IMPORTANT: Highmark NEPA entity change and what it means for your clients.
Highmark is withdrawing small group ACA plans in northeastern Pennsylvania from First Priority Life Insurance Company (FPLIC) to Highmark Care Benefits. Grand-mothered plans will remain in FPLIC.
Below are key details
- Beginning January 1, 2026, and upon renewal thereafter, small group ACA plans will convert from First Priority Life Insurance Company (FPLIC) to the new Highmark Care Benefits entity.
- Moving from the for-profit entity to a non-profit entity saves 2% in premium tax (and we’re trying to find every percentage point for our clients this upcoming year).
- Clients will be mapped from their existing plan(s) to the same plan(s) under the new entity. Clients/members won’t experience other benefit changes as a result of this entity change, aside from standard ACA benefit changes that occur each year.
- The client number will remain the same, but group numbers will change.
- Members will receive new ID cards.
- Pharmacy prior authorizations will carry over.
- Client and member communications will be issued 90 days in advance of the renewal date (for example, 10/1 for January renewals). Client notification will include a copy of the letter members will receive.
- Client renewal letters will issue according to the regular schedule – 60 days in advance of the renewal date.
