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All health benefit plans available for new enrollment are fully ACA-compliant. ACA-compliant plans have an associated “metal level” of Bronze, Silver, Gold, Platinum, or Catastrophic and offer, at a minimum, the Essential Health Benefits package.

The Idaho Department of Insurance received preliminary 2017 health plan information from insurance carriers on May 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. The 2017 health plan rates have now been finalized, and the Department did not find the final rate increases to be unreasonable.

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 the first six months of 2016 and the full 2015 calendar year. In addition to paying medical and prescription drug claims, the premium needs to cover the company’s administrative costs, insurance fees, and taxes. Those costs generally consume up 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.

Jan-Jun 2016 Jan-Dec 2015
Preliminary Final Paid Claims Premium Paid Claims Premium
Average Statewide Rate Increase 5%4% $59,200,000 $80,090,000 $86,530,000 $109,300,000

Jan-Jun 2016 Jan-Dec 2015
Preliminary Final Paid Claims Premium Paid Claims Premium
Aetna Health of Utah 4%4% $130,000 $200,000 $540,000 $620,000
Aetna Life Insurance Company -4%-4% $10,000
Blue Cross of Idaho Health Service 3%3% $19,310,000 $33,220,000 $42,480,000 $56,540,000
Mountain Health CO-OP -4%-4% $410,000 $400,000 $730,000 $950,000
PacificSource Health Plans -5%-5% $250,000 $410,000 $770,000 $1,540,000
Regence BlueShield of Idaho -2%0% $17,010,000 $23,040,000 $18,560,000 $22,600,000
SelectHealth 15%11% $22,000,000 $22,670,000 $22,530,000 $24,570,000
UnitedHealthcare Insurance Company -3%-3% $90,000 $140,000 $920,000 $2,480,000
WMI Mutual Insurance Company 9%9%

Please note that the statewide rate increase 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 seven geographic rating areas in Idaho. Click on a rating area to see detailed rate increase information for that area.

832 832 833 834 834 835 836 838
Region Map
(832) (833) (834) (835) (836-7) (838)

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

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