2026 Rate justification information
Priority Health (29698)
MyPriority HMO – Individual – 29698MI054
Effective date: 01/01/2026
Current review status: Final
Review status date: 10/16/2025
Requested rate change: +19.16%
Submission period: Annual
Submission date: 05/28/2025
Includes exchange plan(s): Yes
Final determination: Not unreasonable
Final rate change: +19.16%
Issuer's rate change justification
A Part II Written Description:
The reasons for the rate change include:
- Updated experience upon which the rates are based.
- Updated medical and prescription Rx cost and utilization trends.
- Updated benefit relative values, which may cause variation in rate changes by plan.
- Prospective benefit adjustments to existing products; the benefit relative values have been updated, which may cause variation in rate changes by plan.
- Re‐evaluation of the anticipated morbidity adjustment to the rating base.
- Anticipated changes in the payments to the Federal Risk Adjustment program.
- Updated factors for administrative expenses and margin. With this filing, the margin varies by plan.
- Updated taxes and fees.
- No impact is assumed for the expiration of the Public Health Emergency.