The Rhode Island health insurance commissioner has approved rate increases for Blue Cross and UnitedHealthcare policies covering “small-group” employers.

The commissioner approved increases averaging 9.2 percent for UnitedHealthcare and 8.7 percent for Blue Cross Blue Shield of Rhode Island, according to the rate structure released yesterday. Unclear is how much more money employers will pay for their insurance premiums when the new rates go into effect after Jan. 1.

The increases will go into effect for organizations with 50 or fewer eligible employees on a rolling basis as insurance policies renew, according to the commissioner’s spokesman. Employers will get rate-increase notices in the coming weeks.

“Some people will face staggering increases and some people will face zero increases,” said Matthew Stark, a policy associate in the Office of the Health Insurance Commissioner.

The rate-increase requests covered five budgetary areas: administrative expenses; contributions to reserve holdings; increases in the cost of inpatient and out-patient hospital care; physician costs; and pharmacy charges.

This is the second set of insurance-premium rates approved under a new simultaneous review system in use by the state. In June, the commissioner’s office approved rate increases of about 8 percent for “large-group” plans — employers with more than 50 workers — administered by Blue Cross and UnitedHealthcare. That rate increase will result in total premium increases of roughly $75 million.

“We are setting up a process to hold the health plans equally accountable for what they can do to keep health care affordable; we’ll continue to improve it,” said Christopher F. Koller, the state’s health insurance commissioner. “We can assure for small groups . . . that the way the health plan calculates their rates is virtually identical to the large groups.”

The reviews this year of small-group and large-group insurance premiums are the first under a new process mandated by state law that requires that affordability be one of the factors considered in setting rates. In the past, basically only the financial health of the insurance company was considered. This would allow companies to build up large reserves without regard to whether those reserves were needed or were making the rates too expensive.

“We have emerging standards,” Stark said. “We’re trying to do it in a thoughtful manner because this is new.”

Regulators reviewed three elements that go into calculating rate increases: how much money the company needs to bolster its reserves; how much it needs to pay increased administrative costs; and how much it needs to pay increased costs of covered medical treatment.

Still, Stark said, there are differences between large and small employers.

“When the employer gets their renewal, the anatomy of the rate increase will be laid bare,” he said.

For instance, insurers can no longer base small-group premiums on a market study once done only every three years.

Recent legislation also removed health status as a determinant of insurance premiums, Stark said. It was once one of four factors used to determine premiums. The remaining factors are age, gender and family status

“One of the things employers are going to see is the impact of health status being taken out as a rating factor.”

Koller approved the administrative cost increases of 17.9 percent sought by United and 14.3 percent sought by Blue Cross. He also approved 10.9-percent and 9.2-percent increases in overall medical costs sought by United and Blue Cross, respectively.

He approved reserve contribution increases of 1 percent for United and 1.33 percent for Blue Cross — both 1 percent less than requested.

Tufts Health Plan, which recently won a license to operate in Rhode Island, will participate in the rate-setting process next year.

“Tufts will have to insert themselves into the regulatory process as they go,” Stark said.

pgrimald@projo.com