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​​​​​​​​​​​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 ​Final Rate Chang​e Decision
Capital Advantage Assurance CABC-134076960 Yes​ 6.54% 7.59% Rating Areas
6, 7, 9​		 10.50% Capital Advantage Assurance Initial Rate Change Request Capital Advantage Assurance Final Rate Change Decision​​​
Keystone Health Plan Central CABC-134107611 No​ 15.20% 13.45% Rating Areas
6, 7, 9​ 		0.11% Keystone Health Plan Central Initial Rate Change Request Keystone Health Plan Central Final Rate Change Decision​
​Highmark, Inc. ​HGHM-134061483 ​Yes
 8.76% ​7.81% Rating Areas
1, 2, 4, 5, 6, 7, 9 		14.37% ​Highmark Initial Rate Change Request Highmark Final Rate Change Decision​
​Highmark Benefits Group HGHM-134061480 ​Yes
 12.76% 10.41%
 4.85% ​Highmark Benefits Group Initial Rate Change Request Highmark Benefits Group Final Rate Change Decision​
​Highmark Coverage Advantage HGHM-134061466 Yes​ 12.96% 9.21%
 5.20% ​Highmark Coverage Advantage Initial Rate Change Request Highmark Coverage Advantage Final Rate Change Decision​
​Geisinger Health Plan ​GSHP-134083328 Yes​ 11.24% ​10.10%
 3.25% ​Geisinger Health Plan Initial Rate Change Request Geisinger Health Plan Final Rate Change Decision​
​Geisinger Quality Options ​GSHP-134083390 ​Yes
 7.39% 6.33%
 0.67% ​Geisinger Quality Options Initial Rate Change Request​
 Geisinger Quality Options Final Rate Change Decision​
​Keystone Health Plan East INAC-134056069 ​Yes
 8.83% ​5.38% Rating Area
8
 24.60% ​Keystone Health Plan East Initial Rate Change Request ​Keystone Health Plan East Final Rate Change Decision
​​QCC Insurance ​INAC-134056107 Yes​ 8.61%​ 5.46%​ Rating Area
8​		 ​6.79% QCC Insurance Initial Rate Change Request​ QCC Insurance Final Rate Change Decision​
UPMC Health Coverage, Inc. UPMC-134082103 Yes​ 7.02% 5.74% Rating Areas
1, 5 		0.42% UPMC Health Coverage Initial Rate Change Request UPMC Health Coverage Final Rate Change Decision​
UPMC Health Options, Inc. UPMC-134082071 ​Yes
 4.83% 3.90% Rating Areas
1, 2, 3, 4, 5, 9		 21.03% UPMC Health Options Initial Rate Change Request UPMC Health Options Final Rate Change Decision​
​PA Health & Wellness ​CECO-134068773 Yes​ 6.21%​ 1.88% ​​​Rating Areas
1, 2, 3, 4, 5, 6, 7, 8		 ​5.83% PA Health & Wellness Initial Rate Change Request PA Health & Wellness Final Rate Change Decision​
​Oscar Health Plan of PA ​OHIN-134107350 ​Yes
 4.40%​ 4.81%​ ​Rating Areas
3, 6, 7, 8		 0.56%​ ​Oscar Health Plan of PA Initial Rate Change Request​ ​Oscar Health Plan of PA Final Rate Change Decision
Health Partners Plans, Inc. ​HEAL-134081943 Yes​ 2.85%​ 2.40%​ ​Rating Areas
6, 8​		 ​1.83% Health Partners Plans Initial Rate Change Request​​ Health Partners Plans Final Rate Change Decision​
​Partners Insurance, Inc. ​PICI-134098077 Yes​ ​0.00% 0.00%​ ​Rating Area
6​
 ​0.00% ​ Partners Insurance Initial Rate Change Request​​​ Partners Insurance Company Final Rate Change Decision​​


​​Small Group Market Plans
​​​ Company Name Tracking # Requested Rate % Approved Rate % Plan
Availability​*
 ​​Market Share in 2024§​
 Initial Rate Change Request ​Final Rate Chang​e Decision
​ Capital Advantage Assurance​ CABC-134095175 6.71% 7.66% Rating Areas
6, 7, 9		 8.61%​ Capital Advantage Assurance Initial Rate Change Request​
 Capital Advantage Assurance Final Rate Change Decision​
Keystone Health Plan Central CABC-134095176
 6.81%
 11.04%
 Rating Areas
​​6, 7, 9		 ​0.03%
 Keystone Health Plan Central Initial Rate Change Request ​Keystone Health Plan Central Final Rate Change Decision
​First Priority Life Insurance
 ​HGHM-134089349
 ​12.92%
 8.56%
 1.65%​ ​First Priority Life Insurance Initial Rate Change Request
 ​First Priority Life Insurance Final Rate Change Decision
​Highmark, Inc.
