due to the COVID-19 pandemic, there was short-term relief under the CARES Act, which was extended by subsequent legislation, which allowed HDHPs to provide first-dollar coverage of telehealth and other remote care services prior to satisfying the HDHP deductible (and regardless of whether such services were preventive services) while maintaining HSA eligibility. The Reconciliation Act The Reconciliation Act further expanded HSA eligibility in several ways. First, the Reconciliation Act resurrected and made permanent the pandemic-related relief previously provided under the CARES Act, which was extended by the CAA 2022 and CAA 2023, and allows HDHPs to provide first-dollar coverage of telehealth and other remote care services prior to satisfying the HDHP deductible (and regardless of whether such services were preventive services) while maintaining HSA eligibility effective for plan years beginning after December 31, 2024. Further, the Reconciliation Act resolved the unsettled question relating to the viability of HSA coverage for individuals with a direct primary care service arrangement (i.e., a contract between an individual and one or more primary care physicians to receive certain medical care in exchange for a fixed periodic fee). Beginning January 1, 2026, a direct primary care service arrangement is not considered disqualifying coverage (and therefore will not preclude an employee from qualifying for HSA coverage), as long as the fixed periodic fee for the direct primary care service arrangement is no more than $150 per month for the individual, indexed for inflation (or $300 per month if the arrangement covers more than one individual, indexed for inflation). In addition to satisfying this dollar limit, the direct primary care service arrangement must not include coverage for: procedures that require the use of general anesthesia, prescription drugs (other than vaccines), or laboratory services not typically administered in an ambulatory primary care setting. Finally, the Reconciliation Act confirms that the fixed periodic fees payable for the direct primary care service arrangement are qualified medical expenses that may be paid on a tax-free basis from the individual’s HSA. Finally, beginning January 1, 2026, the Reconciliation Act provides that all bronze and catastrophic level plans available on the individual market through the Exchange will be treated as HDHPs – and will, therefore, be HSA-compatible – even if those plans do not otherwise meet the standard HDHP requirements (e.g., by providing pre-deductible coverage of non-preventive services, failing to conform to out-of-pocket maximums, etc.). To Read More Click Here

Senate Bill 729 (SB 729) is a California law that mandates certain health insurance plans to cover the diagnosis and treatment of infertility, including in vitro fertilization (IVF). It expands access to fertility coverage for fully insured employer groups, particularly in the small and large group lines of business. The bill aims to make fertility care more inclusive by broadening the definition of infertility to include nonmedical reasons, such as those related to same-sex relationships and single parenthood. Implementation Timeline Updates: SB 729 effective date: January 1, 2026 SB 729 coverage will start Jan 1, 2026, at the next plan renewal. Key Takeaways for Employers & Employees: Large-group fully insured plans (101+ employees): Once effective, must cover infertility treatments up to 3 egg retrievals and unlimited embryo transfers, with parity in cost sharing. Small-group fully insured plans (≤100 employees): Must offer such infertility coverage via riders; coverage is optional to include. SB 729 does not apply to self-funded or level-funded plans. These arrangements are governed by federal ERISA law only and are not subject to the state-mandated insurance requirements enforced by CDI and DMHC. Religious employers and certain groups (like Medi-Cal, CalPERS until 2027) are exempt. What You Should Do: Check your plan type: Large-group, fully insured: Expect automatic inclusion of infertility benefits at renewal. Small-group: Review plan options to include an infertility rider. Self-funded: SB 729 likely won’t apply; voluntary coverage remains an option. Carrier Updates Aetna SOBs plan names will include 'wINF', and a new updated ER application is coming January 1, 2026. Coverage Includes : Comprehensive Infertility Services: IVF, ZIFT, GIFT, cryopreserved embryo transfers, ICSI, ovum microsurgery, ovulation induction, and artificial insemination. Coverage is limited to 3 completed egg retrievals per lifetime and unlimited embryo transfers Anthem Blue Cross Anthem will be releasing a new infertility rider in SOBs. Cost: $90/month per subscriber Coverage Includes: Includes IVF, GIFT, ZIFT, artificial insemination, reconstruction surgery (except sterilization reversal), supplies & appliances, and medications given in a doctor’s office. Blue Shield Large Group: Any increase in plan premiums will take place in 2026 depending on the group’s population and specific plan designs. Groups that already renewed with a July 1, 2025, to December 31, 2025, effective date with originally