Sponsored: This story was created in partnership with Tice Health and Life
Open Enrollment Health Insurance Options: What to Know for 2026
Open Enrollment health insurance options can feel overwhelming. You’re trying to protect your family, control costs, and make the “right” choice with limited time. Community Connector and licensed health insurance agent Derek Tice helps people do exactly that. And this year, he says the rules of the game look different than many consumers realize.
What’s changed for Open Enrollment (2026 coverage)
Derek says the ACA Marketplace has shifted. Subsidies, deductibles, and out-of-pocket maximums changed for many plans. Some households now see higher monthly premiums than they did in recent years.
Another major change affects budgets. The government ended several pandemic-era tax credits that lowered premiums for many families. As a result, some people will pay more to keep similar coverage.
Derek also wants consumers to understand one big truth early. The Marketplace is not always the only option. “The most important thing to know,” he says, “is that there are more options available this time of year besides the ACA Exchange.” That single point can open the door to better-fitting coverage for some households.
Key Open Enrollment deadlines to know
Deadlines matter because they lock in your choices. Derek urges people to review coverage now instead of rushing at the last minute.
With the Marketplace cutoff set for December 15, consumers should compare plans and submit changes as soon as possible. Missing key dates can limit options. It can also delay coverage changes for the year ahead.
Don’t shop by premium only
Derek sees the same mistake every year. People focus on the cheapest monthly premium and stop there.
He tells clients to look at total risk, not just the bill you pay each month. “People shop for the cheapest premium and don’t look at the max out-of-pocket,” he says. Some low-premium plans still allow a very high maximum financial exposure. A medical emergency can turn into a major money problem fast.
Health insurance should protect access to care. It should also cap what you might have to pay in a worst-case scenario. That’s why Derek pushes clients to compare these items side-by-side:
Out-of-pocket maximums matter
The out-of-pocket maximum helps define your financial ceiling during a serious year. A plan that looks “cheap” can still carry high exposure when you use care.
Deductibles and real-world costs
Deductibles can change from year to year. So can copays and coinsurance. Derek wants people to estimate what they would pay in a normal year and a rough year.
Check networks the right way
Provider networks change. Plan types change too. Derek warns people not to assume their current plan still fits just because it has the same brand name.
He also tells families to be specific when they check doctors. “Just asking if your pediatrician takes Blue Cross Blue Shield doesn’t mean anything,” he notes. “They may only accept certain types of plans: PPO, private, or group.”
PPO vs HMO vs other plan types
Two plans can share an insurance company name and still work very differently. Derek helps clients confirm the plan type and the network attached to it. Then he checks whether key providers actually accept that specific plan.
Special Enrollment Periods (life changes that qualify)
Open Enrollment is not the only window for coverage changes. Certain life events can open a Special Enrollment Period, often giving people 60 days to update coverage.
Common triggers include:
Marriage or divorce
A new baby, adoption, or foster placement
Loss of employer coverage
Major income changes
Release from incarceration
In some cases, the Marketplace requires documentation. Derek helps clients gather what they need and choose the best route based on timing and cost.
Know your best path: COBRA, Marketplace, or private alternatives
When someone loses employer-based insurance, stress spikes. The options can feel confusing. Derek guides clients through the main paths and explains tradeoffs in plain language.
COBRA can help some people keep continuity. It can also cost more than expected. The Marketplace can work well for some households, especially with subsidies. Private alternatives may also exist for certain situations. Derek evaluates the full picture before recommending a direction.
Why Derek Tice helps clients plan differently
Derek’s approach comes from personal experience. Before he worked in insurance, he was self-employed. He used the Marketplace for his own coverage. Then an unexpected medical issue hit.
In December 2017, he received an $1,800 urgent care bill even though he had insurance and barely used it. The experience frustrated him. It also pushed him to act. By February 2018, he became a licensed agent. He wanted to help others avoid surprise costs and confusing coverage.
Leadership rooted in service
Derek manages a team of agents. He focuses on accountability and strengths. “We work toward a goal,” he says. “My job is to hold them accountable to what they want, not what I want.”
He believes the best agents lead with service. When they truly care about clients, results follow.
That mindset shows up in how he mentors people, too. In a prior moving and storage business, Derek coached a young man from a difficult background. The employee grew quickly through steady support and real responsibility. A commercial client later hired him away with better pay and room to grow. Derek felt proud, not bitter. He still tells the story because it reflects what happens when someone believes in you.
The most important message for consumers right now
Derek wants consumers to remember one thing during Open Enrollment: you have more options than you think. Many people assume the Marketplace is the only path. Others assume they can’t get coverage without strong tax credits.
Derek disagrees. He urges people to avoid the noise and talk to a professional. “Don’t listen to the talking heads,” he says. “Get with a professional.”
One final tip before you choose a plan
Derek’s advice is simple and direct:
Know all your options
Work with a licensed agent
Compare risk, not just price
He also reminds people of this: his guidance costs clients nothing. “The guidance is always free,” he says. “The insurance companies pay us, not the clients.”
