Timely Health Plan News and Commentary
Health insurance coverage determines what a patient pays, which doctors a patient can see, and whether a claim is paid or denied. This section of Health Plan News covers the plans themselves: individual and family coverage sold on the Affordable Care Act (ACA) marketplace, employer-sponsored health benefits, short-term plans, and the premium, deductible and out-of-pocket changes that arrive every plan year.
This section tracks rate filings and premium increases, open enrollment deadlines, changes to marketplace subsidies (the premium tax credits that lower monthly costs for qualifying households), and the rules that govern prior authorization and claim denials. We also report on employer benefit trends, including high-deductible health plans paired with a Health Savings Account (HSA), a tax-advantaged account for medical expenses.
Coverage news rarely stays in one lane. Federal and state rules shape every plan, so this section works alongside our Healthcare Policy and Law coverage. Carrier decisions drive what is available in each market, which is why we also follow the health insurance companies and the Blue Cross Blue Shield plans by name.
For readers comparing options, our reference guides explain how each type of plan works: choosing a health insurance plan, individual health insurance plans, family health insurance plans, high-deductible health plans, short-term health insurance, catastrophic coverage, health sharing plans and low-income health insurance. Readers aged 65 and older should start with our Medicare section, and lower-income families should review our Medicaid and CHIP coverage.
The latest health insurance coverage news appears below, newest first.
Cigna is leaving the ACA individual market in all 11 states where it sells Marketplace plans for 2027, and several other insurers are pulling out of individual states, from UnitedHealthcare in Georgia to Molina in Florida, Illinois and Ohio, according to KFF’s tracking of insurer participation and state regulators.
Health insurers are returning about $759 million to customers in 2026 under the Affordable Care Act’s medical loss ratio rule, less than half the $1.64 billion they paid in 2025, according to a preliminary KFF estimate based on insurer filings.
Workers can set aside up to $3,500 in a health flexible spending account (FSA) in 2027, up $100 from this year, under inflation adjustments the IRS released November 5. The FSA carryover limit rises to $700, and health savings account (HSA) limits climb to $4,500 for self-only coverage and $9,000 for family coverage.
ACA Marketplace sign-ups fell in 41 states for 2026, with North Carolina down 21.9% and Ohio down 19.5%, according to final Open Enrollment data from the Centers for Medicare & Medicaid Services (CMS). Nationally, 23.1 million people picked a plan, about 1.2 million fewer than in 2025.
Insurers selling Affordable Care Act (ACA) plans on HealthCare.gov denied 18.7% of the in-network claims they received in 2024, according to federal data analyzed by Health Plan News. That is 84.5 million denied claims out of 451 million, and the rate ran from 2.7% at the best insurer to 35.7% at the worst.
A new national survey from Imagine360 paints a clear picture: healthcare costs are no longer just a budget issue. They are now a daily stressor affecting sleep, job decisions, and even medical outcomes. The data is blunt. One in three insured Americans says healthcare expenses have kept them awake at night. Nearly half are skipping care. That is not a minor trend. That is a warning sign. [Read more…]
Millions of Americans are opening enrollment notices and doing a double take. ACA marketplace premiums for 2026 are climbing fast. In many cases, the jump feels less like inflation and more like a cold splash of water.
If you buy health coverage through the Affordable Care Act (ACA) marketplaces, you might want to sit down. A new report from ValuePenguin by LendingTree is sounding the alarm. It’s loud. The average cost for the most popular plans will jump by a whopping 21% across the country in 2026. That’s not a typo. That’s a serious hit to your bank account.
