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2027 ACA Commissions Schedule

As we prepare for another successful Open Enrollment Period, Highmark is pleased to share our commission structure for members enrolled with a 1/1/2027 effective date. Please review the details below:

2027 ACA Product Highlights

As you prepare for the 2027 plan year, here is a quick overview of important ACA product updates, plan changes, and network transitions to keep in mind:

New Bronze $0 Plan

• Adds a true $0 deductible with no medical or prescription deductible, plus copays for medical benefits and Tier 1–3 prescriptions.

Premier Plan Updates

• Premier Gold is being discontinued, with members crosswalked to the existing Gold 0 plan.
• Premier Silver and Premier Platinum members will be crosswalk to replacement plans: Choice Silver and Platinum 0, respectively.
• Additionally, TruHearing (hearing aid benefit) will now be available on any plan with “+ Adult Dental and Vision.”

Expanded Platinum Availability

• Platinum 0 will now be available On-Exchange for my Direct Blue in Western/Central PA and my Priority Blue Flex in Northeastern PA, and Off-Exchange only in West Virginia.

Together Blue Expansion & Renaming

• Expanding to include Beaver County and Heritage Valley facilities and will now become “Together Blue with AHN EPO.”

Lehigh Valley Network Transitions

• my Direct Blue Lehigh Valley EPO is being discontinued, with current members moving to my Blue Access PPO.
• Members who wish to enroll in the new my Direct Blue product centered around St. Luke’s will need to make an active decision to do so.
• In Northeastern PA, St. Luke’s will move to the Enhanced Tier.

Pediatric Dental Updates

• Pediatric dental is being removed from non-bundled PA and WV plans. Delaware will continue excluding pediatric dental from non-bundled plans, with the exception of the Bronze 9500 in WV and DE (which will retain it).
• Pediatric vision will remain on all plans, and plans bundled with “+ Adult Dental and Vision” will also retain pediatric dental.

St. Luke’s University Health Network (Lehigh Valley)

We are pleased to announce that St. Luke’s University Health Network (Lehigh Valley) and Highmark have signed a letter of agreement while they work to finalize a long-term contract. This agreement ensures uninterrupted network access, meaning St. Luke’s remains an in-network provider for ACA, Commercial, and Federal Employee Program (FEP) plans.

Blue Edge Balance Enrollment Process

We are pleased to announce that enrollment for Blue Edge Balance is now live for Pennsylvania, West Virginia, Delaware, and New York! Blue Edge Balance is designed to work independently as a standalone product or alongside current health coverage. Depending on the state, these plans provide comprehensive support, including dental, vision, and hearing coverage in PA, WV, and DE, and dental and vision in NY.

To assist with your client enrollments, please utilize the Producer Portal (producer.highmark.com) for all Blue Edge Balance transactions at this time. While BEB enrollment via Connecture is not yet available, we will notify you the moment it goes live.

Should you happen to be working within Connecture in the interim, the BEB plans will remain visible but the “Add to Cart” functionality will be disabled. The Plan List page will contain a note and direct link guiding you seamlessly over to the Shop.Highmark.com website to complete the enrollment. Please remember to add your NPN within the application when completing the enrollment.

Updated 2027 Agent Field Guide Now Available

To ensure you have the most accurate information following recent CMS updates, the 2027 Agent Field Guide has been updated to reflect the renaming of ICHRA to the CHOICE Arrangement (Custom Health Option and Individual Care Expense Arrangement).

Additionally, we have incorporated the latest CMS Marketing Practices into the ‘Commissions, Compliance, and Agent Oversight’ section of Doing Business with Highmark Federal Markets.

Click here to access the updated 2027 Agent Field Guide.

As a reminder, the most current versions of both the 2027 Agent Field Guide and the 2027 Product Guide will always be available in the Resources section of our weekly communications.

Resources

Here are the most recent versions of the 2027 Highmark ACA Individual Market resources. Please refer to our weekly emails to ensure you always have the latest information.

2027 Agent Field Guide — Click here to download the 2027 Highmark Medicare and ACA Individual Market Agent Field Guide.

2027 Product Guide — Click here to download the 2027 Highmark Medicare and ACA Individual Market Product Guide.

For contact info and other additional resources, view them at the bottom of THIS PAGE.