Health insurance carriers operating in New Jersey’s individual marketplace – where people shop for insurance plans if they don’t have coverage through their employer, Medicare or Medicaid, have filed initial rate increases averaging 15.9% for 2026. 

Enrollment for the 2026 Plan Year begins Nov. 1 for consumers purchasing health plans through the individual marketplace, which includes Get Covered New Jersey, the state’s Official Health Insurance Marketplace. 

Insurance carriers blamed the rate hikes on increased costs and utilization, including higher medical and pharmacy costs, according to the State Department of Banking and Insurance announcement on Thursday. Consumer costs are also expected to increase due to the anticipated expiration of federal enhanced premium tax credits that will directly impact monthly costs for people who purchase plans in the individual marketplace. 

Currently, 88% of consumers enrolled in a health plan through Get Covered New Jersey – approximately 454,000 New Jerseyans – receive the enhanced financial help that is slated to end for plan year 2026. 

“Health insurance plans and prices change every year, so we encourage New Jerseyans to shop around to find the right coverage for them for 2026,” said Banking and Insurance Commissioner Justin Zimmerman. 

“Particularly given the anticipated loss of enhanced financial help made available by the federal government that resulted in lower costs for so many in past years, it will be important for consumers to look closely at their options and choose the plan that best fits their needs and budget,” Zimmerman said.  

Five insurance companies are offering health plans in 2026 through the marketplace: Ambetter from WellCare of New Jersey, AmeriHealth, Horizon Blue Cross Blue Shield of New Jersey, Oscar, and UnitedHealthcare.

Aetna recently announced its intent to withdraw from marketplaces nationwide, and recently notified New Jersey consumers that it will no longer offer plans on the marketplace in 2026.

By law, rate filings in the individual and small employer markets are informational and not subject to prior approval; DOBI may only disapprove an informational filing if the department finds that the filing is incomplete and not in compliance with relevant laws or that the rates are inadequate or unfairly discriminatory. 

Nationwide, health insurers for Affordable Care Act-regulated plans reported a median 18% premium increase in a recent Kaiser Family Foundation (KFF) survey.  

If Congress continues to not act, health carriers reported to DOBI an average rate increase of 15.9%. If federal action is taken this fall to continue enhanced premium tax credits in the 2026 plan year, carriers reported that the average rate increase would be 12.8%.

Below are the average rate changes submitted for plans in the New Jersey Individual Market (on-exchange and off-exchange) if enhanced premium tax credits expire. 

• Amerihealth: 15.5% 
• Horizon Blue Cross Blue Shield of New Jersey: 17% 
• Oscar: 4.6% 
• United Healthcare 18.4% 
• Ambetter from WellCare of New Jersey: 17.1%
   

Only plans offered on Get Covered New Jersey will have access to state subsidies and federal tax credits. The state marketplace launched in 2020 with a state subsidy – called New Jersey Health Plan Savings – to further lower monthly premiums for eligible consumers, beyond the tax credits offered by the federal government. 

The Department is estimated to provide $215 million this year to support state subsidies.