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Insurers submit highest rate increase requests to OHIC in more than a decade

By

Katie Castellani

-

06/13/2025

INSURERS' RATE increase requests for individual, small and large group plans in 2026 were the highest the Office of the Health Commissioner has reported in more than a decade, according to information released Friday.

PROVIDENCE – Insurers’ rate increase requests for individual, small and large group plans in 2026 were the highest the Office of the Health Commissioner has reported in more than a decade, according to information the government agency released Friday. The requested average rate increases for the individual market ranged from 21.2% to 28.9%. By comparison, the

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PROVIDENCE – Insurers' rate increase requests for individual, small and large group plans in 2026 were the highest the Office of the Health Commissioner has reported in more than a decade, according to information the government agency released Friday. The requested average rate increases for the individual market ranged from 21.2% to 28.9%. By comparison, the approved rate increases in 2025 averaged 7.8%. Insurers are asking for more in the individual market as they brace for the expiration of the federal Enhanced Premium Tax Credits. Insurers are expecting fewer people to purchase insurance after these tax credits expire this year, unless they are extended by Congress. The expiration of the tax credits is adding 9.7% to Blue Cross & Blue Shield of Rhode Island's requested increase and 4.9% to Neighborhood Health Plan of Rhode Island’s requested raise, according to OHIC. The tax credits lower some Rhode Islander’s premiums when they get coverage through HealthSource RI. They were originally created under the American Rescue Plan Act of 2021 and extended by the Inflation Reduction Act of 2022. In the small group market, insurers requested an average rate increase ranging from 20.3% to 22% – also much higher than the 12.4% rate increase approved in 2025. Large group market requested average rate increases ranged from 13.5% to 26.4%, while the approved raises averaged 11.2% in 2025. Insurers identified several factors that affected the requested rate increases, including:

Expected rise in spending on health care services, including payments to hospitals and professional providers as well as higher spending on prescription drugs
Increased use of glucagon-like peptide-1 – or GLP-1 – drugs for weight loss
The effects tariffs may have on imported drug and ingredient prices
Additional contributions to reserve margins higher than what was approved in 2025 rates

The health insurance commissioner's office may approve, modify or reject an insurer's rate filing and all decisions are based on data and actuarial analysis. A final decision on the proposed rate increases is expected by September. The health insurance commissioner’s office will now review the data, pricing assumptions, administrative charges and other information to determine how reasonable each insurer’s request is. The commission will also review each health insurer’s coverage and benefit contracts with customers to make sure they comply with state and federal law. “Health insurers are asking working Rhode Islanders and employers to take on significant additional costs for their health benefit plans,” said R.I. Health Insurance Commissioner Cory King. “These costs represent a significant financial burden and OHIC will scrutinize the insurers’ requests as part of our review to determine whether they are justified.” Different from the past three years, R.I. Attorney General Peter F. Neronha will not be conducting an independent actuarial review of the small and large group market requests. In previous years, Neronha’s office had hired financial analysts to review the rate filings and give the health insurance commissioner's office recommendations. The proposed rate increases don’t apply to self-funded employer groups, which account for about 65% of Rhode Islanders with employer-sponsored coverage. Self-funded employers pay health care expenses directly and usually rely on health insurance companies for administrative services like enrollment, provider contracting and processing claims. The weighted average of individual market rate increase requests was 23.7%, including:

Blue Cross & Blue Shield of Rhode Island: 28.9%, 18,172 enrollment
Neighborhood Health Plan of Rhode Island: 21.2%, 36,167 enrollment

The weighted average of small group market rate increase requests was 22%, including:

Blue Cross & Blue Shield of Rhode Island: 22.2%, 38,739 enrollment
Neighborhood Health Plan of Rhode Island: 20.3%, 2,446 enrollment
UnitedHealthcare of New England Inc.: 21.2%, 329 enrollment
UnitedHealthcare Insurance Company: 20.3%, 1,351 enrollment

The weighted average of large group market rate requests was 24.1%, including:

Blue Cross & Blue Shield of Rhode Island: 24.3%, 57,179 enrollment
UnitedHealthcare: 23.8%, 12,880 enrollment
Harvard Pilgrim Health Care of New England, Inc./Harvard Pilgrim Health Care Insurance Company: 26.4%, 5,736 enrollment
Aetna: 13.5%, 1,296 enrollment
Cigna: 16.8%, 563 enrollment

This year, individual rate requests will be considered as part of an administrative hearing process. BCBSRI is scheduled for June 30 and July 1, NHPRI is scheduled for July 15 and July 16. The health insurance commissioner's office will accept written public comment on the proposed rates through July 24 at 5 p.m. Katie Castellani is a PBN staff writer. You may contact her at Castellani@PBN.com.