New webinar: Peak season preparation for commercial groups
Plan to join us on Wednesday, September 17, 2025 at 10:00 AM, when members of our group sales team will provide tips and best practices to help you prepare for December and January peak season.
The invitation for this producer webinar will be hitting your inboxes soon.
Capital Blue Cross would like to invite you to an upcoming training event as you prepare for this year’s ACA Open Enrollment. We are excited to present our ACA plans for individuals and families for the 2026 plan year.
Please join us online on Wednesday, October 1, 2025 from 10:00 AM to 11:00 AM ET to learn more about:
We appreciate your participation in our recent 2026 group product training. A recording of the webinar and presentation deck are available if you would like to refresh what you learned or if you missed the in-person or virtual sessions.
The 2026 benefit grids include links to the highlight sheets and SBC for each plan.
Pennie broker certification training for 2026 is coming soon
The Pennsylvania Health Insurance Exchange Authority will soon launch their annual broker certification program for 2026. Brokers can create or update their registrations and complete the training course on Pennie, the official site of the Pennsylvania Health Insurance Exchange Authority.
Annual certification is required to participate as a broker on the exchange.
Changes to preferred supplier for diabetes testing products
We are making a change that affects our current preferred supplier for diabetes glucose meters, test strips, and solutions covered through certain Capital prescription drug plans. Our current supplier is LifeScan, maker of OneTouch® testing products.
For impacted Capital members with a prescription drug plan that uses the Advantage, CHIP, Value, or Value Plus formulary, Ascensia — supplier of Contour® and Microlet® products — will be the new preferred diabetes testing product supplier.
Capital members with a prescription drug plan that uses the Elite or Exclusive formulary will be able to get coverage for both Ascensia and Abbott diabetes testing products; Abbott offers FreeStyle and Precision products.
This change will take effect October 1, 2025, for members with Capital prescription drug benefits through an employer group plan. For members with Individual Account and CHIP plans, the change will be effective January 1, 2026.
On August 29, 2025, we sent a letter to impacted employer group plan members who use OneTouch diabetes products to advise them of the change and provide information on the new supplier(s).
Health reimbursement arrangement (HRA) administration application required for renewing groups
Groups offering an HRA must complete an administration application annually at renewal, even if the group is not making changes to their HRA offering. The forms are specific to small and mid-market groups or custom groups of 101+. Completing the form confirms the funding and administration components for a group's new benefits period.
The completed form should be submitted at least 30 days before the group’s effective date to avoid potential delays to HRA claims processing.
Three-tier plans for 2026
Capital is adding new three-tier plans for 2026. Advance PPO, Capital Advantage PPO, and Convenience PPO will be available to employer groups (large, nonlarge, and consortium) and to individual account (IA) members
Our existing three-tier plans — PPO Choice, PPO Choice Select, and Performance PPO — will continue to be available for large group customers but will no longer be available to nonlarge employer groups and IA members.
Requests for Capital Blue Cross Dental disruption analysis reports for large groups
Large employer groups with 100 or more employees may request a Capital Blue Cross Dental disruption analysis report. To provide a provider disruption analysis, the following pieces of information are required.
Utilization file in Excel.
Provider participation status with current carrier is crucial to assess the impact to employees and their eligible dependents. Without this information, we are unable to provide a true disruption analysis.
Full NPI (National Provider Identifier) number is a unique identifier necessary for provider identification.
Tax Identification to help in verifying provider information and ensuring accuracy.
By popular demand, we’re hosting a repeat guided demo of MyCareFinder on Wednesday, September 24, at 11:00 AM ET, just in time for AEP.
This webinar is a great opportunity to refresh your skills and feel more confident heading into AEP. You'll learn how to use MyCare Finder to find in-network providers and confirm participation quickly and accurately. We’ll also highlight tips that make provider searches run smoothly during client meetings.
By September 12, the Capital Blue Cross online ordering store will be updated to include 2026 materials. For active Medicare Advantage producers, access will be through single sign-on directly from our Producer Portal. After logging in, click on the online ordering icon to:
Order enrollment kits.
Review and order other items eligible for producer use.
Access one-time and repeat quick ordering solutions.
See tracking features for your deliveries.
Review reporting and quickly replenish materials.
Some helpful tips:
Review and update your profile information, if necessary.
Due to shipping methods, we cannot ship to a P.O. Box, so please update to include your physical address.
Order enrollment kits that correspond to the segments you need (see image below).
Medicare low income subsidy (LIS) premium amounts for PY 2026
The updated low income subsidy (LIS) amounts for 2026 are now available. These amounts outline the reduced premiums that may apply for qualifying members, helping you guide clients toward affordable coverage options. Be sure to review the chart so you’re prepared to discuss how LIS can impact plan affordability during your client meetings this AEP.
Plan name
PBP
Segment
Plan premium
Total plan premium with 100% LIS
Capital Blue Cross Classic PPO
013
N/A
$72
$39.50
Capital Blue Cross Prime PPO
017
N/A
$177
$144.30
Capital Blue Cross Select PPO
044
001/002/003/004
$0
$0
Capital Blue Cross Value PPO
045
001/002/003/004/005
$0
$0
Capital Blue Cross Enhanced PPO
046
001 002 003 004
$26 $26 $22 $29
$0
Capital Blue Cross Complete PPO
047
001 002 003 004 005
$45 $45 $40 $49 $49
$12.30 $12.30 $7.30 $16.30 $16.30
Capital Blue Cross Basic PPO
048
002/003/005
$20
$2
Capital Blue Cross Premier HMO
001
N/A
$86
$60.70
Capital Blue Cross Value HMO
004
N/A
$58
$25.30
Capital Blue Cross Essential HMO
022
001/002/003/004/005
$0
$0
CONTACT
Your producer relations team
Capital Blue Cross has adopted a team approach to support you, as we collaborate to enhance business relationships, foster your growth through education and incentives, and actively support the communities we serve. The Producer Relations teamthanks you for your commitment and hard work. Reach out whenever you need them.
From managers to broker resources and member service information, Capital has you covered. Producers for Individual and Medicare-focused clients, check out your agent guide when you need assistance.
Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital Blue Cross in its capacity as administrator of programs.
