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6 MA Regional PPO Benchmarks Per section 1858(f)(2) of the Act, the standardized PPO benchmark for each MA region is a sum of two components: (i) a statutory component consisting of the weighted average of the county capitation rates across the region for each appropriate level of star rating; and (ii) a competitive, or plan-bid, component consisting of the weighted average of all of the standardized A/B bids for regional MA PPO plans in the region. (Such regional MA plan bids relate to the benefits covered under Parts A and B of Medicare.) The two components are then summed for each region, with the statutory component reflecting the national market share of Traditional Medicare and the regional MA plan-bid component reflecting the market share of all MA organizations in the Medicare population nationally. In other words, the weights used in combining the statutory and competitive components of the benchmark are the same for all regions and are equal to the national enrollment percentages, respectively, for Traditional Medicare and all MA plans. For CY 2026, the national weights applied to the statutory and plan-bid components are 45.6 percent and 54.4 percent, respectively. The separate weighted-average statutory component and weighted-average competitive component in each region are determined based on the following weights: • The weighting for the statutory component is based on all MA eligible individuals in the region — i.e., all Medicare beneficiaries who are either in the traditional, fee-for-service Medicare program or enrolled in an MA plan and who are entitled to benefits under Part A and enrolled in Part B. • The weighting for the plan-bid component is based on the enrollment in regional MA plans in the region for the reference month of June 2025. (That is, the weight for each plan’s bid is based on the plan’s market share in the region.) As stated in the Advance Notice of Methodological Changes for Calendar Year 2026 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies (“2026 Advance Notice”) and Announcement of Calendar Year 2026 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies (“2026 Rate Announcement”), these benchmarks reflect the average bid component of the regional benchmark excluding EGWPs. The statutory and plan-bid components of the MA regional standardized benchmarks for 14 of the 26 MA regions1F2 are in the file Regional Rates and Benchmarks 2026, which can be accessed on the CMS website through the following link: https://www.cms.gov/files/document/regional- rates-and-benchmarks-2026.pdf.

MA Regional EGWP Payment Rates In accordance with the payment methodology finalized in the 2026 Rate Announcement, the 2026 EGWP Regional payment rates are being released concurrently with this 2026 MA Regional benchmark release. For detailed descriptions of the payment policy finalized for 2026, please refer to the 2026 Advance Notice and 2026 Rate Announcement: https://www.cms.gov/ medicare/payment/medicare-advantage-rates-statistics/announcements-and-documents.

2 In the remaining twelve MA regions, there are no regional MA plans.