Broker Buzz October 2026
Eliana S. Ramirez Escalante delivers personalized support to Spanish-speaking communities
Based in Richmond, Virginia, Eliana S. Ramirez Escalante, founder of SEINLA LLC, helps Hispanic and Spanish-speaking individuals and families across Virginia navigate health coverage with confidence. Through personalized guidance in Spanish, she helps clients understand their benefits, compare affordable coverage options, and access quality care close to home.
Eliana values Sentara Health Plans' affordable coverage, strong local provider network, and broker resources, which help her better serve the communities she supports. One family she assisted needed affordable coverage and access to trusted local providers. By combining Sentara Health Plans' coverage options with Eliana's personalized support, the family was able to enroll with confidence and better understand how to use their benefits.
"Sentara Health Plans provides affordable coverage options, strong provider networks, and valuable resources that help us better serve our clients," said Eliana. "Together, we're helping families feel confident in their healthcare decisions and coverage."
Important information about changes to Medicaid Expansion
Beginning January 1, 2027, new federal requirements may affect some Medicaid Expansion members. Virginia Medicaid will begin reviewing eligibility every six months instead of every 12 months. In addition, certain adults may need to meet a work requirement or qualify for an exemption to keep their Medicaid coverage.
The biggest challenge is awareness. Many individuals could lose coverage simply because they are unaware of the upcoming changes. This could affect your D-SNP clients, so please help us spread the word.
These changes will be phased in beginning in January 2027 and only apply to Medicaid Expansion members. Medicaid Expansion covers adults who:
- Are ages 19-64
- Have income below 138% of the federal poverty level
- Are not eligible for Medicare
To meet the new work requirement, members must have a qualifying activity. They may meet the requirement by:
- Completing at least 80 hours per month of work, job training, community service, or a combination of these activities.
- Being enrolled at least half-time in an educational program.
- Having a household income of at least $580 per month.
Some Medicaid Expansion members may qualify for a work requirement exclusion or exception. Additional information about exclusions and exceptions is available through Virginia Medicaid resources.
Medicaid eligibility changes for some noncitizen adults
Federal changes to Medicaid eligibility for certain noncitizen adults took effect on October 1, 2026. Under the updated rules, eligibility for full-benefit Medicaid became more limited for noncitizen adults.
To qualify for full-benefit Medicaid after October 1, 2026, non-pregnant adults must be a U.S. citizen or national or be a lawful permanent resident, Cuban-Haitian entrant, or a Compact of Free Association migrant and meet all other Medicaid requirements, such as income limits.
Virginia Medicaid reviewed members who could be affected by these changes and provided notices explaining the new requirements and any actions that might be needed.
Review Eligibility Changes
D-SNP alignment campaign
Sentara Health Plans is supporting the 2027 Annual Enrollment Period (AEP) with updated enrollment materials, refreshed marketing assets, and ongoing broker resources designed to help educate eligible Medicare and Medicaid prospects on the value of D-SNP coverage.
Our statewide D-SNP alignment campaign remains active with ongoing paid media efforts.
Last month, Sentara Health Plans launched a direct mail campaign targeting Sentara Health Plans Medicaid unaligned D-SNP eligible members. The mailing highlighted key benefits including Flex Card allowances, dental coverage, transportation, fitness benefits, and in-home support services, while encouraging members to connect with a Licensed Plan Advisor. Outreach efforts continue as part of our broader strategy to engage and educate eligible members during AEP.
Throughout AEP, brokers can expect continued support to assist current and prospective members in making informed enrollment decisions.
Open Enrollment Period marketing campaign
Sentara Health Plans has launched the Sentara Individual & Family Health Plans (IFP) Open Enrollment Period (OEP) marketing campaign on with tactics scheduled to run through January 29, 2027. Sales and broker support includes the website, annual marketing materials, OEP trifold, and the Buyers Guide. The key markets are Hampton Roads, Richmond, Northern Virginia, Blacksburg, Danville, Harrisonburg, and Lynchburg.
Meet Shavon Johnson, Senior Sales & Account Specialist
Give your clients more reasons to choose Sentara Health Plans
Programs and services available through Sentara Employer Solutions include:
- Onsite clinics
- Occupational health programs
- Executive health physicals
- Behavioral health resources
- Wellness programs
These standalone services give employers more options to support employee health and complement their overall health strategy.
More solutions. More ways to care for employees. More reasons to choose Sentara Health Plans.
For more information about how Sentara Employer Solutions can help your clients support their most important asset, their employees, contact Katharine LeHew at kxlehew@sentara.com.
A new eBroker experience is coming soon!
Get ready for a smarter, faster way to do business. The new eBroker dashboard will put the tools, insights, and resources you use most within easier reach, all in a fresh, intuitive experience designed around you. With streamlined navigation and greater visibility, you’ll spend less time searching and more time serving your clients and growing your business.
Highlights will include:- Quick access to frequently used tools, including Quotes & Enrollment, Commissions, and ID Cards
- A personalized dashboard view with key business insights and reporting
- Streamlined access to member service tools such as Eligibility, Claims Search, and Provider Search
- Centralized resources, including forms, support materials, FAQs, and Broker Buzz communications
- A dedicated section for important announcements, updates, and system notifications
The new, enhanced dashboard will reflect our ongoing commitment to delivering a more efficient and broker-friendly experience while keeping the tools you rely on right at your fingertips. Stay tuned for additional details and launch information.
Employee Navigator best practices for participating brokers
If you use Employee Navigator to manage Open Enrollment for your Sentara Health Plan groups, a few well-timed checks can help elections process accurately and keep renewals on track. Use the checklist below to coordinate key dates, confirm plan readiness, and avoid changes that could delay enrollment or ID card production. If you do not use Employee Navigator, this guidance does not apply to your enrollment process.Open Enrollment Date Checklist
- Understand the dates: The OE Admin Ends Date starts transmission of Open Enrollment elections, while the OE Closeout Date ends the transmission period.
- Confirm timing before every renewal: Review the OE Admin Ends Date, OE Closeout Date, renewal effective date, and plan readiness with ENSupport@sentara.com.
- Verify renewal setup: Confirm that renewal plans, benefit offerings, effective dates, group numbers, and plan mappings match the finalized renewal before elections transmit.
- Allow enough processing time: Schedule the OE Admin Ends Date early enough for the next file transmission, discrepancy review, corrections, enrollment completion, and ID card production before the renewal effective date.
- Request extensions promptly: Contact EN Support as soon as additional enrollment time is needed rather than leaving an incorrect default date in place.
- Coordinate all date changes: Do not change default dates, hard-close, reopen, or extend OE without first coordinating the revised timing with EN Support. These changes can create conflicting records, delay processing, require manual corrections, and affect ID card production.
- Do not transmit before plans are ready: Elections should transmit only after Sentara Health Plan’s renewal plans and mappings are complete.
2027 Broker Guides now available
The 2027 Commercial and Sentara Individual & Family Plans Broker Guides are now available on our Broker Support page. They include policies and guidelines for all lines of business as well as broker resources.
2027 Individual & Family Plans Broker Guide
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