Open enrollment begins: What you need to know | Articles

Open enrollment for health insurance opens next month amid many changes to healthcare and the Virginia Insurance Market.

Open enrollment is an annual window during which people can sign up for health insurance and adjust or cancel their current plan, which mostly applies to individual and family Health Insurance Marketplace plans. Open enrollment for the Virginia Insurance Marketplace starts on Nov. 1 and ends on Jan. 29, 2027.

Lydia Allen, the director of community health at Northern Virginia Family Services (NVFS), said that families have many questions as they access the insurance marketplace, such as how long each coverage period is, what services are covered by the proposed plans, and the differences between private and publicly subsidized insurance, since some of the private insurance carriers are also providers for Medicaid.

According to Allen, one of the biggest barriers for choosing health insurance is understanding how the coverage works.

“The terminology is complex, and so we really take the time to meet with the individuals that we work with one on one to explain the difference between copays, coinsurances, deductibles, premiums, and having people feel confident in understanding what coverage they have. It takes time. It takes many, many appointments,” she said.

Another barrier Allen identifies is how health insurance plans sometimes change year to year.

“The barrier really is just in the complexity of the terminology and the frequency that it changes,” she said.

Allen lists several ways families and individuals can prepare for the insurance market, including reading the mail they receive from their insurance companies and using the online tool at enrollva.org, which provides free and unbiased assistance when browsing insurance plans. Allen also advocates for spreading information about open enrollment via word of mouth.

“Even if you think you’re not in the market to purchase a health insurance plan, maybe you get employer-sponsored insurance or are on public assistance. Maybe a neighbor or a friend could use that information,” she said.

According to an August press release from the State Commission Corporation (SCC), Virginia’s market will have nine insurers, which, according to the 2027 ACA Rates Presentation, are Sentara Health Plans, Sentara Health Insurance Company, Anthem HealthKeepers, Kaiser Permanente, Anthem Health Plans of Virginia, CareFirst, Optimum Choice, Oscar and Group Hospitalization and Medical Services, Inc. (GHMSI). The insurers requested premium rate increases for 2027, ranging from 3.9% to 22.7% above their 2026 rates. Additionally, Cigna Healthcare, which currently accounts for 8% of Virginia’s individual market enrollment, is exiting the individual market in 2027, making it important for consumers who previously enrolled in Cigna plans to choose a new healthcare plan.

“Insurers have identified the elimination of enhanced federal subsidies, market uncertainty, hospital and pharmacy costs, and utilization as driving factors for the proposed increases,” said SCC officials. “These factors are affecting rates in the individual health insurance market across the country, including Virginia. In Virginia’s small group market, insurers are requesting to increase rates an average of 11.7% for 2027.” This comes after a 20.9% rate increase for 2026.

Sentara Health Plans has the highest requested rate increase at 22.7%, with the next-highest requested increase from Oscar at 13.4%. Optimum Choice has the lowest requested rate increase at 3.9%. The actual difference in premium prices that households and individuals will pay depends on factors such as plan choice, the consumer’s age, and whether they qualify for subsidies.

Virginians purchasing in the individual market will have access to both the SCC’s Commonwealth Health Reinsurance Program (CHRP) and the new Virginia Premium Savings Program, both of which aim to lower premiums for individuals and households.

Since its establishment in 2023, CHRP “has reduced rates on average 15% or more below what Virginians would see without the program.” It is funded at both the state and federal level and will remain in place for 2027. Though initially established for a period of five years, the Bureau of Insurance “has started the process to extend the program for an additional five years.”

The Virginia Premium Savings Program is entirely state-funded and was established by the 2026 General Assembly and Governor Abigail Spanberger. Virginians with household incomes between 138% and 250% of the federal poverty level are eligible to receive these savings, with exact savings depending on income, household size, and the plan chosen. 

Open enrollment is the only way to enroll to receive these benefits. Virginia Premium Savings will not limit health plan choices and can supplement federal Advance Premium Tax Credits (APTC) a household may also receive. Savings are on a first-come, first-served basis.

For more information about open enrollment and Virginia-specific health insurance plans, residents can visit marketplace.virginia.gov.