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Benefits Bites

2025 Individual Plans

9/13/2024

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The Washington State Office of the Insurance Commissioner (OIC) released approved 2025 rates for 11 of the 13 individual carriers who will offer options in the state.  We are still waiting to see final approvals for Asuris NW and Providence Health plan. Currently we have 14 individual medical carriers, so we will be losing one option (PacificSource) as we enter the new year.  While requested increases ranged from 4.5% to 23.8%, the final approvals fall between 5.7% and 23.7%.
 
Carriers Approved
Of the 11 individual carriers that have been approved, many finalized their plans at or below their requested rate adjustment. Four carrier’s rates have been approved at a higher level than initially requested: Community Health Network, Kaiser NW, Kaiser WA, and United Healthcare.

There are five carriers who received a double-digit increase for 2025.
  • United Healthcare (23.7%)
  • Regence BlueShield (22.8%)
  • Regence BlueShield of OR (16.7%)
  • Premera Blue Cross (14.9%)
  • Bridgespan (14.9%)
For comparison, there were three carriers with double-digit increases in 2024 and six in 2023.

There are no carriers who were approved for a decrease in rates in 2025. For comparison, there were three carriers with rate decreases in 2024 and two in 2023.

To see our 2025 Individual Rate Tracking spreadsheet for more in-depth information about each carrier’ requested rate change and final approval, log in (or create an account) HERE. Scroll down to our Monthly Freebie Section.
 
Changes to County Coverage
In 2025, we will see one carrier exit the individual marketplace in Washington (PacificSource) which currently serves Clark, Pierce, Spokane, and Thurston counties. This will affect roughly 4,000 current customers. Options will remain for these individuals: Clark county will have 7 carriers offering benefit plans, Pierce county 9, Spokane county 9, and Thurston county 8.

Only one carrier, Lifewise, will be eliminating coverage in some counties. They will be dropping Clallam, Jefferson, and Mason counties. They will also be adding coverage in Grays Harbor. Two other carriers will be expanding their county lists. Community Health Network will be adding Lincoln county. And Ambetter (Coordinated Care) will be expanding into Clark, Cowlitz, Island, San Juan, Skagit, and Whatcom counties, becoming the only carrier in 2025 to offer individual coverage state-wide.
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All counties continue to have at least 3 carriers offering individual medical coverage as we head into 2025. King, Pierce and Spokane counties continue will have the most carriers available, at 9.  A full summary of carrier offerings by carrier and county can be found on our agent website. Log in (or create an account) HERE. Scroll down to our Monthly Freebie Section.
 
Comparing 2025 to Past Years
For the fourth year in a row, at least one carrier has requested an increase of over 16% to their average individual medical rates in Washington state.
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The Bottom Line
For yet another year, we are able to enter the new year with a rather stable individual medical market, with each county having 3 to 9 carriers to choose amongst. Unfortunately, the average rate increase will be higher than what we experienced last renewal cycle. Individuals currently enrolled with PacificSource will need to change their carrier, as well as those on Lifewise who live in Clallam, Jefferson, and Mason counties. There certainly could be movement from one carrier to another in counties where carriers are entering the market, including Clark, Cowlitz, Grays Harbor, Island, Lincoln, San Juan, Skagit, and Whatcom counties. And there is a high likelihood of individuals at least looking at alternatives who are currently with carriers who have had their rate filing approved at double-digit rate increases, which includes Bridge Span, Premera Blue Cross, Regence BlueShield, Regence BlueShield of OR, and United Healthcare. I am predicting it will be quite a busy open enrollment season for agents and brokers this fourth quarter.
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2024 Individual Plans

9/15/2023

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The WA state OIC has approved 2024 rates for all individual carriers. Let's take a peek at what is in store for next year's individual market.

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2023 Proposed Rates – Small Group & Individual Plans

7/11/2022

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The carriers have submitted 2023 rates to the OIC for review. Let's take a peek at what is in store for next year's individual and small group premiums.

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2022 Individual Plans

11/19/2021

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We have all the latest info on rates and county coverage for individual plans in Washington State in 2022.

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Cascade Care – Going Live 1/1/2021

10/20/2020

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We've been telling you about Cascade Care for months, now with plans coming online in mere months, the OIC has laid out what the program will look like and which Washington state counties will have the "Public Option" available on the Exchange.

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2021 Individual Plans

10/2/2020

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The Washington State Office of the Insurance Commissioner released approved 2021 rates for 13 of the 15 carriers that proposed individual plans. 

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2021 Proposed Rates – Small Group & Individual Plans

6/17/2020

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The proposed 2021 premium numbers for small group and individual plans have been submitted to the OIC. We're diving into the details and looking ahead to what's the future looks like for carriers, counties and rates in Washington state.


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Benefit Bites - Resources Edition - June, 2019

6/30/2019

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In this Benefit Bites:
Blog: Guest blog from Gina Marken: ICHRA
Monthly Freebies:
  • 2020 Individual Plans by County
  • 2020 Proposed individual rates
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Benefit Bites - Industry Edition - June, 2019

6/15/2019

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In this Benefit Bites:
Blog: 2020 Individual and Small Group Proposed Rates
Carrier Corner:
  •  Aliera - OIC ordered to stop selling in WA
  • ALLtech/AIMS - employers can pay invoices online
  • Benefit Resource Hub - changing to AP Connect
  • BIAW - now providing telehealth through Doctor on Demand
  • First Choice EAP - new telehealth technology through BetterHelp
  • HealthNet - will not sell individual or small group in WA in 2020
  • IRS 2020 Limits - HSA and out of pocket maximums
  • PCORI - payments due 7/31
  • UHC - new preferred lab network
  • Farm Bureau - moving administration to Rehn
  • Zywave - acquired RateFactory
  • SURVEYS AND SUCH
    BenefitFocus - 2019 Consumer Benefits Coverage Index

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Breaking News: WA OIC releases 2020 individual & small group rates

6/3/2019

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Mike Kreidler's office released proposed rates from 13 individual medical carriers with an average increase of <1%. We pulled the requested changes, by carrier, for both individual and small group plans.  Here's how it breaks down.

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    About Sandy

    I love numbers.  I'm a math geek. I read benefits industry articles and periodicals for relaxation (but, honestly, I'm still a fun gal).  I also like to share what I've learned and you'll find it all here.

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