RI Approves, for Many, Double-Digit Increases in Health Insurance Premiums

The State of Rhode Island’s Office of the Health Insurance Commissioner (OHIC) has approved commercial health insurance premiums for 2025 -- for many, their rates are going up double digits.

Overall, the OHIC-approved weighted average rate changes are 7.8% for the individual market, 12.4% for the small group market, and 11.2% for the large group market. 

The increases were approved by Governor Dan McKee's appointee, Health Insurance Commissioner Cory B. King.

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Since the rate filings were submitted in May, OHIC said it had reviewed the medical and pharmacy expense trend assumptions, administrative charges, and margin requests for each insurer. Additionally, OHIC staff reviewed the benefit coverage documents for each health plan to ensure compliance with state and federal laws. The premiums approved by OHIC are predominantly driven by payments to healthcare providers and drug costs due to increasing unit prices and the use of healthcare goods and services.

 

“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. He continued: “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.”

 

The approved rates do not apply to self-funded employer groups that account for approximately 65% of Rhode Islanders with employer-sponsored coverage. Self-funded employers pay the health care expenses of their employees and dependents directly, commonly relying on health insurance companies for administrative services, such as member enrollment, provider contracting, and claims processing.

In a statement to GoLocal, McKee said, "While Rhode Island is not alone in dealing with the consequences of an increase in insurer claims payments, our residents cannot be expected to weather large rate increases like these in the future. We must work with insurers, providers, and policymakers to bring down these rates next year."

 

Tables 1 – 3, below, summarize the approved rates for 2025 and the enrollment with each insurer, by market, as of March 2024. The rate change approved by OHIC is shown along with the recommendations from the RIAG’s consulting actuary, and the rate change requested by the insurers in the May filings. Overall, the OHIC-approved weighted average rate changes are 7.8% for the individual market, 12.4% for the small group market, and 11.2% for the large group market. 

 

Table 1: Individual Market Approved – Weighted Average Rate Change

Insurer	Enrollment	OHIC Approved	RIAG Actuary Recommendation	Insurer Requested
BCBSRI	17,614	11.0%	14.2%	14.3%
NHPRI	29,713	5.9%	7.6%[1]	5.6%

 

Table 2: Small Group Market Approved – Weighted Average Rate Change

Insurer	Enrollment	OHIC Approved	RIAG Actuary Recommended	Insurer Requested
BCBSRI	39,660	12.9%	15.2%	15.6%
NHPRI	2,203	6.0%	7.9%	8.9%
UHCNE	403	1.0%	4.1%	8.8%
UHIC	1,644	14.0%	18.0%	22.7%
HPIC	435	6.9%	6.5%	10.2%
HPHC	427	7.5%	7.0%	11.0%

 

Table 3: Large Group Market Approved – Weighted Average Rate Change

Insurer	Enrollment	OHIC Approved	RIAG Actuary Recommended	Insurer Requested
BCBSRI	59,990	11.3%	13.0%	13.5%
UnitedHealthcare	12,314	10.6%	10.5%	14.9%
HPHC	2,897	11.4%	12.8%	13.6%
HPIC	3,709	11.1%	12.5%	13.3%
Aetna	74	7.5%	6.2%	7.9%
Cigna	383	0.9%	1.3%	2.5%

 

This story was updated at 1:34 PM with comment from Governor McKee.

429 Too Many Requests

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