2026 Marketplace Exit

General FAQs

What is happening?

• Chorus Community Health Plans (CCHP) is exiting the Individual and Family Plan (IFP) market (also referred to as Marketplace, Exchange and ACA) and will no longer offer health insurance coverage for IFP members after December 31, 2025.

Why is Chorus Community Health Plans (CCHP) exiting the Individual and Family Plan (IFP) market?

• CCHP has made the decision to discontinue its IFP product at the end of this calendar year. This strategic decision allows CCHP to focus our resources and efforts on our core Medicaid lines of business, which have been foundational to our mission and organization since the inception of CCHP in 2006.

What process did CCHP go through to decide to exit the IFP market?

• CCHP implemented numerous cost-saving measures to continue to offering a comprehensive and affordable health insurance product to our members. While several of our efforts were successful, the significant increases in pharmaceutical and medical costs, led to this decision.

When will CCHP’s Individual and Family Plan end?

• Individual and Family Plan members’ coverage will end on December 31, 2025. Individuals that need coverage after this timeframe will need to search for a new plan during Open Enrollment, which begins November 1, 2025. CCHP’s Individual and Family Plan will not be an option on healthcare.gov for the upcoming Open Enrollment period for benefit year 2026.

Does CCHP plan to re-enter the IFP market at some point in the future?

• Per Centers for Medicare and Medicaid Services regulations, carriers that exit the IFP market are not allowed to re-enter the IFP market for 5 years. The earliest CCHP could re-enter the IFP market is 2031 and will evaluate any re-entry decision at that time.

Will CCHP still offer Medicaid coverage?

• Yes, CCHP has been participating in the BadgerCare program for children, adults, and families since our inception in 2006. In fact, we continue to expand our Medicaid service area throughout Wisconsin and look forward to serving Medicaid beneficiaries across the state. More information on CCHP’s Medicaid coverage can be found here.

What is the Communication Plan and Timeline for notification to CCHP IFP members, providers, and partners?

• General Agents and Brokers will be notified via email June 17-June 18, 2025.
• Members will be notified by a letter mailed to their homes on or before June 23, 2025.
• Providers are being notified by letter mailed on June 23, 2025.
• Partners and vendors are being notified by CCHP’s Legal Department, and/or their CCHP business contact throughout June and July of 2025.
• Additional communications to our members and providers will occur through a variety of sources, including email, letter, newsletter, texts and/or phone calls, and via the website.

Where can I go for more information or with questions?

• Information about CCHP’s market exit is available on CCHP’s website at chorushealthplans.org.
• IFP members who have questions can be referred to the IFP team at 844-708-3837, their broker, or healthcare.gov at 800-318-2596.
• IFP Customer Service and Brokers should attempt first call resolution. If needed, they can reach out to the IFP team at 844-708-3837.
• IFP Providers can reach out to CCHP Provider Relations at cchpproviderrelations@chorushealthplans.org.
• IFP Partners and vendors can reach out to their designated CCHP business contact.
  

Member FAQs

Does CCHP exiting the market impact my current 2025 coverage?

• No, current coverage will remain in effect until the end of 2025 so long as premiums are paid. CCHP will be exiting the Individual and Family Plan market on 12/31/2025 meaning any current coverage will not be renewed into 2026. Thereafter, alternative coverage options will need to be pursued either through the Federal Marketplace or through a broker.

What are key dates I need to be aware of?

• 11/1/2025 – The start of the 2026 open enrollment period where shopping for a new health plan can begin.
• 12/15/2025 – Last day to enroll in a new plan elsewhere for coverage beginning  January 1, 2026.
• 12/31/2025 – The final date of coverage for members currently enrolled in the CCHP Individual and Family Plans.

What should I consider when looking for a new Individual and Family Plan?

• The primary criteria to be aware of when shopping for a new health plan are premium, provider network make-up, and prescription drug coverage.
  • From a provider network standpoint, it’s important to ensure that your current provider(s) and associated facilities will be part of your new health plan.
  • Prescription drug coverage can vary widely by issuer. Knowing if and how your medications are covered under a new health plan is very important. You may want to inquire with a prospective health plan as to what tier your medications fall under as that will have a direct impact on your cost.
  • Other important things to be aware of when shopping for a new health plan are: what is the cost share make-up of the plan (i.e. what is the deductible, out-of-pocket max, specific copays, etc.), are any benefits/services you require to be covered excluded, do they offer health management programs to support a healthy lifestyle, etc.

