Beyond Open Enrollment: Your Growth and Client Nurturing Checklist
By Jói Sigurdsson is the CEO of CrankWheel
The phones won’t stop ringing. Your calendar’s a wall of back-to-back appointments. Every conversation feels like a race against the clock.
Welcome to open enrollment. The make-or-break season for insurance agents. But, here’s the twist: the real money and long-term loyalty aren’t built in these frantic weeks alone. They’re earned in the moments after the dust settles.
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Children’s Hospital Los Angeles’ unique model to unite NICU leaders and elevate care
During the COVID-19 pandemic, Kathy Van Allen, MSN, RN, administrative director of the Fetal and Neonatal Institute at Children’s Hospital Los Angeles, recognized a growing need for stronger support systems for NICU nurse leaders navigating extraordinary pressures.
The NICU is an intense care environment, with leaders facing unique challenges related to high-acuity care, staffing, regulatory demands and supporting teams in a highly demanding setting.
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IRS employer health insurance ‘pay-or-play’ penalties to rise 15.2% in 2026
The new numbers will affect what some employers owe if employees apply, and get, federal premium subsidies.
The Internal Revenue Service said Tuesday that it will increase two figures that could be used to calculate employers’ health-benefits-related “pay or play” penalty payments by 15.2%.
The agency is changing one of the penalty-calculation factors to $3,340 in 2026, from $2,900 this year, and the other factor to $5,010, from $4,350, according to IRS Revenue Procedure 2025-26.
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PBM market dominated by four giants, raising concerns about costs, competition
Nine of the 10 largest PBMs share ownership with health insurers.
The nation’s four largest pharmacy benefit managers control two-thirds of the market. This high concentration, along vertical integration between PBMs and insurers, may contribute to higher prices and lower reimbursement rates, according to a new report from the American Medical Association.
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Considering a Life Change? Brace for Higher ACA Costs
People thinking about starting a business or retiring early — before they’re old enough for Medicare — may want to wait until November, when they can see just how much their Affordable Care Act health insurance will cost next year. Sharp increases are expected.
Premiums for ACA health plans, also known as Obamacare, which many early retirees and small-business owners rely on for coverage, are going up, partly due to policy changes advanced by the Trump administration and Congress. At the same time, more generous tax subsidies that have helped most policyholders pay for coverage are set to expire at the end of December.
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MEDICARE
UnitedHealthcare to exit certain Medicare Advantage markets as costs balloon, impacting 600K enrollees
UnitedHealthcare CEO Tim Noel offered investors a deeper look at the medical cost spike that’s plaguing the insurance giant’s finances.
He said during the company’s earnings call Tuesday morning that pricing assumptions set by the company “were well short of actual medical costs” for 2025. UHC’s current outlook, he said, instead reflects an additional $6.5 billion in medical costs, with more than half, or about $3.6 billion, coming from its Medicare plans.
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Reminder: ICYMI (In Case YOU Missed It!)
August 2025 California Broker Magazine
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