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