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| Agent Use Only - Confidential
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Important Updates:
Community Blue Medicare HMO, 2026 Star Ratings, & D-SNP Provider Search Tool
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In This Edition:
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Community Blue Medicare HMO Signature Plan (Eastern PA)
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Highmark's 2026 Star Ratings Released
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D-SNP Provider Search Tool
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Agent of Record Reminder
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Plan Termination Special Enrollment Period (SEP)
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Resources
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Contacts and Additional Resources
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Community Blue Medicare HMO Signature Plan (Eastern PA)
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The Community Blue Medicare HMO Signature plan in Franklin
, Fulton
, Monroe
, Schuylkill
, Susquehanna
, and Tioga
counties is now available to submit an enrollment exclusively through the Highmark Producer Portal.
Commission eligibility for this plan excludes individuals new to Highmark. This consists of those new to Medicare or those transitioning from a competitor's coverage.
For current Highmark members, we will continue to pay renewals on their enrollments, even if they are in a plan terminating effective 12/31/2025, provided there is no lapse in their coverage.
This update does not apply to the Community Blue Medicare HMO Signature plan outside of the six counties listed above. Additionally, the other products available in the six counties are still eligible for commissions.
We understand you may have questions regarding these updates. Please do not hesitate to reach out to your dedicated Highmark Broker Manager for further clarification.
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Highmark's 2026 Star Ratings Released
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We are pleased to share Highmark’s 2026 Medicare Advantage (MA) Star Ratings, recently announced by the Centers for Medicare & Medicaid Services (CMS).
A high-level overview of our 2026 Star Ratings is provided below for your reference, offering valuable talking points to support your sales efforts.
Pennsylvania
Pennsylvania HMO: 4.5 Stars
Highmark's Together Blue Medicare HMO, Community Blue Medicare HMO, Complete Blue HMO, and Security Blue HMO-POS plans achieved a very high 4.5 out of 5 Stars.
Pennsylvania PPO: 4.5 Stars
Highmark's Complete Blue PPO, Freedom Blue PPO, Complete Blue Plus PPO, Community Blue Medicare PPO, and Community Blue Medicare Plus PPO plans received a very high 4.5 out of 5 Stars.
Pennsylvania D-SNP: 4.0 Stars
In addition, Highmark Wholecare's Dual Eligible Special Needs Plan (D-SNP) received 4 out of 5 Stars.
West Virginia
West Virginia PPO: 3.5 Stars
Highmark's Complete Blue PPO and Freedom Blue PPO plans received a 3.5 out of 5 Stars.
Delaware
Delaware PPO: 4.0 Stars
Highmark's Complete Blue PPO and Freedom Blue PPO plans received a 4 out of 5 Stars.
New York
Western and Northeastern New York HMO: 4.0 Stars
Western and Northeastern New York PPO: 4.5 Stars
In both Western and Northeastern New York, HMO plans scored 4 out of 5 Stars and PPO Plans scored a very high 4.5 out of 5 Stars.
Star Rating Insert bundles are currently being shipped and are expected to be delivered by October 31st. You should anticipate receiving 3 inserts for every 4 MA Enrollment Kits ordered. Each bundle will also include a helpful cover letter. Additional 2026 inserts will be available for download via Plan Documents by Friday, October 31.
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D-SNP Provider Search Tool
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To enhance your efficiency and provide a seamless experience, we're pleased to share direct links to the D-SNP provider search tools for Pennsylvania, Delaware, and West Virginia.
D-SNP Provider Search Links:
We encourage you to bookmark these links for future reference.
To find a doctor or pharmacy in Pennsylvania, please follow these steps:
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1. Navigate to the Find a Doctor or Find a Pharmacy field in the top toolbar (see screenshot above).
2. Enter the member's Zip Code in the designated field. You'll also have the option to include the Plan information.
4. From this point, you can search for providers by Name, Speciality, or Location.
5. Refine your search results using Filters such as "Accepting new patients" and "distance." Additionally, you can compare providers.
To find a doctor or pharmacy in Delaware or West Virginia, please follow these steps:
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1. Navigate to the Find a Doctor or Pharmacy option in the menu bar (see screenshot above). Note: If the member is in DE, select Medicare D-SNP Provider Directory from the dropdown menu.
2. Enter the member's Zip Code in the designated field. You'll also have the option to include the Plan information.
4. From this point, you can search for providers by Name, Specialty, or Location.
5. Refine your search results using Filters such as "Accepting new patients" and "distance." Additionally, you can compare providers.
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Please note that all internal plan changes will continue to maintain the existing Agent of Record (AOR). There will be no automatic change to the AOR when a client makes an internal plan adjustment.
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Plan Termination Special Enrollment Period (SEP)
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The Plan Termination SEP, running from December 8th through the last day in February, provides an opportunity for members whose plans are terminating on December 31st to enroll in a new plan for the following year.
