Health insurance rate increases proposed

The Pennsylvania Insurance Department (PID) today announced that 2025 rate changes requested by insurance companies currently operating in Pennsylvania's individual and small group markets are now available online. This initiative upholds the Shapiro Administration's commitment to providing consumers with the information they need when shopping for health insurance.

Rate filings for 2025 health insurance plans were submitted to PID on May 15, 2024. Ever since, PID has been working with insurers to review these insurance companies' proposed rate changes, as rates vary by plan and region and are subject to change by the Department to ensure rates are adequate and fair. Final approved rates will be made public in the fall.

"The Shapiro Administration continues to stress the importance of keeping consumers informed," said Pennsylvania Insurance Commissioner Michael Humphreys. "At PID, we see the true value in transparency at every point in the rate review process. This is why we make it a point to let Pennsylvanians know – each year – about the proposed rate increases their insurers are requesting. In doing so, we're hoping to build on the trust we've already gained from consumers, while also doubling down on our mission to keep their best interests at the forefront."

Insurance companies offering individual and small group health insurance plans are required to file proposed rates with PID for review and approval before plans can be sold to consumers, serving as an important consumer protection. The Department reviews rates to ensure that the plans are reasonably priced – not excessive or inadequate – and are not unfairly discriminatory.

One reason health insurers are required to annually file their plans is to allow for the plan-pricing to reflect the expected claims and operational costs for the upcoming year. For Plan Year 2025, general reasons for the requested rate increases, as filed by insurers, center around increases in medical unit costs. This includes rising drug costs, increased labor costs in the health care industry, and the utilization of medical services.

Most insurer proposed rate change requests show an average premium increase around 8%, which appears to be lower than the national average. The proposed rates may not reflect final reinsurance or risk adjustment amounts due to flexibilities provided to insurers to submit data needed to calculate the adjustments.

Insurers who are currently selling in the individual market that propose selling plans in 2025 have filed plans requesting an average statewide increase of 7.9%. The rates are rounded to the nearest tenth and vary by region (rating area) as indicated in the filings:

Capital Advantage Assurance Company (Rating areas 6,7 and 9; average rate request 6.5%)

Geisinger Health Plan (Rating areas 2,3,5,6,7 and 9; average rate request 11.2%)

Geisinger Quality Options (Rating areas 2,3,5,6,7 and 9; average rate request 7.4%)

Health Partners Plans "Jefferson Health Plans" (Rating areas 6 and 8; average rate request 2.9%)

Highmark Benefits Group Inc. (Rating areas 3 and 8; average rate request 12.8%)

Highmark Coverage Advantage Inc. (Rating areas 1 and 4; average rate request 13.0%)

Highmark Inc. (Rating areas 1,2,4,5,6,7 and 9; average rate request 8.8%)

Independence Blue Cross (QCC Ins. Co.) (Rating area 8; average rate request 8.6%)

Keystone Health Plan Central (Rating areas 6,7 and 9; average rate request 15.2%)

Keystone Health Plan East Inc. (Rating area 8; average rate request 8.8%)

Oscar Health Plan of PA (Rating Areas 3, 6, 7 and 8; average rate request 4.4%)

Pennsylvania Health & Wellness Inc. (Rating areas 3,6,7 and 8; average rate request 6.2%)

UPMC Health Coverage Inc. (Rating areas 1 and 5; average rate request 7.0%)

UPMC Health Options Inc. (Rating areas 1,2,3,4,5,6,7 and 9; average rate request 4.8%)

Insurers in Pennsylvania's small group market have filed 2025 plans requesting an average statewide increase of 7.8 percent.

In the proposed 2025 individual and small group market filings, the following expansions have been filed:

Geisinger Health Plan and Geisinger Quality Options propose expanding into Franklin County (individual and small group markets)

Health Partners Plans Inc. proposes expanding its individual ACA market offering into Delaware, Lehigh, and Northampton counties

Pennsylvania Health & Wellness Inc. proposes expanding its individual ACA market offering into 11 counties: Blair, Cambria, Clarion, Clearfield, Centre, Elk, Fayette, Huntingdon, Jefferson, Somerset, and Westmoreland.

Public comment on rate requests and filings will be accepted through September 2, 2024, and can be emailed to [email protected].

Rate filings for 2025 health insurance plans were submitted to PID on May 15. Proposed rate changes vary by plan and region and are subject to change as the department conducts its review process. Final approved rates will be made public in the fall.