Important Health Insurance Updates You Should Know Before Open Enrollment

Hey there, friends! As your trusted health insurance broker, I promised to keep you informed about upcoming changes in the health insurance world—and 2025 is shaping up to be a year full of updates you won’t want to miss.

Let’s break it down in a friendly, easy-to-understand way so you can be ready well before Open Enrollment hits. Because once the deadline passes, there are no do-overs!

Open Enrollment is Getting Shorter

Mark your calendar: November 1 – December 15, 2025.

That’s your window to enroll, make changes, or switch plans on the Health Insurance Marketplace. After December 15, 2025, you’ll be locked out of the system unless you qualify for a special enrollment period.

Even if your income is below the poverty level, the flexibility we’ve seen in previous years for late enrollments is going away. So now more than ever, it’s crucial to plan ahead.

Extended Tax Credits May Expire

If you’re a middle-class family currently benefiting from the extended tax credits to help pay for premiums, be aware: Congress has signaled that it will not renew these subsidies.

That means higher out-of-pocket premiums could be coming unless legislation changes. If these tax credits have helped your family stay covered, it’s time to contact your local representatives and advocate for continued support. Every voice matters!

Carrier Changes: Who’s Staying, Who’s Going

More carrier shake-ups are happening:

• Cigna is shrinking its service areas, especially outside Austin—including Dallas, San Antonio, and Houston.

• Aetna removed bronze and silver plans in 2025, and now they’ve announced they’re exiting the individual health insurance market altogether by 2026.

If you currently have an Aetna plan, we’ll need to explore alternative coverage for next year. I recommend speaking with your doctor soon to find out which carriers they’ll continue accepting in 2026.

Private PPO Alternatives Still Exist

For those looking for more flexibility, I still have access to private PPO plans with nationwide networks including:

• Anthem Blue Cross Blue Shield

• Aetna (until end of 2025)

• PHCS (Private Healthcare Systems)

These plans offer greater provider access and are available outside of open enrollment if you qualify. However, they typically don’t offer tax subsidies, so we’ll need to weigh the benefits versus the cost based on your health and financial situation.

Self-Employed? Consider Forming an LLC

If you’re self-employed, forming an LLC could open the door to group insurance plans with larger networks and PPO access. Here’s how to make that work:

• You and your spouse can both be on the LLC (or one can be W-2).

• You may qualify for small group insurance with great network access and pricing.

• Group plans can be started any time of year, not just during open enrollment—but you’ll want to set up your LLC now to avoid delays later.

Don’t wait until the busy fourth quarter—get ahead of it now so you’re ready to act when enrollment season hits.

Final Thoughts: Let’s Prep Early and Stay Covered

With all the upcoming changes to plans, tax credits, and carriers, 2025 will be a year to stay proactive about your healthcare coverage.

Let me help you make a smart, informed decision that fits your life and your budget. We’ll talk through all your options—from marketplace plans to private PPOs, to small business group coverage.

👉 Schedule your free consultation today at jkappconsulting.com. Let’s find the plan that works for you.

Until next time, stay well and stay informed!