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Health benefit plans available for purchase all offer, at a minimum, the Essential Health Benefits package, and they have an associated “metal level” of Bronze, Silver, Gold, Platinum, or Catastrophic.

The Department of Insurance received preliminary 2018 health plan designs and rates from insurance carriers on June 2 and began reviewing the proposed plan documents and rates for compliance with Idaho and federal regulations. The Department of Insurance does not have the authority to disapprove or establish insurance rates, but it does have the authority to deem rate increases submitted by insurance companies as reasonable or unreasonable. After the review and negotiation process, the carriers submit their final rate increase information, which is what is now available below.

A key driver of the increases is the level of health claims paid compared to the premium collected. The table below shows the level of claims paid and premium collected by each insurance company for ACA-compliant health benefit plans during 2016. In addition to claims paid, the premium needs to cover the company’s administrative costs, insurance fees, and taxes. Those costs generally consume 20 to 25 percent of the premium. Larger rate increases may be needed when the prior year’s premium is not sufficient to pay for health claims and administrative costs and fees. Each insurance company that submits a rate increase of 10 percent or greater must also submit a consumer-oriented explanation, which is available by clicking on the name of the insurance company in the table below.

Preliminary Final Jan-Dec 2016
Overall Bronze Silver Gold Overall Paid Claims Premium
Average Statewide Rate Increase 38%11%39% 9%27% $563,570,000 $494,910,000

Preliminary Final Jan-Dec 2016
Insurance Company Overall Bronze Silver Gold Overall Paid Claims Premium
Blue Cross of Idaho Health Service 28%4%38%10%26% $254,360,000 $258,110,000
BridgeSpan Health Company n/a n/an/an/an/a $27,820,000 $22,660,000
Mountain Health CO-OP 25%7%37%6%31% $55,830,000 $50,840,000
PacificSource Health Plans 44%7%48%14%28% $5,500,000 $6,280,000
Regence BlueShield of Idaho 51%38%23%N/A29% $11,830,000 $11,150,000
SelectHealth 48%11%44%9%28% $208,230,000 $145,870,000

Of note in this table is that BridgeSpan Health Company will not be offering 2018 health benefit plans in Idaho. Also, the Regence BlueShield of Idaho contracts and rates are still under review by the Department. This table will be updated once the review of the Regence filings is finished.

The statewide rate increases and the carrier-specific rate increases shown are overall averages. The premium increase for an individual or family may vary greatly based on the geographic area, choice of plan, changes in enrollees or ages, eligibility for the advanced premium tax credit, and other factors. More detailed information is available below about rate changes for each Idaho rating area.

Detailed Rate Increase Information by Geographic Area

The average rate increases shown above may not be representative of the rate increases in any one geographic area or for a specific health plan. This map shows the six geographic rating areas in Idaho. Click on a rating area to see detailed rate increase information for that area.

South East South Central North East North Central South West North
Region Map
(SE Idaho) (SC Idaho) (NE Idaho) (NC Idaho) (SW Idaho) (N Idaho)

For questions regarding this information, contact the Department of Insurance at (208) 334-4250 or Idaho Department of Insurance.

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