Sentara Health Plans plans to raise its individual Virginia market premiums by 22.7% next year.
The State Corporation Commission’s Bureau of Insurance finalized its review of 2027 market rates as of Sept. 1. And Sentara’s is the highest average increase of any carrier that will be offering comprehensive individual health insurance coverage in the state, said Katha Treanor, SCC communications manager.
“This is an average, so each member will not experience this change in premiums,” she said.
Mike Kafka, Sentara’s senior director of corporate communications and public relations, said in an email Sentara’s rate increase will depend on a member’s location, as plans are offered statewide, but on average the increase will be 22.7% per member per month. He said the increase keeps Sentara competitive.
“In 2026, we offered the lowest premium plans in all regions,” Kafka said. “For 2027 we are the lowest or second lowest in most regions.”
Sentara Health Plans’ increase looks larger on a percentage basis because of how low premiums were this year, Kafka said. The drivers behind the rate increases in the individual market include medical costs, cost of goods, utilization, and severity of illness, he said.
State lawmakers’ ban on tobacco use surcharges this year for Affordable Care Act markets next year is a small component of the overall increase, Kafka said. Sentara, Oscar Insurance Co. and Optimum Choice had all reinstituted the tobacco surcharge in 2026, when the temporary prohibition expired after 2025.
Sentara has also paid out more in claims relative to its collected premiums compared with other carriers, Treanor said. “Sentara Health Plans’ 2025 loss ratio was 110% compared to the state average of 95%,” she said.
A presentation by the SCC shows that Sentara Health Plans also expects its individual market enrollment to drop by about a third next year, which the insurer attributes to continuing effects from the expiration of enhanced federal subsidies and affordability of rates, Kafka said.
“The Virginia ACA product continues to be an evolving market with federal and state regulatory changes, price sensitivity and carrier withdrawals,” Kafka said. “The impact signals membership challenges for 2027.”
Nine insurers are approved to offer comprehensive individual health insurance coverage in Virginia for 2027, Treanor said. The insurance bureau approved plans from seven of those carriers to be offered via the state’s health benefit exchange. Two carriers, Anthem Health Plans of Virginia Inc. and Sentara Health Insurance Co., only filed rates for plans to be offered off the exchange.
Other carriers on the exchange next year are expected to include: Oscar, HealthKeepers, Kaiser, GHMSI, CareFirst, and Optimum Choice. Cigna Health and Life Insurance Co. is exiting the individual market on Dec. 31.
Virginia has not had any new carriers enter the market to sell individual health insurance coverage since 2023.
The 2027 proposed average premium increase in Virginia’s individual market is 16.7%, according to the SCC. The 2027 proposed average small group market premium increase in the state is 11.7%.
Sandra J. Pennecke, 757-652-5836, sandra.pennecke@pilotonline.com
