Some WNY health insurance rates will stay flat. Others will rise 13.5%

Many consumers and small businesses in Western New York will see increases for health insurance in 2027, but the hikes won’t be as steep as in recent years.

In Western New York, some people and small employers could see premium increases of up to 12% to 13%, but others will see rates that remain flat after the state Department of Financial Services on Friday announced the approved rate actions for 2027.

More so than in past years, the state seemed to keep the requested increases in check. While that’s good news for consumers, health insurance trade groups said the lower-than-requested approved rates do not reflect the actual cost of care and do nothing to fix escalating prices from providers and pharmaceutical companies.

In the individual market statewide, insurers requested an average rate increase of 20.6%, but state regulators knocked that down to 6%. Meanwhile, in the small group market, insurers requested an average rate increase of 23.7%, but the state cut that to 8%.

The rate adjustments affect people who buy individual commercial health insurance and small employers with 100 or fewer full-time workers, together constituting a small slice of members for most insurers. While the rate increases do not affect large employers with more than 100 workers, the situation is indicative of the rising cost of medical care, hospital stays and drug prices.

Here is what the state approved for Western New York’s three largest health plans:

• Highmark Western and Northeastern New York, which includes Highmark Blue Cross Blue Shield of Western New York, wanted an average increase of 23.8% in its individual market – in which it has 2,735 members – but the state approved a 12.2% increase. For small group plans, in which Highmark has more than 35,700 members, the insurer sought an average increase of 9.2%, but the state approved a 0% increase, meaning the rate will stay flat.

• Independent Health requested an average rate increase of 14.2% in the individual market, where it has about 4,000 members, but the state approved no increase. On the small groups, in which Independent Health has 25,000 members, the insurer requested an increase of 11.4%, but the state cut that to 6.2%.

• Excellus Health Plan, which does business in Western New York as Univera Healthcare, sought an average rate increase of 17.2% in the individual market, but was approved for a 12.2% hike. For small groups, Excellus requested an average increase of 17%, but the state cut that to a 13.5% hike. Excellus, based in Rochester, has 17,260 members in its individual plans and more than 137,500 small-group members.

Independent Health said its combined 29,000 individual and small group members represent about 10% of its total membership. Independent Health, which is in the process of affiliating with Schenectady-based MVP Health Care, reported a net loss of $64.2 million on revenues of more than $2.6 billion in 2025, but its results were improving in the second half of the year and into 2026.

“Independent Health always takes an actuarially sound approach when it comes to rating our products which reflect rising healthcare cost trends and the actual medical care and services for our members,” Independent Health spokesperson Frank J. Sava said in a statement Friday. “Although the approved rates differ from our requested rates, we respect the state’s role in reviewing premium requests and share the goal of keeping coverage affordable as healthcare costs continue to rise.”

After four straight years of financial losses, the local Highmark affiliate reported net income of $101 million on revenue of $3.1 billion in 2025.

In a statement Friday, Highmark said health insurance premiums reflect the rising cost of care for members, including hospital and physician services, prescription drugs and advancements in medical technology.

“While Highmark works diligently to manage these costs through operational efficiencies and affordability initiatives, healthcare costs continue to rise across the entire healthcare system statewide and nationally,” Highmark said.

Other insurers with a presence in Western New York also received increases.

That includes Fidelis, which requested a 28.4% increase in the individual market, but was approved for an 8% hike. MVP Health Plan was approved for its requested 10.7% increase in the individual market. MVP wanted a 19.6% increase in the small group market, but it was approved for a 13.6% hike.

Eric Linzer, president and CEO of the New York Health Plan Association, which represents 20 managed care health plans, said the rates the Department of Financial Services approved “fail to fully account for the major factors driving premiums,” such as increases in the prices charged by hospitals, providers and drug companies.

“New York’s healthcare costs are among the highest in the country and the premiums health plans submitted in May reflect that reality,” Linzer said. “Suppressing rates in the name of affordability does nothing to contain the cost of care. Instead, it ignores the ongoing escalation of provider and pharmaceutical prices.”

The state said about 224,000 New Yorkers are enrolled in individual commercial plans, while more than 630,000 New Yorkers are enrolled in small group plans.

By cutting insurers’ requested rates by 71% in the individual market, the state said that saved consumers $324 million. By cutting insurers’ requested rates by 66% in the small group market, that saved small businesses $1.25 billion, the state said.

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