Health insurance in Northern California might have cost you more than it should have. And now, you might be getting some of it back. [Read more…]
The Bowen Homes community in Atlanta is getting a much-needed revival, thanks to a partnership between Peach State Health Plan, the Centene Foundation, and city leaders. A groundbreaking ceremony on March 5 marked the start of a project that will bring affordable housing, health services, and community resources to the area. [Read more…]
In a groundbreaking initiative, ‘Ohana Health Plan has teamed up with Hope Services Hawaii to launch a revolutionary residential program in Hilo. This innovative project aims to provide transitional housing and comprehensive healthcare support for some of Hawaii’s most vulnerable residents—those who are homeless and dealing with complex medical and behavioral health needs. [Read more…]
A new report from QuickQuote.com highlights Prudential as the top life insurance provider for individuals with disabilities, boasting an average monthly premium of $100. The ranking underscores a critical need in the insurance industry: equitable coverage options for people living with disabilities. [Read more…]
Health insurance can feel like a maze, but Inland Empire Health Plan (IEHP) is making it easier—and cheaper—for residents of San Bernardino and Riverside counties. As they kick off their second year on the Covered California health exchange, IEHP is once again offering the most affordable Silver plan in these regions. Open enrollment for new members starts November 1, but current plan holders can make changes now. [Read more…]
Great news for Louisiana residents—affordable healthcare coverage just got easier to access. Ambetter from Louisiana Healthcare Connections has announced its expansion into 22 parishes for 2025, making it possible for more people to find the coverage they need during open enrollment starting on November 1. [Read more…]
Starting November 1, Arizona residents across nine counties will have more affordable health insurance options, thanks to Ambetter from Arizona Complete Health. The open enrollment period for the Health Insurance Marketplace® will run until January 15, 2025, giving people the chance to sign up for coverage that kicks in as early as January 1. [Read more…]
In a major boost for brokers, Remodel Health has just announced the launch of ICHRA Academy™—a unique training program designed to help brokers take charge of the growing Individual Coverage Health Reimbursement Arrangement (ICHRA) space. This first-of-its-kind course is packed with tools to help brokers sharpen their expertise and offer more value to clients, all while boosting their own business. [Read more…]
Discover how AXA’s new insurance series prioritizes early detection and comprehensive support to safeguard your health
In a groundbreaking move to elevate health protection, AXA Hong Kong and Macau have launched the TotalAssure Critical Illness Series. This innovative insurance product aims to provide extensive coverage for 135 illnesses, emphasizing early detection and intervention for conditions linked to colorectal cancer, breast cancer, and heart disease. By offering proactive care, the new series promises to enhance the overall well-being of its insured members. [Read more…]
UNITED STATES OF AMERICA
Before the
SECURITIES AND EXCHANGE COMMISSION
ADMINISTRATIVE PROCEEDING
File No. 3-20932
In the Matter of Health Insurance Innovations, Inc., now named Benefytt Technologies, Inc., and Gavin D. Southwell, Respondents.
PLAN NOTICE OF HEALTH INSURANCE INNOVATIONS, INC. FAIR FUND
TO: Individuals and entities, or their lawful successors, who purchased and/or acquired shares of Health Insurance Innovations, Inc. under the symbol HIIQ (“HIIQ” or “Security”) during the period from March 2, 2017 through March 12, 2019, inclusive (the “Relevant Period”). [Read more…]
Inland Empire Health Plan (IEHP) is on a mission to help individuals discover their “Best Self” in the year 2024 with the launch of an exciting and free wellness program – “Healthy Living: My Best Self.” [Read more…]
Miami-based HealthBird, a pioneering InsurTech startup renowned for its side-by-side health insurance plan comparisons, is embarking on a strategic expansion into Latin America (LATAM). The company is set to launch its successful application in three LATAM countries—Ecuador, Colombia, and Peru—in the fourth quarter of this year. [Read more…]
Sendero Health Plans Inc. (Sendero) has announced the appointment of Sharon J. Alvis as its new Chief Executive Officer, tasked with leading the nonprofit Health Maintenance Organization (HMO) created, funded, and owned by Central Health. Sendero is renowned for providing health insurance plans through the federal Health Insurance Marketplace, in accordance with the Affordable Care Act (ACA). [Read more…]
