Syracuse, NY — Excellus BlueCross BlueShield will raise its premiums by 20.7% next year for individuals who buy coverage through the state\u2019s health insurance marketplace.<\/p>\n
Central New York\u2019s largest private insurance company was approved for the second-largest rate increase among insurers statewide. The average rate increase was 7.1% among the dozen insurers on the individual Affordable Care Act-created marketplace.<\/p>\n
Excellus acknowledged the difficulty of the steep rate hike, but said it was necessary.<\/p>\n
\u201cWe know that any increase in costs can be difficult,\u201c the health insurer said in a statement. \u201dHowever, the significant rise in the cost and demand for health care, especially for hospital care and prescription drugs, is impacting health insurers\u2019 premium rates both locally and nationally.\u201d<\/p>\n
Roughly 240,000 New Yorkers bought coverage through the individual marketplace last year. Premiums are regulated by the state\u2019s Department of Financial Services. <\/p>\n
It\u2019s the second year Excellus has secured a large increase to its individual market premiums. In 2024, the insurer was approved for an 18.3% hike, compared to an average 12.7% hike statewide. <\/p>\n
Here are the requested and approved 2026 rate hikes for all insurers in the individual marketplace in New York: <\/p>\n
Company NameRequested 2026 Rate ActionsApproved 2026 Rate ActionsAnthem HP, LLC (Formerly Empire HealthPlus)*10.3%4.6%CDPHP*13.7%12.1%Emblem (HIP)*0.9%-9.0%Excellus*24.8%20.7%Fidelis (NY Quality Healthcare Corp)*8.1%2.9%Healthfirst PHSP, Inc.*14.3%9.0%Highmark (Formerly HealthNow)*23.9%19.4%IHBC*38.4%20.8%MetroPlus*10.1%4.4%MVP Health Plan*8.0%7.4%Oscar*17.0%3.5%UnitedHealthcare of NY Inc.*36.6%9.1%Average:13.5%7.1%<\/p>\n
* Indicates the Company will offer products on the NY State of Health Marketplace in 2026.<\/p>\n
Another 685,000 New Yorkers are insured under small-group plans covering employers with 100 members or fewer. Those rates are also regulated.<\/p>\n
Excellus won a 15% rate increase in the small-group market for 2026, compared to a 13% average increase for all insurers.<\/p>\n
Here are the requested and approved 2026 rate hikes for all insurers in the small group marketplace: <\/p>\n
Company NameRequested 2026 Rate ActionsApproved 2026 Rate ActionsAnthem HealthChoice Assurance, Inc. (Formerly Empire)*10.9%9.7%CDPHP*22.2%22.1%CDPHP UBI*20.3%20.0%Emblem (HIP)*6.3%1.3%Excellus*19.6%15.0%Highmark (Formerly HealthNow)18.0%11.4%IHBC19.0%14.4%MVP Health Plan*21.5%17.9%MVP Health Service Corp*15.8%15.8%Oxford Health Insurance Inc.*28.8%11.8%UnitedHealthcare Ins Co NY23.8%6.8%Average:24.0%13.0%<\/p>\n
State regulators echoed Excellus in blaming in-patient hospital stays and rapidly increasing drug prices for the high yearly premium increases. <\/p>\n
Insurers were held to a 1% profit provision in the coming year, regulators said.<\/p>\n
Nationally, marketplace premiums are expected to go up 18% next year — higher than the New York average, according to the Peterson-KFF Health System Tracker<\/a>. But that comes a year after rates went up only 7% nationally, lower than the 2024 New York average. <\/p>\n Excellus says the two regulated plans accounted for about 10% of its 1.5 million members. <\/p>\n The regulated rates do not cover state Essential Plan members, Medicare, Medicaid or large employer insurance plans. <\/p>\n Excellus says that 92% of its premiums go back to patient care. The non-profit lost $163 million last year on day-to-day operations, but turned a $25 million profit in 2024 based on investment revenue. <\/p>\n Staff writer Douglass Dowty can be reached at ddowty@syracuse.com<\/a> or (315) 470-6070.<\/p>\n If you purchase a product or register for an account through a link on our site, we may receive compensation. By using this site, you consent to our User Agreement<\/a> and agree that your clicks, interactions, and personal information may be collected, recorded, and\/or stored by us and social media and other third-party partners in accordance with our Privacy Policy.<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"Syracuse, NY — Excellus BlueCross BlueShield will raise its premiums by 20.7% next year for individuals who buy…\n","protected":false},"author":2,"featured_media":134547,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253],"class_list":["post-134546","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-health","tag-health-care","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/134546","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=134546"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/134546\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/134547"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=134546"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=134546"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=134546"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}