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Excellus wants to increase premiums by 20+ percent this year: Will state allow it?

Excellus BlueCross BlueShield has announced a proposed 19.5% increase in premium rates for certain health plans in 2025. Letters are being sent to affected customers explaining the changes.

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The rate adjustment request, filed with the Superintendent of the Department of Financial Services on May 15, seeks approval for the hike in community-rated small group plans and individual plans. If approved, the new rates will impact approximately 167,000 members, or 11.5% of Excellus’ total membership, across 39 counties in upstate New York, starting January 1, 2025. A decision on the proposal is expected this summer.

Excellus attributes the rate increase to the rising costs of healthcare services, equipment, and products. Other contributing factors include the Risk Adjustment Program, leveraging, and the compounding effects of price and utilization. The company says that 93 cents of every premium dollar were spent on direct patient care in 2023.