Rate Reflects Collective Work Across State to Address Healthcare Affordability As Claims Costs Continue to Rise
by Timothy McQuiston, Vermont Business Magazine Blue Cross and Blue Shield of Vermont announced May 12 that it has requested a 2027 premium rate increase of 3.1% and 5.2% for small group and individual QHP plans respectively. The rate increase is smaller than any of the previous five years, reflecting collective efforts across the state to control healthcare costs, as medical and pharmacy claims costs continue to increase year over year.
MVP, based in Schenectady, NY, the only other insurer in the small group and individual markets in Vermont, is proposing an average rate increase (MVP’s revenue increase) in the small group market of 9.1%, with increases ranging from 6.7% to 11.0%. The book of business affected by this rate filing is 1,384 policyholders, 12,578 subscribers and 20,791 members based on February 2026 membership.
In the individual market, the proposed average rate increase (MVP’s revenue increase) is 7.8%, with increases ranging from 4.7% to 108.8%. The book of business affected by this rate filing is 11,975 policyholders, 11,975 subscribers and 16,542 members based on February 2026 membership.
The rates are filed with and available through the Green Mountain Care Board. The public comment period ends on Monday, July 27, 2026.
“I’m proud of the work our team has done to address healthcare costs and minimize premium increases for members,” said Beth Roberts, President and CEO of Blue Cross VT. “We know Vermonters are still struggling to afford healthcare, and we are committed to working with leaders across the state to bring costs down further. We are working directly with hospitals on contracting, finding healthcare cost savings internally, and we have opportunities with proposed legislation on reference-based pricing that has the potential to lower costs for all Vermonters if implemented broadly.”
Blue Cross Vermont Individual Market: The average rate change is 5.2 percent. Changes for specific plans range from 1.6 percent to 10.8 percent. The range of changes is due to changes to the actuarial values and plan designs.
Blue Cross Vermont Small Group Market: The average rate change is 3.1 percent. Changes for specific plans range from -0.3 percent to 4.6 percent. The range of changes is due to changes to the actuarial values and plan designs.
As of February 2026, Blue Cross VT had 30,609 members enrolled in the Vermont QHP markets, with 17,428 enrolled individually through Vermont Health Connect or directly through Blue Cross VT and 13,181 small group employees and their dependents.
Blue Cross VT has been actively working to find savings for members through a variety of different mechanisms, specifically:
- Lowering drug costs through medication therapy management, medical drug rebates, formulary management, biosimilars and partnerships via Blue Cross and Blue Shield-backed organizations.
- Proactive payment management including ongoing hospital contracting work and close management of payment integrity to ensure claims are paid accurately and only for services that are appropriately coded, billed and coordinated.
- Proactive clinical management such as case management for members with complex medical needs to improve health and reduce avoidable hospitalizations, and utilization management to ensure healthcare services are clinically appropriate, evidence- based, and delivered in the most appropriate care setting.
- Maintaining low administrative expenses so that 94 cents of each premium dollar goes directly to paying claims. Blue Cross VT is among the top 1% of plans nationally for responsibly managing administrative costs.
- Designing new products to provide more affordable choices for Vermonters, including new lower premium products.
Despite work to lower healthcare costs, medical utilization and overall pharmacy trends are expected to increase by approximately 4.5% and 16% respectively. Healthcare costs have increased each year for several years. Utilization trends and costs factor into premium rates, as do a range of factors including prior year claims, membership make-up, impact of federal and state regulations and more.
For more information about how premium rates are developed, visit https://www.bluecrossvt.org/health-community/blog/listing/how-cost-your-health-insurance-premium-decided.
About Blue Cross and Blue Shield of Vermont Blue Cross and Blue Shield of Vermont is a local, not-for-profit health plan. For over 40 years, the company has been enhancing the health and well-being of the Vermonters we serve by offering innovative plans to individuals, older Vermonters, and businesses. Our employees are dedicated to developing new ways to support high-quality care, programs and events that promote wellness. Blue Cross and Blue Shield of Vermont is a licensee of the Blue Cross and Blue Shield Association.
Berlin, VT, May 12, 2026 — Blue Cross and Blue Shield of Vermont bluecrossvt.org
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