September 11, 2024
OLYMPIA, Wash. — The Office of the Insurance Commissioner (OIC) announced today that 11 health insurers have been approved to sell in Washington's 2025 Exchange health insurance market. The approved average rate increase of 10.7% is lower than the 11.3% average increase requested.
Rates and plans for two additional insurers that only sell outside of the Exchange (Asuris Northwest Health and Providence Health Plan) are still pending.
"I know this rate increase will hit hard for many people, especially at a time when other expenses are up," said Insurance Commissioner Mike Kreidler. "A key driver behind these rates is the increase in services used and the cost to deliver that care. Addressing the underlying costs of health care will require some difficult choices, but consumers and our health care system cannot afford to wait. Our recent report delivered to the state Legislature last month details the impact several policy strategies can have on health care and insurance costs. I'm hopeful the Legislature will use this data to work toward meaningful, concrete changes in our health care system. These costs will not decrease if we don't act now."
Each year, the OIC scrutinizes insurer's rates and the basis for any increase or decrease. If the rate request is determined to be justified, state law requires the OIC to approve it.
People who do not get health insurance from their employers shop for health plans in the individual market. Financial subsidies that help lower monthly premiums are available, based on income, through Washington's Exchange, an online health insurance marketplace, www.wahealthplanfinder.org.
As of July 2024, an estimated 259,454 people in Washington were enrolled in health plans through the individual market, with 232,713 enrolled through the Exchange.
How much premium someone pays will depend on their income, the plan they select, the number of people covered, their age, whether they smoke and where they live.
See 2025 Exchange insurers and plans by county (PDF, 247.65KB)
| Company | Est. people impacted | Requested average rate change | Approved average rate change |
|---|---|---|---|
| Bridgespan Health Company | 544 | 20.3% | 14.9% |
| Coordinated Care Corp. | 83,378 | 12.1% | 9.3% |
| Community Health Plan of Washington | 23,598 | 4.5% | 9.3% |
| Kaiser Foundation Health Plan of the Northwest | 7,232 | 6.4% | 9.9% |
| Kaiser Foundation Health Plan of Washington | 44,311 | 7.9% | 8.6% |
| LifeWise Health Plan of Washington | 26,659 | 8.0% | 8.0% |
| Molina Healthcare of Washington, Inc. | 41,454 | 7.5% | 5.7% |
| Premera Blue Cross | 10,952 | 14.9% | 14.9% |
| Regence BlueShield | 28,369 | 23.8% | 22.8% |
| Regence Blue Cross Blue Shield of Oregon | 8,397 | 16.8% | 16.7% |
| UnitedHealthcare of Oregon, Inc. | 6,207 | 23.6% | 23.7% |
| Total | 281,101 | 11.3% | 10.7% |
How rates are reviewed
Health insurance rates must be reasonable in relation to the benefits provided. During our review, we scrutinize the insurers' projections and the information they've based these on, including the last three years' rates, enrollment and claims as well as the following information:
- The rates, claims and administrative costs to ensure they're consistent with what the company reported in its financial statement.
- The actual vs. projected medical and prescription drug costs.
- The assumptions used to project the medical and prescription drug costs, including changes in these costs and the benefit design.
- The actual vs. projected administrative costs, including expenses such as agent commissions, taxes, salaries, case management activities, claims and appeals processing costs, customer services, etc.
- How much profit the company expects to make; this is generally called "contribution to surplus" or "projected profit." Whether this amount is considered reasonable depends on the company's current level of surplus, as well as the type of business.
If the rate change is determined to be justified, we are required by law to approve it.