SCC Announces Proposed Individual and Small Group Health Insurance Premiums in Virginia for Plan Year 2027

The State Corporation Commission's Bureau of Insurance is providing an opportunity for members of the public to view and submit comments on proposed health insurance rates in Virginia's individual and small group markets, as submitted by insurers for plan year 2027. The public also may view information related to Virginia's health insurance market as a whole, key factors in insurance rate changes for 2027 and the rate impact or change for identified health insurance products that insurers have proposed to offer in the individual and small group markets. 

The bureau has been delegated with the authority to review and approve rates for health benefit plans issued in Virginia in the individual and small group markets. Additionally, the bureau - with assistance from the Virginia Department of Health and the SCC's Virginia Health Benefit Exchange - performs plan-management functions required to evaluate health benefit plans and standalone dental plans for participation in Virginia's Insurance Marketplace (Virginia's state-based health insurance exchange), in accordance with the federal Patient Protection and Affordable Care Act. As part of its review of rates, the bureau confirms that premiums are reasonable in relation to the benefits provided, and that the actuarial assumptions are reasonable and supportable, projecting to hold carriers' loss ratios within the required limit. The bureau will complete its review of Qualified Health Plans for the 2027 plan year by September 1, 2026.

Each year, the bureau coordinates a presentation of insurance companies' proposed premium rates before providing the results of its review of Qualified Health Plans and finalizing form and rate approvals for health insurance products for sale and use in Virginia - both on and off Virginia's Insurance Marketplace. The presentation provides an overview of the range of rate impact or change for identified health insurance products proposed to be offered in the individual and small group markets for use in Virginia as of January 1, 2027. The bureau provides the presentation as a way to help consumers make informed decisions about their health insurance choices as well as educate the public about the health insurance market as a whole and key factors in rate changes.

To view the plan year 2027 rate presentation, visit Virginia SCC - ACA Rate & Form Filing Information and review "Past Workshops, Presentations and Meetings." To view rate summary information, visit Virginia State Corporation Commission. Information and instructions on how to submit public comment are provided as part of the rate presentation. 

Nine insurers plan to participate in Virginia's individual market in 2027, and they have requested rate increases above their 2026 rates that range from 3.9% to 22.7%, with an average per member per month rate increase over 2026 rates of 16.7%. Insurers have identified the elimination of enhanced federal subsidies, market uncertainty, hospital and pharmacy costs, and utilization as driving factors for the proposed increases. These factors are affecting rates in the individual health insurance market across the country, including Virginia. In Virginia's small group market, insurers are requesting to increase rates an average of 11.7% for 2027, based on rising costs of care. 

Virginia consumers purchasing coverage in the individual market will have continued access to the Commonwealth Health Reinsurance Program. This program was established by the General Assembly in 2023 and has reduced rates on average 15% or more below what Virginians would see without the program. The program, which is funded by both the federal government and Virginia, will remain in place through plan year 2027. As directed by the General Assembly earlier this year, the bureau has started the process to extend the program for an additional five years.

Eligible consumers also will see premium reductions under the new Virginia Premium Savings Program established by the 2026 General Assembly and Virginia Gov. Abigail Spanberger. The program, administered by the Virginia Health Benefit Exchange, will provide $150 million in state subsidies that directly reduces monthly premiums for eligible consumers purchasing qualified health plans through Virginia's Insurance Marketplace.

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Contact: Katha Treanor, 804-371-9141

Source URLs:
https://www.scc.virginia.gov/regulated-industries/companies/life-health-companies/aca-rate-form-filing-information/ https://www.scc.virginia.gov/boi/serffinquiry/default.aspx