Health insurance in Pennsylvania may see biggest hike in years

Tentative 2026 health insurance rates for individual plans show a 19% average increase and small business group plans show a 13% jump, according to Pennsylvania regulators.

The proposed rate hikes must be approved by the state Insurance Department and comments from the public are being accepted through Sept. 2 at ra-in-comment@pa.gov.

The department reviews rates to ensure they are not excessive or inadequate – and are not unfairly discriminatory. The premiums consumers are charged will be based on the rates that are approved after review. Final approved rates will be made public in the fall.

Three main reasons for the 2026 increases have been cited, according to the department: the rising cost of health care; higher use of benefits, including for more expensive outpatient services and medication; and the anticipated end of Affordable Care Act Enhanced Premium Tax Credits on Dec. 31.

The proposed rate increases for 2026 are significantly higher than the 2025 proposals, which averaged 7.9% for individuals and 7.8% for businesses, and the 2024 proposals, which averaged 3.9% for individuals and 4.1% for businesses.

“This year, even more than previous years, Pennsylvanians should consider shopping around to find the best plans to meet their individual needs, at a price that makes sense for their current financial situation,” said Pennsylvania Insurance Commissioner Michael Humphreys as the 2026 numbers were released.

Individual plans

These tentative average statewide rates changes are rounded to the nearest tenth and vary by region:

• Ambetter Health of Pennsylvania Inc: up 30.1%
• Capital Advantage Assurance Company: up 26%
• Geisinger Health Plan: up 14.1%
• Geisinger Quality Options: up 16.2%
• Health Partners Plans “Jefferson Health Plans”: up 7.3%
• Highmark Benefits Group Inc.: up 18%
• Highmark Coverage Advantage Inc.: up 14.1%
• Highmark Inc.: up 17.2%
• Independence Blue Cross (QCC Ins. Co.): up 16.7%
• Keystone Health Plan Central: up 27.9%
• Keystone Health Plan East Inc.: up 23.5%
• Oscar Health Plan of PA: up 22%
• Partners Insurance Company Inc.: down 10.1%
• UPMC Health Options Inc.: up 11.7%
• UPMC Health Plan Inc.: up 16.3%

Notes: Ambetter is a new plan for Centene in the individual market, transitioning from the previous plan, Pennsylvania Health & Wellness. UPMC Health Plan is a new plan for UPMC in the individual market, transitioning from the previous plan, UPMC Health Coverage.

Source: Pennsylvania Insurance Department

Small business group plans

These tentative average statewide rates changes are rounded to the nearest tenth and vary by region:

• Capital Advantage Assurance Company: up 17.6%
• Geisinger Health Plan: up 11.4%
• Geisinger Quality Options: up 12.5%
• Highmark Inc.: up 15.7%
• Highmark Benefits Group: up 16.6%
• Highmark Care Benefits: up 22.5%
• Highmark Coverage Advantage: up 17%
• Highmark Senior Health Company: up 12.3%
• Independent Assurance Company: up 11%
• Keystone Health Plan Central: up 17.6%
• Keystone Health Plan East/AmeriHealth HMO Inc.: up 16.7%
• UnitedHealthcare Insurance Company: up 10.7%
• UnitedHealthcare of PA: up 20%
• UPMC Health Benefits: up 6.5%
• UPMC Health Options Inc.: up 8.9%
• UPMC Health Plan Inc.: up 8.2%

Notes: UPMC Health Plan is a new plan for UPMC in the small group market, transitioning from the previous plan, UPMC Health Coverage. Highmark Care Benefits is a new plan for Highmark in the small group market, transitioning from the previous plan, First Priority Life Insurance Company.

Source: Pennsylvania Insurance Department