Individual Plans
The average rate increase from 1/1/2018 to 1/1/2019 is 8.9% based on the plans that are considered to have uniform modifications of coverage according to 45 CFR 147.106.
The following items are the main reasons for the rate adjustment:
- Medical and drug trend
- Morbidity and demographics are assumed to change in 2019 due to regular enrollment turnover, the removal of the individual mandate, and expansion of short term plans
- ACA taxes and fees are different
- Some benefit plans have been modified
- Some plans have been eliminated and new plans have been introduced.
- New agreements with providers for HMO plans
Small Group Plans
The weighted average rate change from 2018 is 11.2% for PPO plans. The weighted average rate change from 2018 is 15.7% for HMO plans.
The following items are the main reasons for the rate adjustment:
- Health care costs increase each year
- ACA taxes and fees changes
- Benefit modifications
- Medical and drug trend
- Morbidity change in 2019