New Affordable Care Act Changes

Below is a list of changes. See CMS Notice

The monthly Special Enrollment Period (SEP) for individuals under 150% Federal Poverty Limit would be discontinued immediatly.

• This change will restrict SEP eligibility unless the consumer experiences a Qualifying Life Event (QLE).

A new $5 monthly premium for fully-subsidized passive renewals effective January 1st 2026.

• Consumers eligible for $0 premium plans who don’t actively confirm their income may be required to pay $5/month until they verify their income.

Reinstatement of Failure to Reconcile (FTR) APTC eligibility restrictions

• Consumers will become ineligible for advance payments of the premium tax credit (APTC) if they didn't file their taxes and reconcile their APTC for one year (current regulations stipulate two years).

Shorter Open Enrollment Period (Nov 1–Dec 15 effective plan year 2026)

• The annual Open Enrollment Period (OEP) will be shortened to November 1–December 15 (currently OEP is November 1–January 15). These were the original dates when the Affordable Care Act was first put into place.

Resumption of SEP pre-enrollment verification immediatly

• If the Marketplace can’t verify your Special Enrollment Period, you may lose eligibility to enroll outside of Open Erollment. You will need to ensure you have proper

2026 Health Savings Accounts Updates

Individual coverage

• Minimum deductible: $1,700 (a $50 increase from 2025)
• Maximum out-of-pocket amount: $8,500 (a $200 increase from 2025)
• Maximum annual contribution amount: $4,400* (a $100 increase from 2025)
• 
  
• Family coverage
• 
  
• Minimum deductible: $3,400 (a $100 increase from 2025)
• Maximum out-of-pocket amount: $17,000 (a $400 increase from 2025)
• Maximum annual contribution amount: $8,750* (a $200 increase from 2025) 



Wellmark Proposed Rate Increases

Wellmark has requested the following rate increases with the Iowa Insurance Commissioner.

• Grandfather & Grandmothered Plans (NOT Affordable Care Act Plans): 3.0%
• Affordable Care Act Plans: 12.6%

Trends Impacting Wellmark Premium Increase:

6.6% Increase in cost and use of medical services and prescriptions

8.4% increase in cost and use of office and clinic services

9.7% increase in cost and use of inpatient services