|
Small Group - Average Annual Increase Over 2024 Rates |
|||
|
Insurer |
Initial Request |
Final Request |
GMCB Approved |
|
BCBSVT |
19.1% |
24.0% |
22.8% |
|
MVP |
9.3% |
11.5% |
11.1% |
|
Individual - Average Annual Increase Over 2024 Rates |
|||
|
BCBSVT |
16.3% |
21.0% |
19.8% |
|
MVP |
11.7% |
14.9% |
14.2% |
Vermont Business Magazine The Green Mountain Care Board (GMCB) directed Blue Cross and Blue Shield of Vermont (BCBSVT) and MVP Health Plan, Inc. (MVP) to adjust their proposed 2025 premiums for individuals and small businesses, affecting over 70,000 Vermonters. The final approved rates were historically high and reflected concerns that the insurers, which are the only ones covering small groups and individuals in Vermont, could face insolvency if their reserves were not sufficiently funded.
To that point, both Blue Cross Vermont and MVP increased their requests before the final GMCB review.
The regulators, as they typically do, adjusted down the final requests somewhat and approved a Blue Cross increase in premiums of 22.8% for their small group customers and 19.8% for individuals. MVP was approved for 11.1% for the small group rate and 14.2% for individuals.
Key points:
- Federal premium assistance will continue to be available in 2025 to most people who purchase a plan in the individual market. The total amount of assistance will also be much larger than in prior years. As a result, despite significant increases in the gross premiums of individual plans, for most people, the net premiums, after accounting for premium subsidies, are expected to decrease. GMCB encourages people to go to Vermont Health Connect and explore their eligibility for assistance and carefully evaluate their plan options this year.
- GMCB acknowledges that, for purchasers of small group plans, as well as individuals who are not eligible for premium assistance, the approved premium increases are painfully high. However, considering the insurers’ history of losses in these markets and serious concerns expressed by the Department of Financial Regulation about BCBSVT’s solvency, GMCB had limited latitude this year to require further reductions to the proposed premiums.
- GMCB required the insurers to make changes to the rates recommended by GMCB’s actuaries. GMCB also required the insurers to lower their assumptions about price increases at Vermont hospitals, which GMCB regulates through its hospital budget review authority.
- GMCB Board Chair, Owen Foster, stated: “These rates reflect deep fundamental failures in our healthcare system and the immediate need for systematic change. While these rates are plainly unacceptable, the alternative of an insolvent insurer unable to pay for patient care was worse. Vermont must address its underlying healthcare cost structure, demographic and housing challenges, and transform its healthcare system if we are to alleviate the healthcare affordability crisis we are facing.”
This year’s rate requests underscore the vital importance of ongoing transformation efforts included in the Act 167 Community Engagement work. These efforts aim to create a more sustainable and affordable healthcare system to better meet the needs of Vermonters while ensuring financial stability. GMCB calls on all stakeholders—hospitals, insurers, policymakers, community health care leaders, and the public—to actively engage in these transformation efforts to build a healthcare system that is both resilient and accessible.
About: The Green Mountain Care Board (GMCB) is a 5-member, independent Board with a vision of a sustainable and equitable healthcare system that promotes better health outcomes for Vermonters. The GMCB was created in 2011 with an ambitious mission to drive system-wide improvements in access, affordability, and quality of healthcare to improve the health of Vermonters. Through public meetings, the GMCB ensures a transparent approach to healthcare regulation and a voice for stakeholders, including healthcare organizations, clinicians, and members of the public. With a holistic, data driven approach, the GMCB carries out its regulatory duties, supports innovation in healthcare delivery and payment reform, and serves as an important resource for independent, transparent analyses of Vermont’s healthcare system performance.
Source: 8.13.2024. Green Mountain Care Board
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