CT insurers ask for bigger health plan rate increases: What to know
CT insurers ask for bigger health plan rate increases: What to know

CT insurers ask for bigger health plan rate increases: What to know

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CT insurers ask for bigger health plan rate increases: What to know

Connecticut insurers want to boost the cost of state-regulated individual health plans by an average of 17.8% next year. They have also asked for an average rate increase of 13.1% on small group policies. Attorney General William Tong called the rate increase requests unaffordable and pledged to scrutinize the proposals. The public can weigh in on the proposed rate increases during a hearing on Aug. 18, from 9 a.m. to 2 p.m., at Connecticut’s Legislative Office Building (Room 1A, 300 Capital Ave., Hartford). Residents can also post comments online by clicking “select’ under each rate request listed here. The final decisions will be published later this summer, and state officials must ensure the requests are not excessive, inadequate or unfairly discriminatory. The state’S insurance department can choose to approve the full requested increases, reject them or amend them, and the final decision will be made in late August or early September, the insurance department said in a statement.

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Amid a storm of policy changes, new cuts to Medicaid, tighter restrictions on care at community health centers and expiring federal subsidies, Connecticut insurers want to boost the cost of state-regulated individual health plans by an average of 17.8% next year.

They have also asked for an average rate increase of 13.1% on small group policies.

The requests are considerably higher this year. In 2024, insurance companies asked for an average rate hike of 8.3% on individual plans and 11.9% on small group.

The plans collectively cover about 224,000 residents (158,000 in individual policies and 66,000 in small group).

“The Affordable Care Act was created to increase access to affordable care. In 2025, a record 24 million people enrolled in ACA marketplace plans nationwide. The progress the ACA has made over the years is at risk,” Connecticut Insurance Commissioner Andrew Mais wrote in an op-ed earlier this month, pointing to federal subsidies that will lapse later this year and rising rate hike requests nationwide.

Attorney General William Tong called the rate increase requests unaffordable and pledged to scrutinize the proposals.

“I’ll be combing through every page of these applications and demanding that insurers justify every penny and every step they have taken to curb these out-of-control costs,” he said. “Year after year, insurers demand soaring rate hikes that far outstrip the pace of inflation and other cost growth benchmarks. They give us padded applications with vague references to trends they do not disclose or take any steps to control. … We need to hold them accountable and require better.”

Here’s what to know about the proposed rate hikes.

How much of an increase are insurers seeking?

Three insurers sell plans through the state’s exchange, known as Access Health CT: Anthem Health Plans, ConnectiCare Insurance Company and CTCare Benefits Inc.

Anthem asked for an average rate hike of 14.2% (increases range from 6.4% to 22.8% depending on the plan) for individual policies that cover 83,790 people.

ConnectiCare is seeking an average increase of 26.1% (rate hikes range from 5.9% to 28.6% depending on the plan) for individual policies that cover 3,685 residents.

And CTCare requested an average increase of 21.7 % (rate hikes range from 4.7% to 26.7%) for individual plans that cover 70,160 people.

Anthem is also seeking a 13.2% average hike for its small group plans that include 48,666 residents.

Additionally, insurers are asking for increases on off-exchange policies.

Does the state have to approve the increases?

No. The state’s insurance department can choose to approve the full requested increases, reject them or amend them. The final decisions will be published later this summer.

State officials must ensure the requests are not excessive, inadequate or unfairly discriminatory. Actuaries will review the proposals, examining trends in unit cost (total expenditure incurred by the company), utilization of services and expected severity of claims.

Does the public have a say?

Yes. The public can weigh in on the proposed rate increases during a hearing on Aug. 18, from 9 a.m. to 2 p.m. at Connecticut’s Legislative Office Building (Room 1A, 300 Capital Ave., Hartford).

Residents can also post comments online by clicking “select” under each rate request listed here.

Why are they asking for rate hikes?

Stephanie DuBois, a spokeswoman for Anthem Blue Cross and Blue Shield in Connecticut, said the higher rate hike request this year is due to more policyholders needing higher cost services, including emergency department visits.

“Our submitted ACA rates are based on the health care services we expect members to access next year, along with the anticipated costs associated with that care,” she said. “Specifically, there has been an increase in ACA members utilizing higher-cost services, including emergency room care and behavioral health services, as well as some prescription drugs and specialty pharmacy. These rates also reflect our ability to deliver on behalf of consumers in Connecticut given the changes at the federal level.”

Officials with ConnectiCare did not respond to a request for comment.

In announcing the rate hike requests, leaders with the state insurance department noted that proposed increases generally stem from rising health care costs, including the price of prescription drugs and greater demand for medical services, among other changes.

What else is happening with plans on the exchange?

Decisions at the federal level will change the cost of many health plans on the state’s insurance exchange as early as this year.

Around 90% of Connecticut residents who purchase a plan on the exchange receive financial support to help cover the cost. At the end of 2025, one type of subsidy, known as “enhanced premium tax credits,” is set to expire. As a result, Connecticut residents with exchange plans could expect to pay $1,700 more on average every year for their health insurance, according to Access Health CT. Over 135,000 people will lose at least some financial support. A fifth of those people, or roughly 27,000, will no longer be eligible for any financial assistance.

The expiration of the enhanced subsidies will also deal a major blow to Covered Connecticut, a program that provides no-cost exchange plans to residents who make too much to qualify for Medicaid but still earn 175% or less than the federal poverty level. Covered Connecticut currently provides more than 40,000 residents with no-cost health and dental coverage. The Department of Social Services estimates it would cost the state $30 million annually to continue the program.

For more information on how federal policy changes will affect plans on the exchange, click here.

CT Mirror reporter Katy Golvala contributed to this story.

Source: Ctmirror.org | View original article

Source: https://ctmirror.org/2025/08/12/ct-health-insurance-rate-increases/

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