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Oregon regulator approves Q4 small‑group rate filings after insurers seek double‑digit increases
Summary
The Oregon Division of Financial Regulation said it will approve insurers’ 4th 0.25 small‑group rate filings and release final decisions in the coming weeks. Carriers presented requests ranging from about 7.6% (Kaiser) to the high 20s–30% (Moda, UnitedHealthcare), citing higher trend, morbidity and shifts in risk adjustment.
The Oregon Division of Financial Regulation held a public meeting to review insurers’ 4th 0.25 rate filings for small‑group health plans renewing on or after Oct. 1, 2026. Ethan Pudwin, health policy adviser and the meeting moderator, led presentations from carriers and a review by division actuaries.
Kaiser Permanente’s testing actuary, Lou Campton, said Kaiser requested an average rate increase of 7.6% (range 5.1%–10.5%), affecting 11,215 members. "We requested an average rate increase of 7.6%" Campton said, adding the change reflects a slightly higher emerging trend for 2025 and does not include plan‑level or geographic rate changes.
Moda Health managers Alex Vanos and Matt Cozzine said their Q4 filing shows an average annualized change around 28.2%, driven by rapid membership growth, higher-than‑expected claims experience, a 3% upward trend adjustment (with an estimated ~6% impact on rates) and a 3.9% morbidity adjustment. Vanos said risk‑adjustment projections flipped from a small receivable to a significant payable, removing an expected offset and increasing the requested rate.
Benjamin Shea, actuarial manager for PacificSource, said PacificSource requested an average Q4 change of 18.1%, with the largest consumer increase in rating area 1 (about 24.1%), and attributed the request to more recent medical and pharmacy claims experience that worsened relative to the Q1 annual filing. Riong Wu presented two UnitedHealthcare filings: UnitedHealthcare Insurance Company requested a 26% average annual increase for Q4 (incremental change of 7.5% versus prior QA rates, affecting about 1,161 subscribers/19.8 total members as of Dec. 2025), and UnitedHealthcare of Oregon requested a 30.1% average increase for Q4 for two standard plans; both filings revised the base rate to reflect combined medical and pharmacy claims trend.
Michael Sink, senior life and health actuary for the division, summarized the review framework used for quarterly filings: verifying data credibility, checking assumptions for reasonableness, and validating calculations. He said the filings were reviewed individually and collectively against small‑group market experience and that the evidence supported carriers’ assumptions. "We are approving these filings as filed," Sink said.
The division opened the meeting to public comment and reported it received no public comments during the session and none submitted on these filings at this time. Division staff reminded insurers must notify impacted groups at least 30 days before changes take effect and that the division’s consumer advocacy team provides confidential assistance (call (888) 877‑4894 or visit dfr.oregon.gov). The division said final rate decisions will be posted within the next few weeks.
The meeting included technical actuarial discussion about trend, morbidity and risk‑adjustment mechanics; no formal votes were recorded during the session and staff indicated the approvals are proceeding through the division’s standard posting and decision process.
