You can expect minimal changes to the 2026 plan portfolios. The changes introduced include expanding access and enhancing care for pharmacy, virtual provider, and behavior health management.

Enhanced PPO plans with Virtual Blue
Starting January 2026 all Small Group Off-Exchange PPO plans will now have virtual health care through the Virtual Blue ^SM program benefits, replacing Teladoc and NurseHelp 24/7 ^SM upon renewal. A notice of this change will be communicated to members who have utilized Teladoc and/or NurseHelp 24/7 ^SM in the past 12 months.

Additional virtual care features include:

• Preventive care: Connect to primary care healthcare professionals (MDs/DOs), often with a same-day appointment
• Specialist care: Specialists available in 20 specialties, appointments confirmed within three days
• Dedicated 24/7 Care Team: Doctors, behavioral health providers, nurses, and health coaches available to connect around the clock

Visit the Virtual Blue page for more information.

Blue Shield’s Oncology Utilization Management Program
Available to all Small Group Off-Exchange PPO plans upon renewal. Blue Shield will expand its partnership with Evolent in 2026 to launch a new oncology utilization management program. Evolent brings expertise in oncology care management and a proven technology platform to support the highest quality outcomes consistently for members.

Behavioral Health update
Beginning January 1, 2026, Blue Shield will directly manage the behavioral health benefit for all of our members including those receiving Applied Behavior Analysis (ABA) services. This transition enhances overall member and provider experience, ensures high-quality care and builds a whole-person approach by connecting physical and behavioral health. Blue Shield members will experience:

• An expanded quality network of behavioral health providers
• A dedicated behavioral health customer support team
• A connected support system across customer care, claims and care management
• Easier provider search through the Blue Shield portal

Please review the behavioral health FAQs for additional information.

Click here for more 2026 Small Group updates or contact your Amwins Connect Team.