[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-239855-105":3,"doc-detail-239855-en":85,"detail-sidebar-cat-1-en-105":100},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":78,"head_meta":80,"extra_data":82,"updated_unix":84},105,"en","wellpoint-maryland-inc-rate-justification-for-qhp-plans-general-information-rate-increase-effective-january-1-2026","Wellpoint Maryland, Inc. - Rate Justification for QHP Plans - General Information - Rate Increase Effective January 1, 2026","","Rate Justification for QHP Plans submitted by Wellpoint Maryland, Inc. explains the rationale for a rate change effective January 1, 2026 for Wellpoint’s fully ACA-compliant individual medical Qualified Health Plan offerings in Maryland. The filing covers the overall average rate change of 10.0% (excluding aging impact), the expected range at the individual plan level, and the size of the affected enrollee population. It also details financial experience constraints, medical service cost drivers, benefit design changes in cost-sharing elements, and how administrative costs and anticipated margins align with Affordable Care Act medical loss ratio requirements.",{"@graph":14,"@context":77},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/template/","Template",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/template/letters/","Letters",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/template/wellpoint-maryland-inc-rate-justification-for-qhp-plans-general-information-rate-increase-effective-january-1-2026/239855/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/wellpoint-maryland-inc-rate-justification-for-qhp-plans-general-information-rate-increase-effective-january-1-2026/239855.png","ImageObject",442,249,{"name":42,"@type":43},"Jiven","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-19","2026-09-11",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",6,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69,73],{"name":60,"@type":61,"acceptedAnswer":62},"What effective date and market does this rate justification cover?","Question",{"text":63,"@type":64},"The justification covers a rate change effective January 1, 2026 for Wellpoint individual medical QHP plans offered in Maryland that fully comply with the ACA.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What is the overall average rate change and how does it vary by plan?",{"text":68,"@type":64},"The filing states an average rate change of 10.0% excluding the impact of aging. For renewing plans, individual plan-level increases range from 6.8% to 11.0%.",{"name":70,"@type":61,"acceptedAnswer":71},"Why are the premium changes primarily expected?",{"text":72,"@type":64},"The primary driver is increased healthcare costs, reflected in higher unit costs of services and higher utilization by members, including hospital, physician, and pharmaceutical cost increases and the impact of new prescription drugs.",{"name":74,"@type":61,"acceptedAnswer":75},"How do administrative costs and ACA requirements affect the proposed rate?",{"text":76,"@type":64},"Wellpoint states administrative and selling costs are effectively managed and anticipated profits are not expected to materially change. The filing notes the ACA requirement that at least 80% of premium dollars go to medical expenses, with premiums targeted to meet this requirement.","https://schema.org",{"og:url":32,"og:type":79,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":81,"canonical":32},"index,follow",{"doc_id":83,"site_id":7},239855,1789153933,{"code":4,"msg":86,"data":87},"success",{"doc_id":83,"user_id":88,"nickname":42,"user_avatar":89,"doc_module":22,"category_id":90,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":91,"file_id":92,"file_url":93,"file_type":94,"file_size":95,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":96,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":97,"faqs":98,"seo_title":99,"seo_description":12,"update_tm":84,"read_time":4},1099513958607,"https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399",18,"Wellpoint Maryland, Inc.  \nRate Justification for QHP Plans  \nGENERAL INFORMATION  \nQualified Health Plan (QHP) issuers are required to post a justification for a rate change to its website. Below is the justification for the rate change effective January 1, 2026 for Wellpoint individual medical QHP plans offered in Maryland that are fully-compliant with the Patient Protection and Affordable Care Act (ACA) .  \nSCOPE AND RANGE OF RATE INCREASES  \nThis filing includes an average rate change of 10.0%, excluding the impact of aging, effective January 1, 2026. At the individual plan level, rate increases range from 6.8% to 11.0% for renewing plans. A subscriber’s actual rate could be higher or lower depending on the age characteristics, dependent coverage, and other factors. The rate changes are expected to affect around 900 enrollees.  \nFINANCIAL EXPERIENCE OF THE PRODUCT  \nSince Wellpoint was a new entrant in the Maryland individual market for 2025, this product does not have any 2024 experience. Active 2025 membership and premiums are shown on Worksheet 2, Section II of the URRT. The requested rate increases account for Wellpoint’s latest expectations for 2026 , and are expected to result in a loss ratio of 88.85% in 2026 using the methodology prescribed by 45 CFR 158.221.  \nCHANGES IN MEDICAL SERVICE COSTS  \nThe primary driver of the premium changes is the increase to the cost of healthcare. The rate changes are associated with increases in the “unit” cost of services primarily from hospitals, physicians, and pharmaceutical companies, coupled with increases in the consumption of services, or “utilization,” by members. Increases in the unit costs of services are driven by many things, including technological advances, cost shifting to private insurers due to reductions in Medicaid and Medicare reimbursement, general inflationary pressures, and a variety of other factors. In particular, the costs of new prescription drugs will continue to have a notable effect on pharmacy inflation.  \nCHANGES IN BENEFITS  \nWellpoint will renew all plans offered in 2025. Relative to plan designs offered in 2025, Wellpoint’s renewing 2026 product portfolio involves various changes to cost sharing to maintain a competitive market position and align with consumer demand. The changes include adjusting the deductible, out-of-pocket maximums, coinsurance, and copay amounts. All plan designs comply with applicable laws and guidelines.  \nADMINISTRATIVE COSTS AND ANTICIPATED MARGINS  \nWellpoint continues to effectively manage administrative and selling costs. Anticipated profits are not expected to materially change such that the changes would impact the proposed rate increase. The Affordable Care Act requires that no less than 80% of a health insurer’s premium dollars go to medical expenses, otherwise a premium rebate to employers and subscribers must be generated to refund the difference. Accordingly, Wellpoint files premiums targeting compliance with that requirement.","cbCainHjeFHabztC","https://ap.wps.com/l/cbCainHjeFHabztC","pdf",87209,"English","# GENERAL INFORMATION\n# SCOPE AND RANGE OF RATE INCREASES\n# FINANCIAL EXPERIENCE OF THE PRODUCT\n# CHANGES IN MEDICAL SERVICE COSTS\n# CHANGES IN BENEFITS\n# ADMINISTRATIVE COSTS AND ANTICIPATED MARGINS","[{\"question\":\"What effective date and market does this rate justification cover?\",\"answer\":\"The justification covers a rate change effective January 1, 2026 for Wellpoint individual medical QHP plans offered in Maryland that fully comply with the ACA.\"},{\"question\":\"What is the overall average rate change and how does it vary by plan?\",\"answer\":\"The filing states an average rate change of 10.0% excluding the impact of aging. For renewing plans, individual plan-level increases range from 6.8% to 11.0%.\"},{\"question\":\"Why are the premium changes primarily expected?\",\"answer\":\"The primary driver is increased healthcare costs, reflected in higher unit costs of services and higher utilization by members, including hospital, physician, and pharmaceutical cost increases and the impact of new prescription drugs.\"},{\"question\":\"How do administrative costs and ACA requirements affect the proposed rate?\",\"answer\":\"Wellpoint states administrative and selling costs are effectively managed and anticipated profits are not expected to materially change. The filing notes the ACA requirement that at least 80% of premium dollars go to medical expenses, with premiums targeted to meet this requirement.\"}]","Wellpoint Maryland, Inc. - Rate Justification for QHP Plans - General Information - Rate Increase Effective January 1, 2026 | PDF",{"code":4,"msg":86,"data":101},[102,107,112,117,122,127,132,135,140],{"id":103,"doc_module":22,"doc_module_name":25,"category_name":104,"show_sort_weight":105,"slug":106},11,"Presentations",90,"presentations",{"id":108,"doc_module":22,"doc_module_name":25,"category_name":109,"show_sort_weight":110,"slug":111},12,"Resumes",80,"resumes",{"id":113,"doc_module":22,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},14,"Invoices",70,"invoices",{"id":118,"doc_module":22,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},15,"Posters",60,"posters",{"id":123,"doc_module":22,"doc_module_name":25,"category_name":124,"show_sort_weight":125,"slug":126},16,"Social Media",50,"social-media",{"id":128,"doc_module":22,"doc_module_name":25,"category_name":129,"show_sort_weight":130,"slug":131},17,"Forms",40,"forms",{"id":90,"doc_module":22,"doc_module_name":25,"category_name":29,"show_sort_weight":133,"slug":134},30,"letters",{"id":136,"doc_module":22,"doc_module_name":25,"category_name":137,"show_sort_weight":138,"slug":139},21,"Paper Templates",5,"papers-templates",{"id":141,"doc_module":22,"doc_module_name":25,"category_name":142,"show_sort_weight":4,"slug":143},158,"General","general-158"]