Health insurance marketplace rates rise, with costs offset by subsidies

People enrolled in the Delaware Health Insurance Marketplace will be able to choose from 45 plans from four carriers. Rates will go up, but are offset by subsidies.

The Marketplace is designed for people who cannot get health insurance from their employer, are between jobs or are self-employed.

"Increasing competition, emphasizing primary care, and addressing high-costs claims has helped us create a thriving Delaware Health Insurance Marketplace. Enrollment has increased 77% since 2021, and we continue to benefit from programs that lower consumer premiums" said Delaware Insurance Commissioner Trinidad Navarro. "We continue to ensure that 80% or more of premium is paid toward health care costs, and hold our carriers to important affordability standards. And, we're proud to support efforts to address the impact a lack of providers and competition has on premiums here in Delaware."

During the 2024 plan year, Delaware's Health Insurance Marketplace is serving roughly 45,000 residents, a 29% year-over-year increase from 2023 plans.

After Advance Premium Tax Credits, premiums average $147, a decrease of $50 per month from the prior plan year. A total of 7,971 Delaware enrollees had a premium at or below $10/month. Commissioner Navarro and staff visited D.C. earlier this year to encourage Congress to continue the enhanced premium tax benefits of the Inflation Reduction Act, which saves Delawareans in Marketplace plans an average of $527 per month.

The state also renewed its 1332 State Innovation Waiver with the U.S. Department of Health and Human Services and the U.S. Department of the Treasury. This state-based reinsurance program, now authorized through 2029, projects it will result in the lowering of statewide average premiums by 15.9%.

Rates

Following reviews by staff, independent actuaries, and the Office of Value-Based Health Care Delivery, rates for 45 regulated 2025 Marketplace plans have been announced:

Aetna Health's final average rate increase of about 11.7% is 22.79% lower than their initially filed rate increase request of 34.53%. Their two plans are marketed as offering $0 MinuteClinic and CVS Health Virtual Primary Care.

AmeriHealth Caritas' request to increase rates by 6.05% on average was approved. Their eight Marketplace are promoted as not requiring referrals.

For Celtic Ambetter Health of Delaware's second year on the Marketplace, the company requested a rate decrease of 14%, which was approved. Their 17 Marketplace plans include marketed offerings with connected health savings accounts (HSAs), vision, and dental.

Highmark requested a rate increase of 12.4%, and an average increase of 9% was approved. Highmark markets 17 comprehensive plans and one catastrophic plan which includes three primary care visits. Comprehensive plans include health savings account offerings, as well as connected vision and adult dental coverage.

All ACA-compliant health plans offer essential health benefits, including coverage of pre-existing conditions, prescriptions, emergency services and hospitalization, mental and behavioral health coverage, outpatient care, telehealth, lab services, and more.

Plans on the Marketplace are spread among metal-level categories – bronze, silver, gold, platinum and catastrophic – and are based on how enrollees choose to split the costs of care with their insurer.

Off-market individual offerings include one plan from AmeriHealth Caritas, increasing the requested average of 6.05%. Two off-market plans from Highmark are increasing an average 9% after a 12.4% request.

Delta Dental will increase rates by an average of 6% for two offered marketplace family plans and one off-market pediatric plan. Dominion Dental requested no change to their ACA premiums on their 10 plans, which include pediatric plans.

Off-market small group plan options for the coming plan year will be finalized in October.