CRANSTON – The R.I. Office of the Health Insurance Commissioner on Tuesday approved commercial health insurance rate hikes for 2025 for all insurers, though less in most cases than requests for individual, small- and large-group plans.
Large-group rate requests in June ranged from an increase of 2.5% to 14.9% and small-group market rate requests ranged from an increase of 8.8% to 22.7%, while individual rate requests ranged from an increase of 5.6% to 14.3%.
The Office of the Health Insurance Commissioner modified and approved weighted average rate hikes of 11.2% for large-group rates, 12.4% for small-group rates and 7.8% for individual rates.
One insurer, Neighborhood Health Plan
of Rhode Island, did, however, see an increase to its request for individual rates, getting a 5.9% bump after requesting a 5.6% rate hike.
Participants will save $26.6 million in 2025 compared with what the commercial health insurers requested, according to the release. The Office of the Health Insurance Commissioner reviewed medical and pharmacy expense trend assumptions, administrative charges and margin requests for each insurer.
“Each year my office must strike a difficult balance between affordability, the funding needs of the health care delivery system and insurer solvency.” said Health Insurance Commissioner Cory B. King. “Rising premiums negatively impact Rhode Islanders’ economic well-being. When insurers pay more for health care goods and services, premiums go up. Addressing the rising cost of health care is a core focus of my office, and we will continue our work with health care providers and insurers to lower Rhode Islanders’ health care costs.”
On Aug. 13, Attorney General Peter F. Neronha urged OHIC to reject all of the proposed commercial health insurance rate hikes for 2025, saying, “We have a system that is broken.”
“History has shown that significant rate increases year after year have not translated into improved access to and quality of care,” Neronha said in a public comment letter submitted to the R.I. Office of Health Insurance Commissioner Aug. 8 urging the agency to reject the requested increases. “Insurers get what they need, while consumers, providers, and our healthcare system continue to suffer.”
Days before sending his comments to OHIC, Neronha released a statement urging the agency to reject Blue Cross & Blue Shield of Rhode Island’s proposed 14.3% individual market increase, deeming it “staggering and unfair.”
Blue Cross on Tuesday was approved for an 11% increase.
In a statement, Blue Cross said it is "concerned" by the reduction in its proposed increase.
“Health care costs in Rhode Island are soaring. We have experienced 20% growth in medical and drug costs since 2023, which is far outpacing premium increases OHIC approved last year,” said Blue Cross CEO and President Martha L. Wofford. “We are highly focused on improving affordability and the last thing we want to do is increase rates for our customers and members, however, it is imperative for health care stability in Rhode Island that OHIC establish premiums that adequately cover surging costs.
"[Blue Cross] posted an operating loss of $26 million in 2023, projects a significant budget gap for 2024, and, given the premiums approved by OHIC for 2025, anticipates further financial shortfalls next year," she said.
In his letter to OHIC, Neronha called for reform of the health care system.
He noted Rhode Islanders struggle to find a place to receive health care and the state has not been able to maintain an adequate workforce. On top of this, Rhode Island’s reimbursement rates are lower than neighboring states.
Despite repeatedly increasing insurance rates, prices paid by employer sponsored health plans were lower in Rhode Island than both Massachusetts and Connecticut, Neronha said.
Neronha also called for changes including an “independent and robust” government that has authority and mandated to assess the system as a whole. He added that there needs to be “bold” health care payment reform that offers alternatives to traditional insurance by combining the group’s purchasing power, risks and streamline administrative costs.
Rate increases that OHIC approved:
Small-group rates:
- Blue Cross & Blue Shield of Rhode Island: 12.9% increase approved after requesting a rate 15.6% hike.
- Neighborhood Health Plan of Rhode Island: 6% increase approved after requesting an rate 8.9% hike.
- UnitedHealthcare of New England: 1% increase approved after requesting an 8.8% rate hike.
- UnitedHealthcare Insurance Co.: 14% increase approved after requesting a 22.7% rate hike.
- Harvard Pilgrim Health Care Insurance Co.: 6.9% increase approved after requesting a 10.2% rate hike.
- Harvard Pilgrim Health Care of New England: 7.5% increase approved after requesting an 11% rate hike.
Large-group market rates:
- Blue Cross & Blue Shield of Rhode Island: 11.3% increase approved after requesting a 13.5% rate hike.
- UnitedHealthcare: 10.6% increase approved after requesting a 14.9% rate hike.
- Harvard Pilgrim Health Care Insurance Co.: 11.4% increase approved after requesting a 13.6% rate hike.
- Harvard Pilgrim Health Care of New England: 11.1% increase approved after requesting a 13.3% rate hike.
- Aetna Inc.: 7.5% increase approved after requesting a 7.5% rate hike.
- The Cigna Group: 0.9% increase approved after requesting a 2.5% rate hike.
Individual market rate:
- Blue Cross: 11% increase approved after requesting a 14.3% rate hike.
- Neighborhood Health Plan: 5.9% increase approved after requesting 5.6% rate hike.
(ADDS paragraphs 10-13 with comment from Blue Cross.)
