What's new in 2026!

What's new in 2026!

For All Employees:

  • Change to Family Tier Structure – The Committee has decided to make a change to our family tier structure that more accurately reflects who is covered. This change will add a tier for those employees that are only enrolling a child or children which we did not have before. In addition, the 4-tier structure better aligns premium costs with actual healthcare usage by family members. This change also puts us in line with what other comparable counties and private sector companies are doing. (This change does not impact DSG or CDG)
    • Employee only
    • Employee + spouse
    • Employee + child(ren)
    • Employee + spouse + child(ren)
  • Increased Deductible and Out-of-Pocket Max for HDHP Plans – Per IRS rules, the deductible under the high-deductible plans (Kaiser and Regence) is increasing to $1,700 for employee only and $3,400 for family (previously $1,650/$3,300). The Out-of-Pocket max is also increasing to $3,400 for employee only and $6,800 for family (previously $3,300/$6,600).
  • Increased Healthcare FSA Annual Contribution Limit – The Healthcare Flexible Spending Account (FSA) annual contribution limit is increasing to $3,400 (previously $3,300).
  • Increased Dependent Care FSA Annual Contribution Limit - The Dependent Care Flexible Spending Account annual contribution limit is increasing to $7,500 (previously $5,000).
  • Increased HSA Contribution Limits – The Health Savings Account (HSA) annual contribution limits are increasing to $4,400 for employee only and $8,750 for family (previously $4,300/$8,550). Employees over age 55 can contribute an additional $1,000 per year.

For Regence Members:

  • Changed all telehealth (virtual) appointments to zero cost – Virtual visits and MDLive are less expensive than traditional in-office visits and are often more convenient for members. In 2026, employees in the PPO plan will pay zero cost for virtual visits, including mental health appointments, and those enrolled in the High-Deductible plan will pay zero cost after the deductible is met.
  • Hormone Therapy Covered at 12-month Supply – Previously under the pharmacy benefits, hormone therapy was covered at a 90-day supply at a time. New legislation allows for a 12-month supply to be covered at a time if requested by the provider.
  • Visit Limit Removed for Nutritional Counseling – There was previously a limit of 3 visits per year for nutritional counseling. That limit has been removed.
  • Coverage for Continuous Glucose Monitors (CGM) Now Subject to Deductible – Under the High-Deductible plan, coverage for CGM’s is now subject to the deductible. CGM’s continue to be covered under the pharmacy benefit as well.
  • Diagnostic and Supplemental Radiology for Breast Exams with a Cancer Diagnosis – For those with a cancer diagnosis, diagnostic and supplemental radiology breast exams are no longer at zero cost but are subject to normal cost share.

For Kaiser Members:

  • Changed In-Office Mental Health Visits to Zero Cost  – Being able to access mental health services is extremely important for our employees and their families. To remove any possible cost barrier, the cost of an in-office mental health appointment will move to zero cost. In 2026, employees in the Traditional plan will pay zero cost for in-office mental health appointments, and those enrolled in the High-Deductible plan will pay zero cost after the deductible is met.
  • Hearing Aid Coverage Change – The yearly allowance for hearing aids will be replaced with a cost share instead of the allowance.
  • Newborn Coverage Extended – Newborns are now covered automatically for 31 days instead of 21 days after birth.
  • Diagnostic and Supplemental Radiology for Breast Exams with a Cancer Diagnosis – For those with a cancer diagnosis, diagnostic and supplemental radiology breast exams are no longer at zero cost but are subject to normal cost share.
  • Nitrous Oxide Coverage Change – Under the dental plan, the cost share of nitrous oxide for members under 12 years of age will increase from $0 to $25 to match the cost share of members over 13.
  • Emergency Dental Coverage – Under the dental plan, emergency dental care from non-participating providers will now be charged at the same rate as nonemergency dental instead of paying for all charges over $100 like it was previously.
  • Composite Fillings on Back Teeth Now Covered – Under the dental plan, composite fillings on back teeth are now covered the same as routine fillings. This removes the buy-up cost for composite fillings on back teeth.

If you have any questions about any of these changes, please contact the Benefits team at Benefits@clark.wa.gov.