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

The Department of Insurance received preliminary 2018 health plan information 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 will submit their final rate increase information. While the Department is reviewing the carriers’ proposed rate changes, the public is invited to provide comments on the rate changes. Please send any comments to Idaho Department of Insurance.

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 7% 2%2% 4%4% $145,550,000 $165,990,000

Preliminary Final Jan-Dec 2016
Insurance Company Overall Bronze Silver Gold Overall Paid Claims Premium
Aetna Health of Utah -5%n/an/a18%18% 260,000 $380,000
Aetna Life Insurance Company 7%n/an/a12%12% - -
Blue Cross of Idaho Health Service -7%-8%-9%-6%-7% $54,790,000 $69,850,000
Mountain Health CO-OP 7%5%7%7%7% $590,000 $510,000
PacificSource Health Plans 11%12%10%12%11% $580,000 $670,000
Regence BlueShield of Idaho 14%15%11%17%14% $41,300,000 $50,650,000
SelectHealth 12%-4%-5%6%4% $47,690,000 $43,480,000
UnitedHealthcare Insurance Company 1%-2%-4%6%1% $340,000 $450,000
WMI Mutual Insurance Company 4%6%2%7%4% - -

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.

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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