(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.
Overall preliminary rate changes via SERFF database, state insurance dept. website and/or the federal Rate Review database.
Aetna Life Insurance Co:
(Aetna/CVS is dropping out of the individual market in all states; I estimate they have around 35,000 enrollees in Kansas who will have to find a different carrier for 2026)
Blue Cross Blue Shield of Kansas City:
Blue Cross and Blue Shield of Kansas City (BCBSKC) is requesting an average rate change of -6.1% for 2025 individual rates as compared to 2023 individual rates and calculated by the URRT. The changes vary by plan, with a minimum rate change of -10.8% and a maximum rate increase of 1.8%.
Table 2.1 summarizes proposed rate increases effective January 1, 2026, and displays significant factors driving the proposed rate increases. Note that this rate buildup is illustrative of changes occurring from 2025 to 2026, and is therefore not reflective of factors displayed in Worksheet 1, Section II of the URRT, which pertains to changes from the experience period (2024) to the projection period (2026). Factors found in The URRT are discussed in later sections.
Healthy Alliance Life Insurance Company (HALIC) has filed for premium rate changes for its Affordable Care Act (ACA) compliant Individual health insurance plans. This filing includes an average rate change of 21.23%, effective January 1, 2026, with plan prices changing between 18.75% and 24.73%. The price changes will impact about 52,000 people that have HALIC plans now and will keep HALIC plans next year. An insured person’s actual rate increase could be higher or lower depending on their benefit, where they live, how old they are, number of children, and if they use tobacco.
Last winter, I initiated an ambitious project in which I generated graphics to illustrate just how much net ACA premiums are likely to increase starting on January 1st, 2026 (slightly over 5 months from today) assuming the enhanced premium subsidies provided by the Inflation Reduction Act over the past several years are allowed to expire.
This project took several months to complete, as I had to generate both tables and bar graphs for all 50 states (+DC), using 4 different households at multiple income brackets for each. All told, that's over 1,600 different examples.
I made sure to include various caveats for these projections. For instance, each of these examples assumes...
Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Arkansas Insurance Department for review and approval before plans can be sold to consumers.
The Department reviews rates to ensure that the plans are priced appropriately. Under Arkansas Law (Ark. Code Ann. § 23-79-110), the Commissioner shall disapprove a rate filing if he/she finds that the rate is not actuarially sound, is excessive, is inadequate, or is unfairly discriminatory.
The Department relies on outside actuarial analysis by a member of the American Academy of Actuaries to help determine whether a rate filing is sound.
Below, you can review information on the proposed rate filings for Plan Year 2026 individual and small group products that comply with the reforms of the Affordable Care Act.
Every year around this time I start my annual individual & small group market rate filing analysis project. This involves spending months painstakingly tracking every insurance carrier rate filing for the upcoming year to determine just how much average insurance policy premiums on the individual market are projected to change.
Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need.
The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier: How many effectuated enrollees they have in ACA-compliant policies this year; the average projected rate change for those policies; and, ideally, a breakout of the rationale behind the changes.
Usually the reasons given are fairly vague things like "increased morbidity" (ie, a sicker risk pool) or the like. Sometimes, however, there's a very specific reason given for some or all of the premium changes. Major examples of this include:
Every year around this time I start my annual individual & small group market rate filing analysis project. This involves spending months painstakingly tracking every insurance carrier rate filing for the upcoming year to determine just how much average insurance policy premiums on the individual market are projected to change.
Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need.
The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier: How many effectuated enrollees they have in ACA-compliant policies this year; the average projected rate change for those policies; and, ideally, a breakout of the rationale behind the changes.
Usually the reasons given are fairly vague things like "increased morbidity" (ie, a sicker risk pool) or the like. Sometimes, however, there's a very specific reason given for some or all of the premium changes. Major examples of this include:
