Nearly 500,000 Pennsylvanians could see their health insurance premiums spike next year.<\/p>\n
Insurers selling coverage on the state\u2019s Affordable Care Act marketplace, Pennie, want to raise premiums by an average of 19% for customers who buy their own insurance and 13% for small businesses, the Pennsylvania Insurance Department announced Friday.<\/p>\n
The department reviews proposed rates to make sure they\u2019re not too high, too low or discriminating against certain groups of customers.<\/p>\n
Companies are asking for much higher hikes than last year, when the average proposed increase came in at 8% for the individual and small-business markets.<\/p>\n
\u201cThis year, even more than previous years, Pennsylvanians should consider shopping around to find the best plans to meet their individual needs, at a price that makes sense for their current financial situation,\u201d Pennsylvania Insurance Commissioner Michael Humphreys said in a statement.<\/p>\n
Western Pennsylvania\u2019s dominant health insurers, UPMC and Highmark, are requesting below average \u2014 but still substantial \u2014 hikes.<\/p>\n
UPMC is seeking increases for individuals of between 12% and 16%. For Highmark, that range is 14% to 18%.<\/p>\n
On small-business plans, UPMC is asking to raise premiums between 7% and 9%.<\/p>\n
Highmark\u2019s requests for such plans, on the other hand, fall between 12% and 23% \u2014 the highest of any insurer in the state.<\/p>\n
The Highmark plan that could see the highest increase covers the northeastern part of Pennsylvania.<\/p>\n
UPMC and Highmark made $237 million and $15 million, respectively, in the first quarter of this year.<\/p>\n
Financial health will be just one factor the Insurance Department uses to approve or adjust rates.<\/p>\n
It also looks at past rate changes, cost estimates and consumer impacts, according to its website.<\/p>\n
Past filings show regulators usually trim requests for individual plans and make limited revisions on small-business plans, which can be bought by companies with 50 or fewer employees.<\/p>\n
State officials work through any objections they have with insurers and give them a chance to revise or withdraw their filings. Companies most often choose to revise, according to Insurance Department spokesman Adrian Sipes.<\/p>\n
The review process saved Pennsylvanians $77 million last year, Sipes said.<\/p>\n
Occasionally, regulators approve a higher-than-requested rate.<\/p>\n
Regulators blame rising health care costs, higher utilization of medical services and the upcoming end of the enhanced premium tax credit to help customers afford insurance on the ACA marketplace.<\/p>\n
Pennie claims its enrollees save around $600 million annually through the expiring program.<\/p>\n
To justify its desired hikes, Highmark cited the same factors as the Insurance Department as well as pent-up demand for care after the pandemic.<\/p>\n
\u201cWe are committed to offering the high-quality coverage and experience that our Pennsylvania ACA members and small group employers have come to expect from Highmark,\u201d David Golebiewski, a Highmark spokesperson, said in a statement.<\/p>\n
Denise Hughes, a UPMC spokesperson, said the organization is \u201ccommitted to continued work with the Insurance Department to continue to make affordable, high quality coverage options for consumers.\u201d<\/p>\n
A company-by-company, plan-by-plan list is available on the Insurance Department\u2019s website<\/a>.<\/p>\n