Over the weekend, the Senate voted to advance a deal that extends government funding through January 30th, in an effort to end the current shutdown. The House will now decide whether to take up the Senate measure to reopen the government.

Things are very much still up in the air at the moment, but here’s what we know so far about health insurance tax credits and what it means for your premiums.

The December Timeline

Senator John Thune has indicated there will be a Senate floor vote on ACA premium tax credits by mid-December, before Congress recesses on December 19th.

That timing is significant because open enrollment is already underway. Right now, the marketplace rates you’re seeing are based on the expiration of tax credits on December 31st. Whether Congress extends those credits will determine what people actually pay for coverage starting January 1st.

What’s on the Table

Representatives Sam Liccardo and Kevin Kiley have introduced a bill to extend the enhanced ACA tax credits for two years, covering households up to 600% of the federal poverty level.

Other proposals are also being discussed, including different approaches to how premium assistance is structured and delivered. Some involve extending the current system, while others propose more significant changes to how subsidies work. So far, Speaker Mike Johnson has not committed to bringing an ACA credit bill to a House vote, even if legislation passes the Senate.

The Current Situation

The timeline is tight. Congressional recess begins December 19th, which doesn’t leave much time for negotiation between now and then.

If enhanced tax credits expire as currently scheduled, many Americans will see their premiums increase at the start of the new year. How much depends on each household’s income level and insurance plan, but for many, the difference will be substantial.

Congress must act soon if they want changes to take effect for January coverage. Anything passed after December 31 would likely require special enrollment periods to allow people to adjust their coverage based on new subsidy levels.

The next few weeks will determine whether enhanced tax credits continue, expire, or get modified in some way. Each scenario has different implications for premiums and affordability.

How This Affects You

If you’re shopping for coverage right now, you’ll need to make decisions based on the current rates. Even if they change, the timing of any congressional action will determine how smoothly those changes can be implemented.

If you have questions about how potential changes might impact your specific situation, please reach out to us. We’re closely monitoring all of these new developments and can help you understand how they can affect you.

The situation is fluid, and we’ll continue tracking this situation through December––so be sure to check back with us for more updates.

 

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📢 RATES ARE IN: Stop Worrying About Your 2026 Health Insurance! 🚨

The wait is over! Open Enrollment starts this Saturday, November 1st, and we finally have the official 2026 health insurance rates.

We know you’ve been worried, but don’t panic. Our early review of the increases shows a mixed bag:

💰 Many of our clients will maintain their $0 premiums!
📈 If you are a higher-income earner, your rates may be changing significantly. You need to call us for brainstorming and a better solution.
🤔 Don’t just panic over the “maybes,” go online and check you ACTUAL renewal rate.

At Ark Insurance Solutions, we are working with real 2026 data now, not just scary rumors! We are ready to find you the best affordable health insurance and subsidies in the ACA Marketplace.

📞 Call Us Today to Schedule Your 2026 Review!

Let’s look at your renewal, brainstorm alternatives, and figure out the right plan for you.

➡️ Click the link in bio or call 801-901-7800 to set up a personalized appointment with our team in Salt Lake City, Utah!

 

 

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The Subsidy Cliff & What You Need to Know NOW:

💵 The expanded healthcare tax credits implemented during COVID-19, which helped eliminate the “subsidy cliff” for those earning more than 400% of the Federal Poverty Level (FPL) are set to expire.

⚖️ If Congress doesn’t act, the pre-COVID rules will return. The “cliff” means that if your income exceeds that 400% FPL (or $62,600) threshold by even one dollar, you could lose your entire tax credit and have to pay it back.

Strategic Planning is Key 🗓️

⚠️ For the self-employed and others who make more than 400% FPL, it’s crucial to prepare now.

The existing tax credits aren’t going away entirely, but they will revert to their limited pre-COVID amounts.

• If you’re over the $62,600 mark, you may need to look at options other than Healthcare.gov.
• In Utah, group plans may be 20-21% less expensive and are a viable alternative for the self-employed to explore immediately.

🗓️ Don’t wait! We must strategize now by considering a group plan. If Congress extends the tax credits by January 1st, we can always cancel and move you back to the individual marketplace during a potential special enrollment period.

Let’s talk now about securing your best healthcare strategy for 2026. Call us at 801-901-7800.

 

 

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Individual Coverage Health Reimbursement Arrangements, or ICHRAs, are a new approach to employee health benefits that give employers a tax-advantaged way to provide flexible health coverage. For small businesses, ICHRAs offer an alternative to traditional group health plans, which can often be expensive and difficult to manage.

So, how does an ICHRA work? Instead of offering a specific group plan, employers give employees a set amount of tax-free money to spend on a health plan they choose themselves. The employer saves money on premiums, and the employees get to select a plan that fits their needs and their family’s needs. It’s a win-win.

One of the biggest advantages of an ICHRA is the flexibility it offers. You can set different contribution amounts for different classes of employees, such as managers and salaried workers, as long as the plan doesn’t discriminate. Plus, since the money is a tax-deductible business expense, both the business and the employees save money.

Key Takeaways About ICHRAs

💰Tax-Advantaged: Contributions are a tax-deductible expense for employers and are not considered taxable income for employees.
🧑 Employee Choice: Employees can choose a health plan that best fits their specific needs, including their preferred doctors and hospital networks.
🤸 Flexibility: ICHRAs are a great option for businesses with a distributed workforce in different states, as they can be used to accommodate varying state health insurance markets.

As the health insurance landscape continues to evolve, staying on top of new options like ICHRAs is essential for small businesses. We’ll be here every week to keep you informed.