As a reminder, if an impacted member enrolls into a plan during AEP, they still retain their SEP and can switch their enrollment between December 8 - December 31, 2025 for an effective date of January 1, 2026.
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Here are the most recent versions of the 2026 Highmark Medicare Advantage and D-SNP resources. Please refer to our weekly emails to ensure you always have the latest information.
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2026 Agent Field Guide
Click Here to download the 2026 Highmark Medicare Advantage, D-SNP, and ACA Individual Market Agent Field Guide.
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2026 Product Guide
Click Here to download the 2026 Highmark Medicare Advantage, D-SNP, and ACA Individual Market Product Guide.
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Contacts and Additional Resources
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Question
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Market
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Region
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Contact
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Broker Managers
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Medicare, ACA,
D-SNP
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Pennsylvania - Northwest
& New York
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Evan Cominsky
Email: Evan.Cominsky@highmark.com
Phone: 716-658-8653
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Pennsylvania - West Central
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Kayla Bracken
Email: Kayla.Bracken@highmark.com
Phone: 814-691-0303
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Pennsylvania - Western
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Bill Glas
Email: William.Glas@highmark.com
Phone: 412-544-0741
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Pennsylvania – Central
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Nicole Sherlock-King
Email: Nicole.Sherlock@highmark.com
Phone: 717-348-3269
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Pennsylvania - Northeast
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Morgan Catherman
Email: Morgan.Catherman@highmark.com
Phone: 570-259-4817
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Delaware & Pennsylvania – Southeast (Philadelphia Market)
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Felicia Anderson
Email: Felicia.Anderson@highmark.com
Phone: 302-559-6640
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West Virginia
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Stephanie Stanley
Email: Stephanie.Stanley@highmark.com
Phone: 304-424-0377
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Application Status, Benefits, Claims, Prescriptions, and Provider Network Questions
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Medicare
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PA, WV, DE
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Phone: 800-652-9459 (M-F, 8am-4pm)
Option 1 (Senior Markets), then Option 1
Email: federalproducer@highmark.com
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WNY, NENY
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Phone: 844-946-6305 (M-F, 8am-4pm)
Option 1 (Senior Markets), then Option 1
Email: albany.liaison@highmark.com
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ACA
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PA, WV, DE
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Phone: 800-652-9459 (M-F, 8am-4pm)
Option 2 (ACA), then Option 1
Email: federalproducer@highmark.com
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WNY, NENY
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Phone: 844-946-6305 (M-F, 8am-4pm)
Option 2 (ACA), then Option 1
Email: federalproducer@highmark.com
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D-SNP
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PA, DE
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Phone: 888-871-0417 (M-F 8am-5pm)
Email: HWCBrokerSupport@highmark.com
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Onboarding, Annual Certification, and Producer Portal Questions
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Medicare
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PA, WV, DE, WNY, NENY
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Phone: 800-652-9459 (M-F, 8am-4pm)
Option 1 (Senior Markets), then Option 2
Email: highmarkseniormarkets@highmark.com
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ACA
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PA, WV, DE, WNY, NENY
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Phone: 800-652-9459 (M-F, 8am-4pm)
Option 2 (ACA), then Option 2
Email: ACASalesSupport@highmark.com
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D-SNP
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PA, DE
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Phone: 888-871-0417 (M-F 8am-5pm)
Email: HWCBrokerSupport@highmark.com
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Additional Highmark Wholecare Resources
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D-SNP
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PA
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Customer Service: 800-685-5209
D-SNP Website: highmark.com/wholecare/medicare
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Highmark Producer Portal
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Medicare, ACA
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PA, WV, DE, WNY, NENY
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producer.highmark.com
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Highmark Consumer Websites
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Medicare, ACA
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Western PA, Northeastern PA
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myhighmark.com
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Central PA
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myhighmark.com
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WV
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myhighmark.com
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DE
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myhighmark.com
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WNY
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myhighmark.com
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NENY
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myhighmark.com
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D-SNP
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PA
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highmark.com/wholecare/medicare
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Highmark Integrity Office
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Medicare, ACA, D-SNP
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PA, WV, DE, WNY, NENY
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Phone: 1-800-985-1056
Email: Integrity@highmark.com
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PA Exchange (Pennie)
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ACA
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PA
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Website: pennie.com
Pennie Broker Contact Center: 844-844-4440
Email: brokers@pennie.com
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DE/WV Exchange
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ACA
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WV, DE
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Website: healthcare.gov
Marketplace Broker Call Center: 855-788-6275
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New York Exchange
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ACA
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WNY, NENY
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Website: nystateofhealth.ny.gov
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HealthSherpa
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ACA
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PA, WV, DE, WNY, NENY
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Broker Support: 888-684-1373
Email: agent_support@healthsherpa.com
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This email was sent from the Highmark Senior Markets Sales team. If you have questions, please contact our Broker Services Team at highmarkseniormarkets@highmark.com or call (800) 652-9459. |
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