HARRISBURG, PA — The Pennsylvania Insurance Department (PID) has made public the requested rate changes for 2025 by insurance companies operating in the state’s individual and small group markets. This move aligns with the Shapiro Administration’s efforts to provide transparency and equip consumers with vital information for informed health insurance decisions.
Insurance companies submitted their rate filings on May 15, 2024. Since then, PID has been diligently reviewing the proposed changes to ensure they are fair and adequate. Rates vary by plan and region and may be adjusted by the Department before final approval. The finalized rates will be announced 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 are required to file proposed rates with PID for approval before selling plans to consumers. This process serves as a critical consumer protection measure, ensuring that plans are reasonably priced and not unjustly discriminatory. The Department reviews these rates to confirm they are adequate and fair.
For Plan Year 2025, insurers have cited several reasons for the requested rate increases. These include rising medical unit costs, drug prices, labor costs in the healthcare industry, and the utilization of medical services. Most proposed rate changes indicate an average premium increase of around 8%, which is lower than the national average.
For the individual market, insurers have proposed an average statewide increase of 7.9%. The rates, rounded to the nearest tenth, vary by region. Key proposals include:
- Capital Advantage Assurance Company: 6.5% (Rating areas 6, 7, and 9)
- Geisinger Health Plan: 11.2% (Rating areas 2, 3, 5, 6, 7, and 9)
- Geisinger Quality Options: 7.4% (Rating areas 2, 3, 5, 6, 7, and 9)
- Health Partners Plans “Jefferson Health Plans”: 2.9% (Rating areas 6 and 8)
- Highmark Benefits Group Inc.: 12.8% (Rating areas 3 and 8)
- Highmark Coverage Advantage Inc.: 13.0% (Rating areas 1 and 4)
- Highmark Inc.: 8.8% (Rating areas 1, 2, 4, 5, 6, 7, and 9)
- Independence Blue Cross (QCC Ins. Co.): 8.6% (Rating area 8)
- Keystone Health Plan Central: 15.2% (Rating areas 6, 7, and 9)
- Keystone Health Plan East Inc.: 8.8% (Rating area 8)
- Oscar Health Plan of PA: 4.4% (Rating Areas 3, 6, 7, and 8)
- Pennsylvania Health & Wellness Inc.: 6.2% (Rating areas 3, 6, 7, and 8)
- UPMC Health Coverage Inc.: 7.0% (Rating areas 1 and 5)
- UPMC Health Options Inc.: 4.8% (Rating areas 1, 2, 3, 4, 5, 6, 7, and 9)
In the small group market, insurers have requested an average statewide increase of 7.8%.
The proposed 2025 filings also include market expansions. Geisinger Health Plan and Geisinger Quality Options plan to expand into Franklin County. Health Partners Plans Inc. aims to extend its offerings into Delaware, Lehigh, and Northampton counties. Pennsylvania Health & Wellness Inc. proposes expanding into 11 counties: Blair, Cambria, Clarion, Clearfield, Centre, Elk, Fayette, Huntingdon, Jefferson, Somerset, and Westmoreland.
Public comments on the rate requests and filings are open through September 2, 2024. These comments can be emailed to ra-in-comment@pa.gov. The final approved rates will be announced in the fall, ensuring transparency and consumer protection in Pennsylvania’s health insurance market.
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