News
The Latest Carrier Updates, Legal Alerts, Industry News and more.
IRS 2027 Contribution Limits, Blue Shield Middle Market Portfolio Changes, Anthem and Central Valley Medical Providers Contract Update
Thursday, June 11 2026
Carrier Updates
Anthem Blue Cross has shared that effective August 1, 2026 , it will terminate its HMO contract with Central Valley Medical Providers, (with providers in Fresno and Madera counties). Anthem has proactively notified affected members by mail, and those members will be seamlessly transitioned to another medical group within Anthem's HMO network. Anthem's HMO network still remains one of the largest and most robust in California. Their 2026 ID cards will reflect the newly assigned medical group and contact number. Importantly, benefits remain unchanged — this is purely a provider group transition. Members are encouraged to get familiar with their new medical group and Primary Care Physician, as affiliated hospitals and specialists may differ from Central Valley Medical Providers. They can use the Find Care feature on the Sydney℠ Health app to explore their options. Your clients will continue to have access to a deep bench of providers, strong specialist coverage, and the same great benefits they've counted on. If You Have Any Questions or Need Help Quoting Anthem, Please Contact Your Dickerson Sales Representative.
Carrier Updates
Blue Shield’s Middle Market 2027 portfolio changes include enhanced PPO Savings plans with expanded weight loss drug coverage, along with a streamlined Virtual Blue care experience featuring $0 virtual care across medical plans. Additional refinements include EOC language updates and targeted portfolio adjustments, while dental plans remain largely stable with select market status changes. 2027 Portfolio Changes Pharmacy updates - PPO Savings Plans with expanded weight loss drug coverage In response to market demand, Blue Shield will launch three PPO Savings Plans offering expanded weight loss drug coverage in 2027: • Full PPO Savings Embedded Deductible 5500 with Enhanced+ Rx • Full PPO Savings Embedded Deductible 3400 100% with Enhanced+ Rx • Full PPO Savings Two-Tier Embedded Deductible 1700/3400/3400 90/60 with Enhanced+ Rx The plans are great options for manually rated groups not eligible for benefit customization as cost shares can be customized within existing filed ranges. Please note: weight loss drugs under these plans are covered with prior authorization for BMI ≥30, or ≥27 with certain weight-related conditions, lowering the requirement from the previous BMI of ≥40. Dental plans Blue Shield will not make any benefit dental plan changes in 2027. However, four plans will receive market status changes. Changing from “Not Marketed” to “Withdrawn” status: • Smile SM Spectrum Advantage 50/1500/Ortho/U80 Changing from “Not Marketed” to “Marketed” status: • Smile SM Spectrum Premier Plus 50/1000/Ortho/U90 • Smile SM Spectrum Premier Plus Rollover 50/1500/Ortho/U90 • Smile SM Spectrum Premier Plus 25/1500/Lifetime Ortho 1500/U80 Blue Shield Middle Market PPO Portfolio Beginning 1/1/27, Blue Shield’s fully insured Middle Market PPO, HDHP, and EPO plans will include the Virtual Blue care experience—with $0 copays for virtual care—bringing virtual primary care, behavioral health, and specialty care into the PPO experience members already know and trust. This enhanced experience replaces Teladoc and NurseHelp 24/7 for new and renewing Middle Market groups, with Premier and ASO groups able to opt in. The Virtual Blue experience helps simplify access to care through: • Virtual access to primary care, urgent care, behavioral health, and 19 specialty providers • Ability to select a virtual PCP for ongoing care • 24/7 access to doctors • Personalized and coordinated member support • Care team that helps with navigation and in-person appointments • Access to physicians supporting 25+ languages • $0 vitals kits Additionally, a number of Virtual Blue plans are being moved to “Not Marketed” in 2027. EOC language changes for 2027 Updates to EOC language impact the following benefits: ">Behavioral Health: language updated to reflect insourcing initiative Skilled Nursing Facilities (SNF): updating visit limit maximum from calendar year to benefit period GIFT (Gamete Intrafallopian Transfer) and ZIFT (Zygote Intrafallopian Transfer): including bracketed lifetime limits ("limited to [1-3] per lifetime"); GIFT/ZIFT coverage is only included when customized Disabled Over-Aged Dependent Children: language in the EOC to add more clarity regarding the required documentation for Over Aged Disabled Dependents LifeReferrals 24/7: language updated to reflect vendor change from Magellan to Headspace Mental Health and Substance Abuse (MHSU): update to SOB to improve alignment with EOC language Connect with your Dickerson Sales Representative to review renewal strategies and position these updates as a competitive advantage.
Compliance News
Employers that are beginning to plan for the 2027 plan year now have the key thresholds needed to set plan design details. The IRS released the inflation adjusted amounts for 2027 relevant to Health Savings Accounts (HSAs) and high deductible health plans (HDHPs). These limits vary based on whether an individual has self-only or family coverage under an HDHP. These limits include the following: • The maximum HSA contribution limit; • The minimum deductible amount for HDHPs; and • The maximum out-of-pocket expense limit for HDHPs To See Adjusted 2027 Limits Chart Click Here The adjusted limits create new opportunities to better align plan design with employee needs, contact your Dickerson Sales Representative to learn how.