Will I be referred or mapped to another company and plan? What if I want to switch?

• When Open Enrollment begins, you can search for and select a new health insurance plan. If you have an on-exchange health plan and do not enroll in a new health plan on your own, CMS may automatically assign you to a new health plan with another issuer. If this happens, you can still change health plans and select whatever option you are eligible for. Consider asking a broker or local independent health care navigators for help as referenced below.

Who can I ask for help finding a new insurance plan?

• CCHP’s Member Sales team can help connect you with a local insurance broker in your area to help you shop for a new health plan. The Member Sales team can be reached Monday – Friday from 8:00 a.m. – 4:30 p.m. CST at 1-844-708-3837.
• Visit HealthCare.gov when Marketplace Open Enrollment begins on November 1, 2025, or contact the Marketplace Call Center directly at 1-800-318-2596 to review your options.
• Wisconsin-located health coverage navigators and assisters can also help support your search. They can be found by visiting WisCovered.com.

Will there be more information shared? Where and when?

• Information on CCHP’s Individual and Family Plan market exit will be communicated out to members via a US Mail notice the week of June 23rd. That notice will include both a CMS mandated notice as well as an accompanying cover letter.
• In addition, CCHP will include updated information on this webpage as well as through upcoming member newsletters..

What happens if I have an issue with a claim or need to appeal something after 12/31/2025?

• CCHP is committed to ensuring the highest level of member satisfaction through this transition and as such, will be available to support members inquiries of all kinds, including claim disputes or appeals even after 12/31/2025. CCHP will continue to keep our website updated with any new information and will update you if anything changes.

What happens to unused HSA funds?

• Any funds in a Health Savings Account are yours to keep. Health Savings Accounts are administered outside of CCHP and any funds within the account may remain or be used to pay for qualified medical expenses.
• To be eligible for Health Savings Account contributions, the IRS stipulates that you need to be enrolled in a High Deductible Health Plan. That said, if you are no longer enrolled in a High Deductible Health Plan after 12/31/2025, you will no longer be eligible to contribute to your existing Health Savings Account.

What happens to my wellness points after 1/1/2026? Do I have to redeem them before 12/31/2025?

• Members are encouraged to redeem any accrued wellness points before 12/31/2025. The redemption process can be initiated through the CCHP wellness portal or over the phone by calling the health promotion team at 414-266-3636.
• After 1/1/2026, wellness points will only be redeemable by emailing the health promotion inbox at healthpromotion@chorushealthplans.org.

Where can I download my personal information from CCHP?

• The CCHP member portal (CCHP Connect) will stay live through the end of 2025. Information contained therein such as explanations of benefits, invoices, payment records, etc. can be viewed and downloaded through 12/31/2025 at which point the portal will no longer be accessible.
• Members can currently also use App Connect to access health records.

What happens to my PHI or medical information that CCHP has access to after 1/1/2026?

• CCHP is committed to protecting your personal privacy and will continue our commitment into 2026. More information on CCHP’s privacy policy, along with how to request a copy of your protected health information (PHI) can be found here. 
• CCHP also allows for members to authorize appointed representatives to access their PHI if required. A PHI release form can be found in the member materials section of our website here. 

Will I still receive my 1095 next year?

• Yes, 1095A’s (on-exchange) and 1095B’s (off-exchange) will be sent out in early 2026 to your address on file. Questions related to 2025 1095A’s should be directed to the Marketplace at 1-800-318-2596. Questions related to 2025 1095B’s should be directed to Customer Service at 1-844-201-4672.

If I have Marketplace related questions, where can I go?

• Any Marketplace related questions such as questions on advanced premium tax credits/subsidies, taxation, etc. may be directed to the healthcare.gov member services team at 1-800-318-2596.

Who can I ask for help with other questions I may have in the future?

• Until 12/31/2025, questions regarding your current 2025 coverage can be directed to Customer Service at 1-844-201-4672.
• CCHP will continue to keep our website updated with any new information and will update you if anything changes.
  

Questions?

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