Excellus proposes 19.5% rate increase to health plans in 2025

Excellus is proposing a 19.5% increase in premium rates for certain health plans in 2025. This proposed adjustment targets community-rated small group plans and individual plans, affecting about 11.5% of Excellus’ membership, or around 167,000 members across 39 counties in upstate New York. The rate increase request was filed with the Superintendent of the Department of Financial Services on May 15, and, if approved, will take effect on January 1, 2025.

Excellus attributes the proposed rate hike to the rising costs of healthcare services, equipment, and products, as well as the Risk Adjustment Program and other financial factors. The company emphasized that 93 cents of every premium dollar were spent on direct patient care in 2023. A decision on the proposal is expected this summer.

Source: Rochester First