Anthem Is Discontinuing Small-Group ACA Health Plans in Ohio for 2027

Anthem small-group ACA plans in Ohio will no longer be available after December 31, 2026.

Employers currently enrolled in one of these plans do not need to make an immediate coverage change. Anthem has stated that coverage will continue through the end of each group’s current policy term.

The announcement will still require affected employers to choose a new direction for coverage renewing in 2027.

This may be challenging, particularly when employees rely on specific physicians, hospital systems, prescriptions, or ongoing care. The first step is to confirm when the current policy ends and begin reviewing the options that may be available to the business.

At a Glance

• Anthem’s Ohio small-group ACA medical plans will no longer be available after December 31, 2026.
• Existing coverage will continue through the end of the group’s current policy term.
• Anthem will send notices to affected employers and members.
• Anthem says groups with dental or vision coverage will receive renewals and can continue those benefits as stand-alone coverage.
• Affected employers may need to consider another ACA plan, a MEWA, a level-funded plan, an ICHRA, or another direction.
• If an affected group considers a different Anthem product, it should confirm the provider network, since networks can vary by plan.
• The review should begin early enough to compare options and communicate clearly with employees.

What Is Happening to Anthem Small-Group ACA Plans in Ohio?

Anthem has notified brokers that its small-group ACA medical coverage in Ohio will no longer be available after December 31, 2026.

Affected groups will remain covered through the end of their current policy terms. Anthem will send legally required notices to employer groups and impacted members, and the employer notice will direct businesses to work with their brokers to identify new coverage options for 2027.

Anthem has also stated that groups with dental or vision coverage will receive renewals for those benefits and can continue them as stand-alone coverage.

Does Anthem Coverage End Immediately?

No.

Anthem has stated that employees will continue to have access to their current health benefits through the end of the group’s existing policy term, provided the employer continues the coverage and pays the required premiums.

Affected employers should confirm:

• The exact date the current medical policy will end
• Whether dental and vision coverage are also affected
• When the employer and employees will receive formal notices
• When replacement-plan information will become available
• What enrollment and implementation deadlines will apply

No immediate coverage action may be required, but the employer should begin planning early enough to avoid a rushed decision later.

Which Anthem Plans Are Affected?

The announcement applies to Anthem’s small-group ACA medical plans in Ohio.

It does not mean Anthem is leaving every part of the Ohio health insurance market.

Anthem has said it will continue serving Ohio’s individual ACA market. It also continues to offer other employer health coverage arrangements, including Multiple Employer Welfare Arrangements, commonly called MEWAs, and level-funded plans.

Dental and vision benefits can continue separately from the discontinued medical coverage.

The exact effect on each employer will depend on the products it currently has and the end date of each policy.

Why Is Anthem Making This Change?

Anthem has said that small businesses are increasingly looking for coverage options that provide affordability, flexibility, and more predictable costs.

The company has indicated that it is focusing more of its resources on arrangements such as MEWAs and level-funded plans, which Anthem says already serve a majority of its Ohio small-business customers.

That does not mean every employer currently enrolled in an Anthem ACA plan will qualify for or should move to one of those arrangements.

MEWA and level-funded eligibility can depend on factors such as participation, employer contributions, association requirements, medical underwriting, and the characteristics of the group. Each employer’s available options still need to be evaluated individually.

What Should an Affected Ohio Employer Do First?

Begin by confirming the policy end date and gathering the information needed to review the alternatives.

That information may include:

• The Anthem discontinuation notice
• The current medical plan and benefit summary
• Current rates and employer contributions
• A current employee census
• Employee eligibility and participation information
• Current dental and vision coverage
• Important provider, hospital, or prescription considerations

This does not mean the employer should collect private medical details from employees. When plan-specific directories, formularies, and search tools are available, employees can use them to review their own providers and prescriptions privately.

Our guide to what to do when a small business health insurance plan is discontinued in Ohio explains the broader review process in more detail.

What Replacement Options May Be Available?

Affected Ohio employers may have several possible directions.

Not every option will be available to every business. The goal is to understand which paths are realistically available and compare them carefully before making a decision.

