WNY health insurers seek rate hikes of 9% to 24% for 2027

The three dominant health plans in Western New York are again requesting rate increases for 2027 as the cost of medical care and pharmaceuticals continues to soar, though most of the proposed hikes are lower than a year ago.

The rate requests submitted to the state, and posted online Friday, affect people who buy individual commercial health insurance and small employers with 100 or fewer full-time workers. Together, they comprise a small slice of members for most insurers.

The rate increases, which do not affect employers with more than 100 workers, highlight the upward pressure on premiums and how consumers continue to pay more for health insurance year after year.

Highmark Western and Northeastern New York, which includes Highmark Blue Cross Blue Shield of Western New York, is requesting an average increase of 23.8% for individuals, a market in which it has 2,735 members. For small group plans, in which Highmark has more than 35,700 members, the insurer is seeking an average increase of 9.2%.

Independent Health is requesting an average rate increase of 14.2% in the individual market, where it has nearly 4,100 members. On the small groups, in which Independent Health lists about 21,800 members, the insurer requested an increase of 11.4%.

Excellus Health Plan, which does business in Western New York as Univera Healthcare, is seeking an average rate increase of 17.2% in the individual market and a hike of 17% for small groups. Excellus, based in Rochester, has 17,260 members in its individual plans and more than 137,500 small-group members.

The average increase requested by health plans in the state was 20.7% in the individual market and 25.7% for small groups. The rate hike requests from Independent Health and Excellus are lower than last year. Highmark's small-group rate request is lower this year, but its individual market request is similar to a year ago.

What the insurers say

The three major Western New York health plans said they are trying to keep costs low for members, who are understandably frustrated by rising health costs. But, the insurers say, the premium rates are primarily a reflection of the cost and demand for medical care and prescription drugs.

Univera, Highmark and Independent Health all spend at least 90 cents out of every premium dollar collected on healthcare for members.

"Healthcare costs are rising for everyone – providers, payers and the people who rely on care – driven by higher demand, an aging population, rising prices and rapid growth in specialty drugs and GLP-1s," Univera President Paul Valley said in a statement. "As these pressures challenge our communities, we're continuing to partner with local providers to support prevention and chronic care. This approach helps keep people healthy, manage ongoing conditions, and catch issues earlier, leading to improved outcomes and better control of healthcare costs over time."

Highmark said its proposed 2027 rates for individual and small-group products – affecting fewer than 10% of its members – reflect growing medical costs, "driven by increased hospital and prescription drug costs, as well as the impact of New York regulatory mandates, taxes and fees." Highmark said it is investing in "innovative solutions to expand access, improve health outcomes and deliver greater value for our members."

Independent Health spokesperson Frank J. Sava said the health plan's proposed premium increases are lower than previous years due to its "successful efforts to lower the trend of rising healthcare costs through our medical management initiatives and collaborative relationships with physicians and providers." A year ago, Independent Health requested a 38.4% increase in the individual market and 19% for small groups.

As part of its efforts to lower costs, Sava said Independent Health has been able to reduce inpatient admissions for individuals with chronic kidney disease, lower readmission rates for members with asthma and increase preventive screenings that helped avoid potential complications. To keep members healthy, Sava said Independent Health also will be bolstering coverage for preventive care, expanding access to virtual service and "will continue to engage members in their own health through our RedShirt Rewards program, which enables members to earn up to $30 in gift cards for completing a variety of preventive services."

Compared to prior years, the finances of the three insurers are starting to stabilize.

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. 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.

Excellus, which includes Univera, reported an operating loss in 2025 of $108 million on revenue of $7.5 billion. But strong returns in the stock market helped Excellus finish 2025 with a net margin of 2%, or $150 million.

How to comment on the rates

From here, the state Department of Financial Services will evaluate the proposed rate requests, gather public feedback and, most likely, adjust the increases downward.

Rates are typically finalized by late August. The rates then go into effect Jan. 1.

Insurers must send affected customers a notice about a proposed premium rate increase filed with the state, alerting consumers that an application has been submitted and that they can send comments in about the planned adjustment.

Those wishing to comment during a 30-day window can submit their comments online through the state Department of Financial Services portal or by mail to: New York State Department of Financial Services, Health Bureau-Premium Rate Adjustments, One Commerce Plaza, Albany, NY 12257.

Comments from the public can factor into the state's review of each rate request. In that review, the Department of Financial Services evaluates the applications and the insurer's underlying calculations to "make sure that rate increases are justified and not excessive," according to its website.

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