Good morning.
Peak season has officially begun! As a follow up to our regional Town Hall meetings and our Q4 2025 Broker Updates meeting, this email is to provide you with a few Highmark Small Group Pennsylvania updates and reminders to assist when writing new business.
To echo the sales strategy we mentioned in those meetings, Highmark is now accepting new business clients for December 1st, with competitor January renewals to help navigate the pricing challenges employers will be facing.
In addition, provided below are a few tips to ensure a smooth transition to Highmark!
January 2026 Updates:
- NEW 2026 forms can be found in the Small Group Sales Resource Center
- Flyers and other marketing materials can be found at Highmark Small Group
- Tax Documents: All pages, including page 1, of the UC2 (Unemployment Compensation Report) must be provided
New Business Reminders:
- Use applicable Small Group Business Application (2025 or 2026): The forms within the Small Group Sales Resource Center are noted with the year (if pulling from the current checklist, it will be the 2026 form).
- The New Business preferred deadline is the 15th of the month prior to the effective date. Any groups submitted to Underwriting after the 15th will experience implementation delays including coding, enrollment, and ID cards. Please ensure to educate the group and promote members to refill any rx’s, etc.
- All new groups must be submitted to Sales via the Producer Portal no later than the last day of the month prior to the effective date at 11:59PM EST (no exceptions will be granted)
- Highmark will be closed in observation of the following holidays: Thanksgiving (Thursday, November 27th and Friday, November 28th) and Christmas (Wednesday, December 24th and Thursday, December 25th)
- Special Enrollment Period: November 15th through December 15th with a January 1, 2026, effective date eliminates the participation (enrollment) and employer contribution requirements, only
- Small Group Market Segment Requirement: Groups must have an average total number of employees (ATNE) of 50 or fewer in the previous calendar year. This calculation includes all common law employees on the UC2. Note: 50.01 or greater would be considered mid-market
- For a January and February 1st effective date, groups should use Q1, Q2, Q3 2025 employee counts along with any completed months in Q4. For any incomplete months, they should estimate the ATNE to determine eligibility.
We are committed to continue providing support and guidance throughout the remainder of 2025, and we look forward to continuing those efforts in 2026! Should you require any assistance or wish to discuss how we can further support your needs, please do not hesitate to connect with your dedicated small group regional Sales Executive.
*Please send this email with anyone who would benefit from this information.
Thank you,
-Jolene
Jolene Schmidt
Senior Sales Executive | Small Group Northeastern & Central PA
P: 570-200-6507
F: 717-635-4601
E: Jolene.Schmidt@highmark.com
Marketing Collateral: Small Group Sales Resource Center
Flyers: Highmark Small Group
