Affordable Care Act Health Rate Filings
What Are Rate Filings?
Insurance companies offering individual and small group health insurance plans in Pennsylvania must file proposed rates for the upcoming plan year. We then review and approve those rates before plans can be sold to consumers.
The rates submitted by the insurers reflect estimates of future costs, including medical and prescription drug costs and administrative expenses, based on historical data and forecasts of trends for the upcoming plan year.
How Are Rates Approved?
The goal of the rate review process is to ensure plans are priced appropriately and are not unfair or discriminatory.
During the review process, we consider the insurers' estimates of future costs, historical data, and forecasts for the upcoming year. We also factor in other information, such as the insurer's revenues, actual and projected profits, past rate changes, and the effect the change will have on Pennsylvania consumers.
ACA-Related Rate Filings for 2025 Plan Year
Below you can review information on pending and approved rate filings for individual and small-group plans that comply with the Affordable Care Act. We will post the information as it becomes available. Insurers’ Requested Rate % and Initial Rate Change Requests are usually available in early August. Once the Department has completed its review of those requests the Approved Rate % and Final Rate Change Decision will also be posted to the website, usually in October. Limited portions of the filings are deemed confidential by law. Consumers are invited to submit comments on any pending filings to ra-rateform@pa.gov. Comments submitted in writing may be posted to our website.
| Individual Market Plans | |||||||
|---|---|---|---|---|---|---|---|
| Company Name | Tracking # | Available on Pennie Marketplace® | Requested Rate % | Approved Rate % | Plan Availability* | Market Share in 2024† | Initial Rate Change Request |
| Capital Advantage Assurance | CABC-134076960 | Yes | 6.54% | -- | Rating Areas 6, 7, 9 | 10.50% | Capital Advantage Assurance Initial Rate Change Request |
| Keystone Health Plan Central | CABC-134107611 | No | 15.20% | -- | Rating Areas 6, 7, 9 | 0.11% | Keystone Health Plan Central Initial Rate Change Request |
| Highmark, Inc. | HGHM-134061483 | Yes | 8.76% | -- | Rating Areas 1, 2, 4, 5, 6, 7, 9 | 14.37% | Highmark, Inc. Initial Rate Change Request |
| Highmark Benefits Group | HGHM-134061480 | Yes | 12.76% | -- |
| 4.85% | Highmark Benefits Group Initial Rate Change Request |
| Highmark Coverage Advantage | HGHM-134061466 | Yes | 12.96% | -- |
| 5.20% | Highmark Coverage Advantage Initial Rate Change Request |
| Geisinger Health Plan | GSHP-134083328 | Yes | 11.24% | -- |
| 3.25% | Geisinger Health Plan Initial Rate Change Request |
| Geisinger Quality Options | GSHP-134083390 | Yes | 7.39% | -- |
| 0.67% | Geisinger Quality Options Initial Rate Change Request |
| Keystone Health Plan East | INAC-134056069 | Yes | 8.83% | -- | Rating Area 8 | 24.60% | Keystone Health Plan East Initial Rate Change Request |
| QCC Insurance | INAC-134056107 | Yes | 8.61% | -- | Rating Area 8 | 6.79% | QCC Insurance Initial Rate Change Request |
| UPMC Health Coverage, Inc. | UPMC-134082103 | Yes | 7.02% | -- | Rating Areas 1, 5 | 0.42% | UPMC Health Coverage, Inc. Initial Rate Change Request |
| UPMC Health Options, Inc. | UPMC-134082071 | Yes | 4.83% | -- | Rating Areas 1, 2, 3, 4, 5, 6, 7, 9 | 21.03% | UPMC Health Options, Inc. Initial Rate Change Request |
| PA Health & Wellness | CECO-134068773 | Yes | 6.21% | -- | Rating Areas 1, 2, 3, 4, 5, 6, 7, 8 | 5.83% | PA Health & Wellness Initial Rate Change Request |
| Oscar Health Plan of PA | OHIN-134107350 | Yes | 4.40% | -- | Rating Areas 3, 6, 7, 8 | 0.56% | Oscar Health Plan of PA Initial Rate Change Request |
| Health Partners Plans, Inc. | HEAL-134081943 | Yes | 2.85% | -- | Rating Areas 6, 8 | 1.83% | Health Partners Plans, Inc. Initial Rate Change Request |
| Partners Insurance, Inc. | PICI-134098077 | Yes | 0.00% | -- | Rating Area 6 | 0.00% | Partners Insurance, Inc. Initial Rate Change Request |
| Small Group Market Plans | ||||||
|---|---|---|---|---|---|---|
| Company Name | Tracking # | Requested Rate % | Approved Rate % | Plan Availability* | Market Share in 2024§ | Initial Rate Change Request |
| Capital Advantage Assurance | CABC-134095175 | 6.71% | -- | Rating Areas 6, 7, 9 | 8.61% | Capital Advantage Assurance Initial Rate Change Request |
| Keystone Health Plan Central | CABC-134095176 | 6.81% | -- | Rating Areas 6, 7, 9 | 0.03% | Keystone Health Plan Central Initial Rate Change Request |
| First Priority Life Insurance | HGHM-134089349 | 12.92% | -- | 1.65% | First Priority Life Insurance Initial Rate Change Request | |
| Highmark, Inc. | HGHM-134081015 | 8.44% | -- | 2.63% | Highmark, Inc. Initial Rate Change Request | |
| Highmark Benefits Group | HGHM-134089375 | 12.57% | -- | 6.57% | Highmark Benefits Group Initial Rate Change Request | |
| Highmark Coverage Advantage | HGHM-134080997 | 9.48% | -- | 4.05% | Highmark Coverage Advantage Initial Rate Change Request | |
| Highmark Senior Health | HGHM-134089392 | 4.82% | -- | 0.29% | Highmark Senior Health Initial Rate Change Request | |
| Geisinger Health Plan | GSHP-134083482 | 19.39% | -- | 0.49% | Geisinger Health Plan Initial Rate Change Request | |
| Geisinger Quality Options | GSHP-134083517 | 15.87% | -- | 2.32% | Geisinger Quality Options Initial Rate Change Request | |
| Independence Assurance | INAC-134056112 | 7.17% | -- | 20.42% | Independence Assurance Initial Rate Change Request | |
| Keystone Health Plan East/AmeriHealth HMO, Inc. | INAC-134056078 | 7.01% | -- | 23.25% | Keystone Health Plan East/AmeriHealth HMO, Inc. Initial Rate Change Request | |
| UnitedHealthcare of PA | UHLC-134100158 | 5.85% | -- | Rating Areas All | 0.28% | UnitedHealthcare of PA Initial Rate Change Request |
| UnitedHealthcare Insurance | UHLC-134100161 | 3.88% | -- | Rating Areas All | 3.33% | UnitedHealthcare Insurance Initial Rate Change Request |
| UPMC Health Benefits | UPMC-134078986 | 6.57% | -- | 0.22% | UPMC Health Benefits Initial Rate Change Request | |
| UPMC Health Coverage, Inc. | UPMC-134078971 | 6.52% | -- | 2.09% | UPMC Health Coverage, Inc. Initial Rate Change Request | |
| UPMC Health Options, Inc. | UPMC-134078960 | 7.23% | -- | 23.76% | UPMC Health Options, Inc. Initial Rate Change Request | |
† Individual Plan Market Share for 2024: Percentages are based on 501,240 total members as of 2024.
§ Small Group Plan Market Share for 2024: Percentages are based on 378,959 total members as of 2024.