This story is part of CT Mirror Explains, an ongoing effort to distill our wide-ranging reporting into a "what you need to know" format and provide practical information to our readers.
Editor’s Note: This article is part of CT Mirror’s Spanish-language news coverage developed in partnership with Identidad Latina Multimedia.
The Connecticut insurance department is again considering annual rate hikes for state-regulated health plans on and off the insurance exchange.
Insurers are seeking an average increase of 8.3% on 2025 individual plans and 11.9% on small group policies. The proposed hikes are lower than what was requested the last two years, but similar to those sought in 2021.
Last year, insurers asked for an average rate increase of 12.4% on individual plans and 14.8% on small group. The state approved a 9.4% average hike for individual policies and 7.4% for small group.
The plans collectively cover about 200,000 people.
Attorney General William Tong said residents can’t keep paying higher rates.
“I will be closely scrutinizing each of these requests and expect to play a very active role in every step of this process,” he said. “Connecticut families and small businesses cannot continue to absorb these increases year after year. The burden of proof will fall on the insurers to justify every penny here.
“Decisions here will have an enormous impact on the cost of health care for every one of us.”
Here’s what to know about the proposed rate hikes.
How much of an increase are insurers requesting for plans on the exchange?
Three carriers are selling policies through the state’s health insurance exchange, known as Access Health CT: Anthem Health Plans, ConnectiCare Benefits Inc., and ConnectiCare Insurance Company Inc.
Anthem is seeking an average increase of 9% on its individual plans; the proposed hikes range from 4.3% to 18%, depending on the plan, and cover 63,277 people. It has also requested an average increase of 13.6% on small group policies that cover 37,667 people.
ConnectiCare Benefits is asking for an average hike of 7.4% on individual plans. The suggested increases range from 6.4% to 9% and cover 73,465 residents.
And ConnectiCare Insurance sought a 12.5% average hike on individual policies — with a range of 10.8% to 15.1% — that cover 4,392 people.
Insurers are also asking for increases on off-exchange policies.
What happens next?
Insurance department actuaries will review the requests for increases. As part of the review, they will look at trends in unit cost (total expenditure incurred by the company), utilization of services, and expected severity of claims. The department will issue questions to the insurers and seek clarification if needed.
After that, the department can choose to approve the full requested increases, reject them or amend them. The final changes will be published later this summer.
Why are insurers seeking increases?
Insurance companies have attributed the proposed rate hikes to increased demand for medical services, rising health care costs (including prescription drugs), the impact of Medicaid unwinding (the expiration of a pandemic policy that prevented states from kicking people off Medicaid), and adjustments needed to reflect COVID expenses in 2025 (at a level higher than previously assumed), according to the insurance department.
Will the public have a chance to weigh in?
Residents can post comments online (by clicking “select” under each rate proposal) or mail letters to the Connecticut Insurance Department at P.O. Box 816, Hartford, CT 06142-0816.
A public hearing will be held later this summer, at a date yet to be announced.
When does open enrollment start?
Open enrollment for 2025 health plans begins Nov. 1.