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2027 CopayGo Expansion: Additional ASO Offerings and Fully Insured Products
Effective date
Jan 1, 2027
Identified
Oct 27, 2026
Summary
Highmark is expanding its CopayGo health plan in 2027 to include new product options: ASO clients will gain access to EPO and QHDHP designs (in addition to the existing PPO), and fully insured EPO and PPO products will become available in Delaware, New York, and Pennsylvania. Providers should verify member plan types and tiered copay designations (enhanced vs. standard) through Availity, as these affect member cost-sharing but not provider reimbursement.
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What to do
Action · 4 steps
01Beginning 2027-01-01: Billing and eligibility verification staff should update their familiarity with CopayGo plan variants (PPO, EPO, QHDHP) and verify member enrollment status and provider designation (enhanced or standard) through Availity Essentials or 270 inquiries at point of service.
02Staff should confirm whether individual providers in the practice are designated as enhanced or standard by consulting the CopayGo Health Plan page on the Provider Resource Center (PRC).
03This change affects member copay amounts at point of service but does not alter provider reimbursement.
04No billing workflow changes are required, but front-desk and eligibility staff should be trained to recognize the new plan designs and communicate correct copay amounts to members based on provider designation.
Original notice
2027 CopayGo Expansion: Additional ASO Offerings and Fully Insured Products
providers.highmark.com · Always check the source before changing claims.