2026 Rate Changes

Originally posted 8/11/25

Overall preliminary rate changes via the SERFF database, Alaska Insurance Dept. and/or the federal Rate Review database.

Moda Assurance Co:

(Moda has heavily redacted their actuarial memo and isn't providing the number of current enrollees)

The average rate change is X.XX% as shown on Worksheet 2 of the URRT. The proposed rate Proposed Rate Increase change varies by product and plan, and the proposed rates vary by plan, age, geographic area, and tobacco use. The average rate change was calculated by comparing the weighted average premium for members on current plans and rates to the weighted average premium for members on renewal plans and rates.

A summary of the major components and their contribution to the rate change is provided in the table below.

Components of the rate change / % Impact

Originally posted 8/08/25

Overall preliminary rate changes via SERFF database, Mississippi Insurance Dept. website and/or the federal Rate Review database.

Ambetter of Magnolia Inc.

The proposed rate change of 39.0% applies to approximately 142,324 individuals. Ambetter of Magnolia Inc.’s projected administrative expenses for 2026 are $89.76 PMPM. Administrative expense does not include $34.22 for taxes and fees. The historical administrative expenses for 2025 were $73.84 PMPM, which excludes taxes and fees. The projected loss ratio is 84.4% which satisfies the federal minimum loss ratio requirement of 80.0%.

Blue Cross Blue Shield of MS:

The 2026 monthly health insurance premium is made up of four pieces: estimated claim costs, administrative costs, taxes and fees, and risk/profit margin.

Originally posted 8/11/25

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Overall preliminary rate changes via the SERFF database, Wisconsin Insurance Dept. and/or the federal Rate Review database.

Aspirus Arise Health Plan of WI

The average proposed rate increase of 12.6%, effective January 1, 2026 is expected to impact 13,677 members, based on membership as of March 31, 2025. The rate increase varies by plan, ranging between 4.4% and 20.5%. Rate changes vary by plan due to the impact of changes in benefits and rating adjustments to account for the non-funding of Cost Sharing Reduction (CSR) payments.

Originally posted 8/08/25

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Overall preliminary rate changes via the SERFF database, West Virginia Insurance Dept. and/or the federal Rate Review database.

CareSource WV:

(unfortunately, CareSource WV's actuarial memo is heavily redacted)

Highmark BCBS WV:

Highmark West Virgina (“Highmark WV”) is requesting an average ACA individual market rate increase of 17.0%, ranging from 15.2% to 23.3%. Products submitted with this filing will have effective dates from January 1, 2026 to December 31, 2026. This rate change is projected to affect 28,179 members.

Historical Financial Experience:

Highmark WV incurred an underwriting gain in its ACA individual market programs in 2024.

Change in Medical Service Costs:

Originally posted 8/08/25

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Overall preliminary rate changes via the SERFF database, North Dakota Insurance Dept. and/or the federal Rate Review database.

Blue Cross Blue Shield of ND:

(Unfortunately, BCBSND's actuarial memo is heavily redacted, so I don't know their current enrollment. I've had to make an educated guess on that; see below.)

Welp. From the Colorado Dept. of Regulatory Agencies:

 Congressional failure to extend the enhanced premium tax credits will lead to an estimated 225,000 Coloradans seeing an average 101% increase in health insurance premiums

DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), today released the final approved premium information on private health insurance plans for 2026 for the individual market (for people who don’t get coverage from an employer plan). These filings have been reviewed and updated to reflect the passage of HB25B-1006, which blunted some of the premium increases.

Note: I already published what should be the final gross rate change filings for Colorado last week: +21.2%

Originally posted on 8/08/25

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Overall preliminary rate changes via the SERFF database, New Jersey Insurance Dept. and/or the federal Rate Review database.

Aetna Life Insurance Co:

(Aetna/CVS is pulling out of the entire individual market nationally; I've estimated their current enrollment, see below for methodology)

AmeriHealth HMO:

AmeriHealth HMO, Inc. ("AHNJ”) is revising premium rates for the New Jersey Individual Health ACA compliant products, effective from January 1, 2026. Rate increases average 16.8%, ranging from 16.8% to 16.8%. The proposed revisions to each plan are shown on the last page of this exhibit. About 35 members will be affected.

AmeriHealth Insurance Co of NJ

Originally posted 7/17/25

Well, the Colorado Dept. of Regulatory Agencies isn't mincing words:

Chaos from Congressional Republicans Leads to Average Premium Increases of Over 28% for 2026

  • Average increases as high as 38% have been requested for the Western Slope, and insurance companies estimate nearly 100,000 Coloradans will lose their health insurance coverage

DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA) released the preliminary information on private health insurance plans for 2026 for the individual market (for people that don’t get coverage from an employer plan). The filings will be public once the DOI finishes the preliminary completeness review on or about Friday, July 18.

via the Michigan Dept. of Insurance & Financial Services:

DIFS Encourages Michiganders to Plan for Health Insurance Coverage Now for 2026

(LANSING, MICH) The Michigan Department of Insurance and Financial Services (DIFS) is encouraging Michiganders to be ready for the upcoming Health Insurance Marketplace Open Enrollment period, which starts Nov. 1. A record 530,000 Michiganders are currently enrolled in health insurance through the Marketplace. Recent federal changes, as well as expiring tax credits, mean it has never been more important to review your insurance coverage and make a selection during the upcoming Open Enrollment period.

Fair enough so far...

Originally posted 8/13/25

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Overall preliminary rate changes via the Florida Office of Insurance Regulation and/or the federal Rate Review database.

Aetna Health inc:

(Aetna/CVS announced last spring that they're pulling out of the individual market in EVERY state in 2026.)

AmeriHealth Caritas Florida:

Amerihealth Caritas Florida, Inc. (AHC) has offered comprehensive and fully insured coverage to members in the individual ACA market since 2023. AHC is filing a rate increase for 2026 products. The plans associated with this filing will be offered both on and off the Federally Facilitated Marketplace (FFM) in Florida.

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