Another Small-Group ACA Health Plan

A small-group ACA plan from another carrier may allow the employer to continue offering one traditional group policy without requiring employees to obtain individual coverage.

ACA small-group plans generally use community-rated pricing rather than medical underwriting.

Employers should compare the available 2027 plans based on:

• Provider networks
• Prescription formularies
• Deductibles and out-of-pocket limits
• Copayments and coinsurance
• Employer contributions
• Employee payroll deductions

Carrier participation, rates, networks, and plan availability should be confirmed for the employer’s location and effective date.

A Multiple Employer Welfare Arrangement

A Multiple Employer Welfare Arrangement may provide another group coverage option for qualifying Ohio employers.

Eligibility may depend on factors such as:

• Industry or association requirements
• Employee participation
• Employer contributions
• Medical underwriting
• Minimum enrollment requirements

For employers that meet the requirements, a MEWA may offer a practical path for continuing traditional group coverage.

A Level-Funded Health Plan

A level-funded plan combines elements of fully insured and self-funded coverage.

The employer generally pays a fixed monthly amount that includes estimated claims funding, administrative costs, and stop-loss protection. Depending on the arrangement and claims experience, the employer may also be eligible for a refund or credit.

Level-funded plans usually require medical underwriting.

For employers that qualify, a level-funded plan may offer a practical path for continuing group coverage under a different funding structure.

An Individual Coverage Health Reimbursement Arrangement

An Individual Coverage Health Reimbursement Arrangement, or ICHRA, may offer a different path for an employer that does not want to sponsor another group plan but still wants to help employees pay for health insurance.

The employer establishes a defined reimbursement allowance, and eligible employees obtain qualifying individual coverage. The employer then reimburses them according to the terms of the arrangement.

An ICHRA does not preserve the existing group plan. Employees move to individual coverage, which may have different provider networks, formularies, benefits, and out-of-pocket costs. Its value is that the employer can continue providing meaningful financial support without selecting one group policy for everyone.

Do Not Assume a Different Anthem Plan Uses the Same Provider Network

Anthem’s continued participation in Ohio’s individual health insurance market does not necessarily mean an employee can move from an Anthem group plan to an Anthem individual plan and retain the same provider network.

The Anthem name alone does not determine whether a physician, hospital, or health system will remain in network.

For example, a provider who participates in an Anthem group PPO network may not participate in an Anthem individual HMO network. Different Anthem employer products may also use different networks.

Employers and employees should review the exact network attached to each proposed plan.

When plan-specific directories are available, employees can use them to check their own:

• Primary care physicians
• Specialists
• Hospitals and health systems
• Other facilities

Prescription coverage should also be reviewed separately. When formularies or drug-search tools are available, employees can use them to see how their own medications may be covered under a proposed plan.

Should Employers Consider a Medical Prescreen?

Yes, or at least avoid ruling medically underwritten options out based only on assumptions.

An employer currently enrolled in an ACA plan may assume that a MEWA or level-funded plan will not be available because of concerns about the group’s health history or past claims.

It can be difficult to predict an underwriting outcome without completing the process.

A secure medical prescreen can help determine whether medically underwritten alternatives are realistically available and how they may be priced.

Employees submit confidential health information directly through a secure platform. The employer does not review the individual medical responses.

McCarthy Stevenot Agency offers this prescreening process at no cost and with no obligation. Completing a prescreen does not commit the employer to changing plans.

What If the Employer Does Not Want Another Group Plan?

Some employers may view the Anthem discontinuation as a reason to reconsider whether they want to continue offering an employer-supported health benefit.

An ICHRA provides one way to stop sponsoring a group plan while continuing to help employees pay for qualifying individual coverage. Other employers may decide not to replace the group plan or provide a reimbursement arrangement.

Employers that are not considered applicable large employers under the ACA, generally those averaging fewer than 50 full-time and full-time-equivalent employees during the prior calendar year, are not subject to the ACA’s employer shared-responsibility provisions.

Even when coverage is not federally required, employers may still consider how ending the benefit could affect recruiting, retention, employee compensation, and the people who currently rely on the coverage.

Will Employees Have a Special Enrollment Period?

