Rate justification notice

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.