- Division of Insurance
This month, Massachusetts residents will again have the opportunity to provide comments on the cost of their health insurance. The Massachusetts Division of Insurance (DOI) announced that it has scheduled a virtual Public Information Session that will begin at 9:30 A.M. on June 18, 2024, for health insurance carriers to present on their proposed merged market health insurance rates for 2025.
Under state law, the DOI reviews and approves the rates for health plans sold to individuals and small employers (with 50 or fewer employees), also referred to as the “Merged Market.” A full list of the carriers offering health insurance in the merged market and their proposed rates can be found on the Division’s website here: 2025 Health Insurance Rates | Mass.gov. The weighted average rate change over last 2024 rates is 8.4%.
This marks the second time that the DOI has reviewed health rates as part of an annual review process. This new process, initiated by the Division last year, is more transparent, requiring carriers to participate in a public information session to explain their proposed rates, and allowing stakeholders to provide comments on the proposed rate changes.
Over the next few months, DOI will analyze the proposed rates to determine if the requested rates provide Massachusetts residents with a variety of adequate and affordable options for their health coverage. Carriers must provide to the DOI the reasons for their rate changes with significant detail about changes in membership, claims, administrative expenses and trends that support future projections, such as increases in medical utilization, new medical technologies and higher-cost prescription drugs. The carriers must also demonstrate in their filing that at least 88 cents of every premium dollar collected will be spent on medical costs.
The requested rates are for plans sold to individuals who buy their own coverage directly from an insurance company rather than getting it through an employer, plans for small business, and plans offered on the Massachusetts Health Connector that comply with the Affordable Care Act. The information session does not apply to the rates for coverage offered through MassHealth, the Group Insurance Commission (GIC), Medicare, or any self-funded health insurance plan, as the DOI is not responsible for approving the rates for those plans.
The public can also submit comments to the DOI until June 28. Final rates are expected to be placed on file sometime in August. More information can be found here: https://www.mass.gov/news/division-of-insurance-public-information-session-regarding-merged-market-health-insurance-rates-for-cy2025.
