The proposed rate change of 27.3% applies to approximately 204,837 individuals. Absolute Total Care’s projected administrative expenses for 2026 are $90.21 PMPM. Administrative expense does not include $17.94 for taxes and fees. The historical administrative expenses for 2025 were $78.35 PMPM, which excludes taxes and fees. The projected loss ratio is 82.6% which satisfies the federal minimum loss ratio requirement of 80.0%.
Pennsylvanians can submit comments on rate requests and filings through September 2
Harrisburg, PA – The Pennsylvania Insurance Department (PID) today announced that the 2026 rate changes requested by insurance companies currently operating in Pennsylvania’s individual and small group markets are now available. On average, all Pennsylvania health insurers are requesting premium increases in plan year 2026: 19% increase to premiums in the individual market (for people who buy their own insurance), and a 13% increase to premiums in the small group market (for small businesses).
Pilot expansion of ConnectorCare reshapes affordability and plan options through the Health Connector
This historic expansion allows for more access to health insurance plan choices that are both affordable and better suited to meeting an individual’s health needs
BOSTON – Today, the Massachusetts Health Connector Board of Directors approved regulatory changes that will expand access to the Marketplace’s landmark ConnectorCare program through a two-year pilot program, creating the opportunity for tens of thousands of people to access more affordable health care. The ConnectorCare program is currently available for people who make up to 300 percent of the Federal Poverty Level (FPL) and do not have access to health coverage, such as through an employer.
(Unfortunately, no rate justification summary is available, and the full actuarial memo is heavily redacted. Policy enrollees are estimated based on marketwide estimated enrollment; see below.)
Banner/Aetna CVS:
(Dropping out of the individual market for 2026.)
I am writing to notify the Department that Banner Health and Aetna Health Plan Inc. (“Banner | Aetna”) will exit the individual health insurance market effective December 31, 2025. This notification is sent pursuant to Department guidance and Arizona statute 20-1380(D)(1). We made this decision after careful consideration and after evaluating the evolution of business at Banner | Aetna. The details of our individual market exit include the following:
I still have the preliminary 2026 rate filings to analyze for about 10 more states, but I'm taking a break to go back and revisit ARKANSAS.
Back on July 18th, I posted my original analysis of ACA-compliant individual & small group market filings for Arkansas insurance carriers. At the time, I found that the weighted average increases being requested for individual market policies averaged a disturbingly high 26.2%. Here's what the breakout looked like:
Oregonians continue to have at least five health insurance companies to choose from in every Oregon county as companies file 2026 health insurance rate requests for individual and small group markets
In-depth rate review process just beginning, opportunities for public review and input remain through June 20
June 2, 2025
Oregon health insurers have submitted proposed 2026 rates for individual and small group plans, launching a months-long review process that includes public input and meetings.
Five insurers will again offer plans statewide (Moda, Bridgespan, PacificSource, Providence, and Regence), and Kaiser is offering insurance in 11 counties, giving six options to choose from in various areas around the state.
(sigh) OK, I'm not sure if we've reached the 5th or 6th chapter in this ongoing saga, but I hope it's the last one.
When we last left our story (just 5 days ago), I noted that both the current number of enrollees as well as the average rate increases for each of the carriers on the Arkansas individual market had jumped all over the place at least 4 times, and that while it's common for these numbers to change a bit here and there throughout the multi-month filing process, both the degree of some of the changes as well as the circumstances surrounding them were often far beyond what I've typically seen in over a decade of tracking this stuff:
Given all the confusing numbers I've posted before, I've boiled it all down to the simplified tables below which illustrate the mess:
I already wrote about this over a month ago but it didn't get the attention it deserved at the time, and given that we're much closer to the actual 2026 ACA Open Enrollment Period starting and that there's been another important development since then, I figured I should post an updated entry about it.
Santa Fe, NM – The New Mexico Office of the Superintendent of Insurance (OSI) has approved 2026 rates for individual market Affordable Care Act (ACA) plans sold on and off BeWell, the New Mexico Health Insurance Marketplace, with an average increase of 35.7%. Today, 75,000 New Mexicans buy health insurance through BeWell and 88% of enrollees qualify for federal and state premium assistance.
(Aetna/CVS is pulling out of the entire individual market nationally)
Anthem Blue Cross of CA (DMHC)
This is a rate filing for the Individual market ACA‐compliant plans offered by Anthem Blue Cross (Anthem). The proposed rates in this filing will be effective for the 2026 plan year beginning January 1, 2026, and apply to plans both On‐Exchange and Off‐Exchange.
Anthem will continue to participate in its 2025 marketplace footprint consisting of rating areas 1-10 and 12-14 with EPO plans and rating areas 11 and 15‐19 with HMO plans.
The projected average rate change for plans effective January 1, 2026 is 16.0% which is an average rate change of about $87 per member per month (pmpm). Because 16.0% (or about $87) is an average, it is possible to have a different rate change. Factors affecting a member's premium are age, tobacco use, family composition, plan, and geographic area. Expected cost differences by product are updated every year to ensure premium differences are appropriate. BridgeSpan has approximately 200 members enrolled in this line of business as of March 2025.
...The rate change described above is driven by the following factors:
Medical Trend : 9.1%
Change in Benefits, Age, Area, and Network : -1.5%
Change in Market Morbidity : 5.0%
Exchange User Fees : 1.0%
Other : 2.0%
Other includes: actual results vs. expected, changes to admin expenses, and rx rebates. Actual results vs. expected reflect differences between actual results and past assumptions, including a true-up of market morbidity estimates
