2026 Marketplace Exit

General FAQ

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 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.
  

Provider FAQ

Have CCHP members been notified of this change? 

• Yes, members have been notified. You can review the member FAQ by using the link at the bottom of the page

I would like to read the provider letter. 

• View the provider letter

I'm a provider for both Medicaid and IFP members. Will my day-to-day business have any noticeable changes for the remainder of 2025?

• No, we anticipate no disruption to your day-to-day business processes and operations will remain the same. Please continue to follow the same process for submitting claims and contacting provider services. This information can be found on the provider resources page.

Will my provider agreement need to be amended to remove the IFP product line?

• No, your CCHP provider agreement does not need to be amended. If your contract is for IFP only and you would like to participate in our Medicaid network, please contact the Contracting department at contracting@chorushealthplans.org. 

I'm a new provider and I have updates to one or more of my demographics such as address, phone number, or email. Should I continue to send changes?

• Yes, if you are a new provider that has been added to the CCHP network prior to 12/31/25 and plan to see CCHP IFP members then you'll need to be added to our database.

I'm a provider that is scheduled to be recredentialed in the coming months, do I need to go through the recredentialing process? 

• Yes, if you are an IFP provider and you are due to be recredentialed prior to 1/1/2026, you will need to complete the recredentialing process to continue seeing IFP members.

Will the process for using CCHP's GuidingCare Auth Portal for authorizations change?

• No, this process will remain the same.