mandated fertility benefits will see an adjusted rate. On July 1, 2025 ART riders were updated to comply with the requirements of SB 729, ensuring parity between medical and ART benefit cost shares. Small Group: Customers that chose to offer coverage under SB 729 will see coverage changes take effect upon new enrollment or renewal. Coverage Includes : Natural AI (without ovum stimulation), Stimulated AI (with ovum stimulation), Oocyte retrieval, GIFT, and Cryopreservation of embryos, oocytes, sperm, reproductive tissues. California Choice The Department of Managed Health Care has determined that products offered through the CaliforniaChoice Program are not required to include options covering infertility benefits, as employer groups may access such options directly from the health plan. Covered California If you offer infertility benefits to your employees, all health insurance plans available to your employees will include infertility benefits. If you choose not to offer infertility coverage to your employees, the health insurance plans available to your employees will not include infertility benefits. Previously, infertility coverage guidelines were based on the number of eligible employees and the selected product (HMO, PPO, etc.) Health Net Two SBCs per plan now available (one with infertility, one without). When the IVF/fertility rider is needed for small groups, it is added at a group level to all members/plans. Coverage Includes: Artificial Insemination; Office Visits (professional services); GIFT; Follicle ultrasounds; sperm washing; prescription drugs (oral); Inpatient and outpatient care; IVF, ZIFT, or any process that involves harvesting, transplanting, or manipulating a human ovum; services or supplies (including injections and injectable medication) which prepare the member to receive the service; treatment by injections (only when provided in connection with services that are covered by the plan); medically necessary services and supplies for established fertility preservation treatments in connection with iatrogenic infertility are covered. Iatrogenic infertility is infertility that is caused by a medical intervention, including reactions from prescribed drugs or from medical or surgical procedures for conditions such as cancer or gender dysphoria. There is a lifetime maximum of 3 oocyte retrievals. Kaiser Permanente Large Group: Customers renewing between July and December 2025, the benefit will be included as part of the renewal. As a contract renews and SB 729 coverage is included, this expanded benefit will act as a benefit reset. A covered member will be eligible for SB 729 services, regardless of whether the member has accessed or exhausted any previous supplemental fertility services coverage. Small Group: All existing employers and brokers with INF plans, both ACA-metal and grandfathered, will receive a one-time email notification informing them of the benefit enhancements at time of renewal, beginning mid-June (pending DHMC approval). Coverage Includes: Diagnosis and treatment of infertility and fertility services, including artificial insemination, IVF, and fertility drugs as medically indicated. Medi Excel Infertility/Fertility requirements under SB 729, effective 7/1/25, do not apply to MediExcel Health Plan given its licensure under the Knox-Keene Act, Section 1351.2 Sharp Health The ART C rider will no longer be offered. Plans will now be available with or without Infertility, built into the plan designs, available for all group sizes. New INF SOBs are available on carrier website Coverage Includes: Treatment of diagnosed infertility coverage including but not limited to Assisted Hatching, In Vitro Fertilization (IVF), Gamete Intrafallopian Transfer (GIFT), Intracytoplasmic Sperm Injections (ICSI), and Zygote Intrafallopian Transfer (ZIFT). Up to a maximum of three completed oocyte retrievals (egg retrievals) with unlimited embryo transfers in accordance with the guidelines of the American Society for Reproductive Medicine (ASRM), using single embryo transfer when recommended and medically appropriate. United Healthcare Large Group: UnitedHealthcare has designated infertility, including IVF as a Benefit Standard effective January 1, 2026 for large fully insured groups sitused in CA. Small Group: It will be available only if purchased. The extraterritorial coverage requirement is delayed until January 1, 2026. Coverage Includes: HMO: Covers insemination procedures (artificial insemination (AI) and intrauterine insemination (IUI)); Gamete Intrafallopian Transfer (GIFT); clomid and other approved Injectable medications and syringes. PPO: Covers Ovulation induction; insemination procedures (Artificial Insemination [AI] and Intrauterine Insemination [IUI]); Assisted Reproductive Technologies (ART); outpatient pharmaceutical products for infertility treatment. ART Definition: procedures involving manipulation of reproductive materials (e.g., sperm, eggs, embryos) to achieve pregnancy, including IVF, GIFT, PROST, TET, and ZIFT. *For Key Implementation Details Click Here If You Have Any Questions or Would Like More Information, Please Contact Your Dickerson Sales Representative.