Employees and dependents who lose qualifying group coverage may have a Special Enrollment Period to obtain individual health insurance.

A new ICHRA offer may also create an opportunity for employees to enroll in qualifying individual coverage outside the normal annual Open Enrollment Period.

Timing matters.

Enrollment windows and effective-date rules still apply. Waiting until after the Anthem group plan ends may delay the beginning of the new individual coverage and create an unintended gap.

If individual coverage will be part of the transition, the employer and employees should address the enrollment timing before the group plan ends.

Frequently Asked Questions

Is Anthem Canceling Our Coverage Immediately?

No.

Anthem has stated that affected groups will remain covered through the end of their current policy terms. Employers should confirm the exact termination date shown in the formal notice.

Is Anthem Leaving Ohio Entirely?

No.

The announcement concerns Anthem’s Ohio small-group ACA medical plans. Anthem has said it will continue participating in Ohio’s individual ACA market and offering other employer health coverage arrangements.

Can We Move to Another Anthem Plan?

Possibly.

Another Anthem product may have different eligibility requirements, medical underwriting, plan designs, provider networks, or administrative rules.

Remaining with Anthem does not necessarily mean the coverage will work the same way or include the same providers.

Will Employees Be Able to Keep Their Doctors?

That depends on the exact provider network attached to the replacement plan.

A physician or hospital that participates in an Anthem group PPO network may not participate in an Anthem individual HMO network or another Anthem network.

Employees should review their own providers using the directory for the exact plan being considered.

Can We Move to Another ACA Small-Group Carrier?

Possibly.

The available options will depend on the carriers participating in Ohio’s small-group ACA market for the employer’s 2027 effective date, as well as the group’s location, eligibility, and participation.

Could an ICHRA Replace the Anthem Group Plan?

Possibly.

An ICHRA allows the employer to establish a reimbursement allowance while eligible employees obtain qualifying individual coverage.

Whether it is a good fit depends on the individual plans available, provider networks, prescription coverage, employer contributions, affordability, employee classes, administration, and the effect on Marketplace premium tax credits.

Can Anthem Dental and Vision Coverage Continue?

Yes.

Anthem has stated that affected groups with dental or vision coverage will receive renewals for those benefits and can continue them as stand-alone coverage.

The employer should still confirm the renewal terms and which policies are affected by the medical-plan discontinuation.

What Is the Next Step?

Anthem’s decision will require affected Ohio employers to make a change, but it does not leave them without options.

Confirm when the current policy ends, determine which alternatives are realistically available, and compare how each direction may affect the business and its employees.

For a complete explanation, see our guide to what to do when a small business health insurance plan is discontinued in Ohio.

If your Anthem small-group ACA plan is being discontinued and you need help reviewing the available paths, contact McCarthy Stevenot Agency. There is no pressure and no obligation to change coverage or brokers.

Related Resources

• What to Do If Your Small Business Health Insurance Plan Is Being Discontinued in Ohio
  Review the complete process for comparing replacement coverage and other possible directions.
• Small-Group ACA Health Insurance in Ohio
  Learn how community-rated small-group ACA plans work.
• MEWA Health Plans in Ohio
  Understand MEWA eligibility, underwriting, pricing, and plan structure.
• Level-Funded Health Insurance in Ohio
  Review how level-funded coverage works and what employers should evaluate.
• ICHRA Health Insurance in Ohio
  Learn how an employer can reimburse employees for individual health insurance.
• Health Insurance Prescreening for Ohio Employers
  Learn how a secure prescreen can help determine whether medically underwritten options may be available.

Important Information

This article reflects information available as of its publication date, including Anthem’s June 2026 notice concerning its Ohio small-group ACA health plans. Employers should review their formal Anthem notices and confirm the termination dates and terms applying to their specific policies.

This article provides general educational information and is not legal or tax advice. Health plan availability, eligibility, underwriting, rates, benefits, provider networks, prescription formularies, enrollment deadlines, and effective dates vary by carrier, plan, employer, and individual circumstances and may change. Final coverage terms are controlled by the applicable carrier materials, plan documents, contracts, and governing rules. Nothing on this page guarantees coverage, approval, pricing, or eligibility.