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Health Net Transition Options from Anthem, Aetna Pharmacy Transition Support, Blue Shield Extending Relaxed Participation Promotion, Kaiser Permanente Bonus Program
Thursday, September 17 2026
Carrier Updates
Aetna’s Transition Fill program allows eligible members one non-specialty or preferred specialty prescription fill without prior authorization during their first 90 days of coverage. Certain safety-related authorizations, plan exclusions, and specialty medications may not qualify. This temporary benefit helps minimize treatment disruptions while members complete applicable authorization requirements. Eligible members may also fill a 90-day prescription through participating pharmacies and receive three months of medication for the cost of two copays, subject to plan terms, deductibles, and cost-sharing requirements. After two retail fills, members can use a participating mail-service or retail pharmacy for eligible maintenance medications. Members may also opt out and continue receiving 30-day supplies at the applicable retail cost share. Contact your Dickerson Sales Representative to learn more about Aetna’s pharmacy benefits and available options.
Carrier Updates
Anthem Blue Cross is offering flexible enrollment options for groups affected by Health Net market changes. Groups with October 1, 2026 – March 1, 2027 effective dates and 2 to 100 enrolled employees can take advantage of: • Only 25% participation required • No waiver forms required • Required documents - Employer Application, EFT, No DE9C required - Prior Health Net invoice, and Enrollment Application or Census Enrollment Welcome Home Existing Groups Written Alongside Health Net : Anthem will allow members to come on to Anthem as a special enrollment effective 10/1 - 3/1 and during the group renewal month. Welcome Back Groups who left Anthem: Anthem will allow groups to reinstate within 60 days of leaving Anthem (as long as the group left in good standing). Groups will be required to pay back premium. (Group cancelled 8/1 to go to Health Net can reinstate back to 8/1 but must pay 8/1, 9/1, and 10/1 all at once) To confirm eligibility and review participation, documentation, underwriting, and reinstatement requirements, contact your Dickerson Sales Representative.
Carrier Updates
Blue Shield of California has extended its relaxed participation requirements through December 31, 2026 . Eligible small groups with at least five enrolled employees may qualify with 25% participation for medical, dental, vision, and life plans. The promotion applies to eligible off-exchange and mirror plans, subject to standard eligibility, enrollment, underwriting, and documentation requirements. At least 25% of eligible employees must enroll in a Blue Shield medical plan, and employees covered under another plan offered by the same employer are not considered valid waivers. Blue Shield Refusal of Coverage forms are required for eligible employees who decline enrollment or enroll with an alongside carrier. Blue Shield must also be the sole carrier for dental, vision, and life coverage, while additional restrictions may apply when medical coverage is offered alongside another carrier. Contact your Dickerson Sales Representative to confirm group eligibility, participation calculations, and submission requirements .
Carrier Updates
Kaiser Permanente is offering broker bonuses for new Small Group members enrolled through eligible sales channels with effective dates from February 1, 2026, through January 1, 2027 . Bonuses begin at $1,000 when a broker reaches 25 new members, with additional payments available at higher cumulative enrollment thresholds. Enrolled subscribers and their dependents count toward the member total. Groups submitted through Dickerson are eligible for this program. Each threshold qualifies for a one-time payment, issued within 90 days after the threshold is achieved. The maximum eligible payout is $17,000 per firm during the bonus period. Brokers must remain the broker of record and satisfy applicable licensing, appointment, documentation, and program requirements. Groups sold through Dickerson are eligible for this program. Contact your Dickerson Sales Representative to confirm eligibility, enrollment thresholds, and program requirements.