 ​HGHM-134081015
 ​8.44%
 8.71%
 2.63%​ ​Highmark Initial Rate Change Request
 Highmark Final Rate Change Decision​
​Highmark Benefits Group
 ​HGHM-134089375
 ​12.57%
 10.21%
 6.57%​ ​Highmark Benefits Group Initial Rate Change Request
 Highmark Benefits Group Final Rate Change Decision​
​Highmark Coverage Advantage
 ​HGHM-134080997
 ​9.48%
 9.37% ​4.05%
 ​Highmark Coverage Advantage Initial Rate Change Request
 Highmark Coverage Advantage Final Rate Change Decision​
​Highmark Senior Health
 ​HGHM-134089392
 ​4.82%
 4.82%
 0.29%​ ​Highmark Senior Health Initial Rate Change Request
 Highmark Senior Health Final Rate Change Decision​
​Geisinger Health Plan
 ​GSHP-134083482
 ​19.39%
 19.32%
 0.49%​ ​Geisinger Health Plan Initial Rate Change Request
 Geisinger Health Plan Final Rate Change Decision​
​Geisinger Quality Options
 ​GSHP-134083517
 ​15.87%
 ​15.55%
 2.32%​ ​Geisinger Quality Options Initial Rate Change Request
 Geisinger Quality Options Final Rate Change Decision​
Independence Assurance
 INAC-134056112
 7.17%
 7.15%
 20.42%​ Independence Assurance Initial Rate Change Request
 Independence Assurance Final Rate Change Decision​
​Keystone Health Plan East/AmeriHealth HMO, Inc.
 ​INAC-134056078
 ​7.01%
 ​6.99%
 23.25%​ ​Keystone Health Plan East/AmeriHealth HMO Initial Rate Change Request
 Keystone Health Plan East/AmeriHealth HMO Final Rate Change Decision​
UnitedHealthcare of PA
 UHLC-134100158
 5.85%
 6.45%
 ​Rating Areas
All
 ​0.28%
 UnitedHealthcare of PA Initial Rate Change Request
 UnitedHealthcare of PA Final Rate Change Decision​
UnitedHealthcare Insurance
 UHLC-134100161
 3.88%
 4.49%
 ​Rating Areas
​All
 3.33%​ UnitedHealthcare Insurance Initial Rate Change Request
 UnitedHealthcare Insurance Final Rate Change Decision​
UPMC Health Benefits
 UPMC-134078986
 6.57%
 6.24%
 0.22%​ UPMC Health Benefits Initial Rate Change Request
 ​UPMC Health Benefits Final Rate Change Decision
UPMC Health Coverage, Inc.
 UPMC-134078971
 6.52%
 6.17%
 2.09%​ UPMC Health Coverage Initial Rate Change Request
 UPMC Health Coverage Final Rate Change Decision​
UPMC Health Options, Inc. UPMC-134078960 7.23% 6.86% 23.76%​ UPMC Health Options Initial Rate Change Request​ ​UPMC Health Options Final Rate Change Decision​
*Plan Availability: Counties marked purple indicate plan availability for both the 2024 and 2025 plan years.  Counties marked in light blue indicate plan availability is new for the upcoming 2025 plan year.
​
​​ † 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.​
​