Think you’re all set with your health insurance coverage? You might want to take a closer look. In today’s rapidly evolving healthcare landscape, what worked for you last year might not be the best choice for this year, and just as you schedule regular check-ups for your health, your insurance coverage deserves an annual review.

Why annual insurance check-ups matter

The healthcare industry is always changing. From shifting provider networks to updates in medication coverage, what you signed up for initially might look quite different today. “The costs and the benefits and the laws change every single year and sometimes more frequently,” says Rebecca Yates, CEO of Ark Insurance Solutions. These aren’t minor adjustments. They can significantly impact both your wallet and your access to quality healthcare, which is why it’s important to know how they’ll affect you personally.

It’s also worth considering how your own life changes year over year. Your needs may have evolved, and the medications covered under your current plan may have changed. All of these factors can affect not only the cost of your plan but also its effectiveness in meeting your healthcare needs. Without regular review, you might find yourself paying more than necessary or even worse, lacking coverage in crucial areas.

Recent changes make reviews more critical than ever

New developments in the healthcare sector have made insurance check-ups absolutely crucial. The government has implemented new security measures to protect consumers after incidents involving rogue insurance brokers making unauthorized changes. While these measures provide additional protection, they also illustrate the importance of regularly reviewing your coverage to make sure it aligns with your expectations and requirements.

Insurance companies regularly update their networks, change their formularies, and adjust their coverage terms. Without regular reviews, you might miss important changes that could affect your access to care or your out-of-pocket costs.

Signs you need an insurance check-up

There are a few red flags that suggest it’s time to review your health insurance coverage:

1. Your healthcare needs have changed since last enrollment, such as recent medical issues, new medications, or a recent expansion of your family. These life changes often require adjustments to your coverage so that you’re getting the care you need at the best possible rate.

2. You’re unsure about your current coverage. If you can’t confidently say what your plan covers or what your out-of-pocket expenses might be, it’s time for a review. Understanding your coverage shouldn’t feel like solving a puzzle – if it does, you could benefit from some expert guidance and clarification about your coverage.

3. Your preferred healthcare providers or medications have changed. Network changes can affect your ability to see specific doctors or obtain certain medications at preferred rates. A review can help ensure you maintain access to the care and prescriptions you need without unexpected costs.

4. Your employer has experienced growth or restructuring. Changes in employee numbers or company structure can impact group insurance plans and might open up new, more beneficial options.

What to expect during your insurance check-up

A comprehensive insurance review examines your plan in a few key areas:

Network Evaluation

This is a thorough examination of your current healthcare providers and whether they remain in-network. This includes primary care physicians, specialists and preferred hospitals. Your broker will help identify any potential network changes that could affect your access to care and suggest alternatives if needed. They’ll also look for opportunities to optimize your network access based on your specific healthcare needs.

Prescription Coverage Review

By conducting an in-depth analysis of your current medications and their coverage status, your broker can help you identify if there are more cost-effective options available, or if recent changes might affect your out-of-pocket expenses. They can also help you understand if there are pharmacy benefit programs or mail-order options that could save you money while maintaining access to your necessary medications.

Cost Analysis

A cost analysis is a detailed review of your premium costs, deductibles, and out-of-pocket maximums compared to your actual healthcare usage and budget. This analysis goes beyond simple premium comparisons by looking at your actual total healthcare spending and identifying opportunities for savings. Your broker will help you understand how different plan structures might affect your overall costs based on your specific healthcare needs.

Benefits Assessment

This is a comprehensive evaluation of whether your current benefits align with your needs, including specialized services, mental health coverage and wellness programs. This assessment looks at both your current healthcare requirements and anticipates potential future needs to ensure your coverage provides enough protection for the coming year.

The value of professional guidance

While you might be tempted to handle this kind of review independently, working with a licensed health insurance broker can provide invaluable insights and save you considerable time and effort. Brokers stay current with market changes, policy updates, and new offerings from different insurance providers. And much like you’d call an accountant to do your taxes, or an attorney for a legal matter, brokers know the health insurance landscape inside and out, and will look out for your interests.

One common misconception is that working with a broker adds extra costs to your actual insurance. However, this isn’t the case. “The best part is it doesn’t cost you anything extra to work with us. You can go to the carrier or you can go to us directly. Those premiums are the same,” says Yates.

Making the most of your check-up

To maximize all of the benefits of getting an insurance review, you should come prepared with the following:

– Gather together your current plan documentation and any recent medical bills or prescription costs. This information helps your broker understand your current healthcare spending patterns and so they can identify potential areas for savings.

– List any changes in your healthcare needs or preferences over the past year. Include new medications, healthcare providers, or potential future medical procedures.

– Don’t be shy about asking questions pertaining to your coverage, or discussing areas that you find confusing or concerning. Your broker can help clarify complex terms and ensure you fully understand your benefits.

– It’s a sensitive topic for most, but be ready to discuss your budget and any financial constraints affecting your healthcare decisions. This helps your broker find solutions that balance coverage and your costs effectively.

Making sure your coverage works for you

For the average person, healthcare needs are always evolving, and insurance options will continue to expand and change. By maintaining regular check-ups of your coverage, you can ensure that your health insurance remains a useful tool in maintaining your personal health and well-being — rather than becoming an obstacle to accessing care.

Remember, just as you wouldn’t skip your annual physical, don’t overlook the importance of reviewing your health insurance coverage. If you haven’t yet had a chance to get an insurance check-up, there’s still time. You can revisit your coverage and make changes that will take effect on February 1. But it’s important to reach out for an appointment well before the January 15 deadline.

Now is the time to get a handle on your current and future health insurance needs with a professional who cares about your well-being. “When you call us, you’re going to get a real human that answers the phone, and that real human is going to connect with you and care about you, learn about your family, and figure out what you need,” says Yates.