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2026 Health Insurance Rates

In accordance with the provisions of 211 CMR 66.08(3)(e), and in order to ensure that insurance rates are fair to consumers, the Division of Insurance reviews and seeks public comment on the rates requested by health insurance carriers.
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Merged Market Summary for Proposed Rates Effective for 2026

The following tables depict the proposed overall weighted average premium increase and the key assumptions behind premium development for the merged (individual and small employer) market filed by insurance carriers as part of the Massachusetts Division of Insurance rate review process (for rates effective in 2026). This information is subject to change as the rate review process continues.

The Health Care Access Bureau within the Massachusetts Division of Insurance is currently reviewing these assumptions. This review process will culminate in a final decision in August 2025.

There are 711,563 consumers enrolled in merged (individual/small group) market plans (data as of December 2024).

  • The Average Rate Change represents adjustments to reflect benefit changes in renewing plans and it reflects plans that have been terminated and mapped to existing plan offerings.  This weighted average rate change represents the average rate change consumers will experience before changes due to age.
  • The Medical Expense and Pharmacy Trend Assumptions are the annualized rate of increase due to increases in the unit cost of health care services and in the utilization of health care services.[1]  These trend assumptions are generally applied to current claims experience to project 2026 required revenue rates.
  • The Non-Medical Portion of Premium represents the percent of overall premium that is required to cover administrative expense, contribution to reserves and required taxes and fees, including premium tax, ACA fees.
  • The Risk Adjustment Assumption is the Affordable Care Act’s (ACA) risk adjustment program which redistributes funds from carriers with lower-risk enrollees to plans with higher-risk enrollees.

[1] Provider mix and service mix are typically included within utilization trend assumptions. Cost sharing leverage may also be included in either the pricing AV or utilization assumptions.

Rate Filing Summary Chart 2026

Carrier Rate Filing Summaries (Explanations)

Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. 

Public Summary

Exhibit for Public Release

Plan and Benefit Templates

Boston Medical Center Health Plan, Inc. (d/b/a WellSense Health Plan)

Public Summary

Exhibit for Public Release

Plan and Benefit Templates

Fallon Community Health Plan, Inc.

Public Summary (Narrative)

Exhibit for Public Release

Plan and Benefit Templates

Harvard Pilgrim Health Care, Inc.  

Public Summary (Narrative)

Exhibit for Public Release

Plan and Benefit Templates

Health New England, Inc.  

Public Summary (Narrative)

Exhibit for Public Release

Plan and Benefit Templates

Mass General Brigham Health Plan, Inc.

Public Summary (Narrative)

Exhibit for Public Release

Plan and Benefit Templates

Tufts Health Public Plans, Inc.   

Public Summary (Narrative)

Exhibit for Public Release

Plan and Benefit Templates

UnitedHealthcare Insurance Company

Public Summary (Narrative)

Exhibit for Public Release

Plan and Benefit Templates

Prior Merged Market Rate Changes

Prior Merged Market Rate Changes

Public Information Session

In accordance with the provisions of 211 CMR 66.08(3)(e), health insurance carriers presented their proposed merged market health insurance rates for 2026 at a public information session held on June 17, 2025. To watch the session, click the video link below. The relevant filing materials for each carrier can be reviewed in the section titled Carrier Rate Filing Summaries.

Public Information Session Video, 2025

Written Comments Submitted for Public Session on June 1, 2025

Ryan C. Kearney, General Counsel Retailers Association of Massachusetts

Liz Leahy, Esq., Senior Vice President of Advocacy and Engagement, Chief of Staff, Massachusetts Association of Health Plans

Karen Granoff, Senior Director, Managed Care, Massachusetts Health & Hospital Association

Travis Condon, Director of Public Affairs, North Central Massachusetts Chamber of Commerce

Alex Sheff, Senior Director, Policy and Government Relations, Health Care for All

Kathleen McCarthy, LICSW, CADCII

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