Venteur, a digital health startup that helps companies offer personalized health insurance to their employees has closed a $7.6-million seed funding round. GSR Ventures is the lead investor, with Headwater VC and Revelry Venture Partners as well as Plug and Play and Techstars participating. [Read more…]
Inland Empire Health Plan celebrated the first graduating class from its Community Health Worker Residency (CHW) Program at its Rancho Cucamonga headquarters. [Read more…]
FWD Group Holdings Limited (FWD Group) ranked sixth in the Top 10 Multinational Companies 2023 Million Dollar Round Table (“MDRT”) rankings, maintaining its position from last season. [Read more…]
USAble Mutual is a mutual insurance company that does not make a profit. Today, they announced the launch of My WellSpent in Georgia, an affordable plan for primary care, dental and vision care. My WellSpent covers everyday healthcare requirements, including virtual and in person primary care. The goal of “A Different Kind of Insurance” is to make the basics easier for consumers and employers. [Read more…]
Apollo Medical Holdings, Inc. (“ApolloMed,” and together with its subsidiaries and affiliated entities, the “Company”) (NASDAQ: AMEH), a leading physician-centric, technology-powered healthcare company focused on enabling providers in the successful delivery of value-based care, today announced that it received certification from the National Committee for Quality Assurance (“NCQA”) Healthcare Effectiveness Data and Information Set (“HEDIS®”) Health Plan Measure Certification Program™. It is the second year in which the Company has received this certification, and in measurement year 2023, ApolloMed expanded its certification from 5 to 20 measures, covering the most widely used HEDIS measures in the managed care industry.
NCQA (www.ncqa.org) is an independent, non-profit organization that accredits and certifies a wide range of healthcare organizations and manages the evolution of HEDIS, the healthcare quality measurement tool used by more than 90 percent of health plans in the United States, covering 200 million people.
This certification allows ApolloMed to provide services that align with the industry’s most rigorous clinical quality measurement processes, resulting in more accurate and timely identification of eligible members and services. ApolloMed designed and implemented its HEDIS engine as a RESTful API to work in an interoperable way with other data engines and technologies, increasing the measure outputs’ transparency, interpretability, and usability.
In 2023, ApolloMed was certified by the NCQA HEDIS Health Plan Measure Certification Program™ for 20 different measures. This year’s certified measures include key diabetes measures, such as Hemoglobin A1c Control for Patients with Diabetes (HBD), Blood Pressure Control for Patients with Diabetes (BPD), Eye Exam for Patients with Diabetes (EED), Kidney Health Evaluation for Patients with Diabetes (KED), and 16 other measures.
HEDIS® is a registered trademark of NCQA. NCQA HEDIS Health Plan Measure Certification Program™ is a trademark of NCQA.
For more reporting on this topic, see our Health Insurance Coverage news hub.
Solis Health Plans, a Florida Medicare Advantage Plan is proud to announce Francisco Hernandez’s appointment. As Chief Medical Officer. Dr. Hernandez will be joining the Solis executive team to oversee clinical operations, care management quality improvement, care management, pharmacy, health IT and behavioral health for Solis’ members. [Read more…]
HealthPartners has demonstrated its commitment to simplicity, affordability, and a better shopping experience for Wisconsin residents in their health insurance marketplace. HealthPartners’ partnership with Softheon a top cloud-based provider of health insurance exchange technology, will allow Wisconsin residents to shop for and enroll directly on the HealthPartners website. [Read more…]
TruHearing and Fidelity Security Life Insurance Company have partnered to create a hearing insurance plan. This will allow benefits professionals to offer hearing benefits as an additional offering similar to vision and dental. TruHearing’s strategic partnership with Fidelity Security Life Insurance Companysup>(r) will allow for increased access to hearing benefits for employees, unions, and public sector groups. It also raises awareness about the importance of hearing care. The plan offers health insurance coverage through fixed indemnity benefits that cover hearing exams and hearing aids. The premium can be paid by an employee or the employer. You can either use it as a standalone benefit or combine it with other benefits. [Read more…]