Blue Cross Blue Shield employer health plans in California
Who Blue Cross Blue Shield insures among California employers and what those plans pay in premium and broker compensation, and what the Blue Cross Blue Shield network pays physicians and hospitals.
Blue Cross Blue Shield employer health plans in California at a glance
What the data shows
Blue Cross Blue Shield insures 1,178 employer health plans in California (18% of 6,525 insured large plans), 3rd of 8 carrier groups; Kaiser Permanente (3,845), Anthem (Elevance Health) (1,448) hold more.
The Blue Cross Blue Shield book in California has held steady since 2020 (1,184 plans then).
Most of these plans cover 100–499 people (571 plans); 68 cover 1,000 or more.
Median premium per person covered was $8,573, 13% above the California all-carrier median of $7,612. Benefit design and group mix differ, so this is not a price comparison.
70% of these plans reported broker or agent pay on their Blue Cross Blue Shield contracts; where paid, the median was 5.3% of premium (middle half 4.2%–5.8%).
In BCBS: BS CA, 22 of the 50 Employer 50 services have a California benchmark, at a median of 125% of Medicare across those services.
At California hospitals, Blue Cross Blue Shield's commercial rates run higher than other carriers' at the same hospital for 12 of 17 services; a hip or knee replacement stay has a median rate of $19,803 across 26 hospitals.
Blue Cross Blue Shield plans in California, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 1,184 | 497,382 | 18% | $7,226 |
| 2021 | 1,108 | 510,940 | 17% | $7,359 |
| 2022 | 1,181 | 538,468 | 18% | $7,390 |
| 2023 | 1,211 | 526,374 | 18% | $7,878 |
| 2024 | 1,178 | 503,677 | 18% | $8,573 |
| 2025 (partial) | 813 | 285,184 | 18% | $8,590 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 455 | 39% |
| 100–499 | 571 | 48% |
| 500–999 | 83 | 7% |
| 1,000–4,999 | 60 | 5% |
| 5,000 or more | 8 | 1% |
Premiums and broker pay
| Measure | Blue Cross Blue Shield | All carriers, California |
|---|---|---|
| Median premium per person covered | $8,573 | $7,612 |
| Premium per person, middle half | $7,072–$11,093 | $5,825–$9,721 |
| Plans reporting broker or agent pay | 70% | 84% |
| Median broker pay, % of premium | 5.3% | 5.0% |
| Broker pay, middle half | 4.2%–5.8% | 4.0%–5.8% |
| Median broker pay per person covered | $432 | $354 |
Industries
Blue Cross Blue Shield's California employer clients are concentrated in professional and technical services (225 plans) and manufacturing (173), followed by health care and social assistance (137).
| Industry | Plans | Share |
|---|---|---|
| Professional and technical services | 225 | 19% |
| Manufacturing | 173 | 15% |
| Health care and social assistance | 137 | 12% |
| Finance and insurance | 94 | 8% |
| Information | 74 | 6% |
| Retail trade | 67 | 6% |
Blue Cross Blue Shield employer clients in California
1,146 employers in California have a Blue Cross Blue Shield major-medical contract, 68 of them covering 1,000 or more people. For each one Medlyze has the plan year, the broker on each contract and what that broker was paid, and compiles the list for a state, an industry or a single employer on request.
| Employer | Persons covered | Plan year ends | Broker | Broker pay, % of premium |
|---|---|---|---|---|
| Employer name | Locked | Locked | Locked | Locked |
| Employer name | Locked | Locked | Locked | Locked |
| Employer name | Locked | Locked | Locked | Locked |
Brokers: request the Blue Cross Blue Shield Prospect List for California →
What the Blue Cross Blue Shield network pays physicians in California
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Echocardiogram, transthoracic complete with Doppler | 93306 | $78 | $73–$96 | 115% | $95 | 127 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $87 | $80–$100 | 117% | $82 | 123 |
| Skin biopsy, single lesion (tangential) | 11102 | $100 | $100–$100 | 105% | $202 | 13 |
| Colonoscopy (diagnostic, with biopsy, with polyp removal) | 45378 | $214 | $157–$254 | 130% | $530 | 107 |
| Upper GI endoscopy (diagnostic, with biopsy) | 43239 | $149 | $109–$177 | 121% | $333 | 107 |
| Abdominal ultrasound, complete | 76700 | $43 | $42–$67 | 116% | $53 | 90 |
| Bone density scan (DXA), axial | 77080 | $11 | $10–$16 | 121% | $13 | 99 |
| CT abdomen and pelvis with contrast | 74177 | $100 | $88–$108 | 119% | $116 | 99 |
| CT chest without contrast | 71250 | $62 | $59–$94 | 125% | $68 | 90 |
| Chest X-ray, 2 views | 71046 | $12 | $10–$18 | 117% | $14 | 99 |
| MRI brain without and with contrast | 70553 | $100 | $98–$134 | 95% | $144 | 99 |
| MRI cervical spine without contrast | 72141 | $87 | $76–$100 | 127% | $98 | 99 |
| MRI knee (lower-extremity joint) without contrast | 73721 | $82 | $78–$125 | 130% | $89 | 90 |
| MRI lumbar spine without contrast | 72148 | $89 | $86–$137 | 131% | $98 | 90 |
| MRI shoulder (upper-extremity joint) without contrast | 73221 | $82 | $78–$126 | 130% | $90 | 90 |
Professional fee only: facility, implant and anesthesia charges are not included. Limited: rates come from a sample of providers, and groups are counted only in specialties that perform the service.
What the Blue Cross Blue Shield network pays hospitals in California
Blue Cross Blue Shield commercial rates are on record at 52 California hospitals (the hospitals covered so far, not every hospital). Compared at the same hospitals, Blue Cross Blue Shield's rate is higher than the other carriers' median for 12 of 17 services and lower for 2. For Emergency visit, level 4, the rate runs from $137 to $5,756 across 9 hospitals.
This page shows 3 of the 17 services in full. The other rates, the size of each gap and every hospital's prices are in the Plan Cost Benchmark.
| Service | Hospitals | Median rate | Range (P10–P90) | vs other carriers, same hospitals | Cash price, median |
|---|---|---|---|---|---|
| Hip or knee replacement (hospital stay) | 26 | $19,803 | $11,310–$24,973 | About the same | $31,982 |
| C-section delivery (hospital stay) | 27 | Locked | Locked | About the same | Locked |
| Vaginal delivery (hospital stay) | 27 | Locked | Locked | About the same | Locked |
| MRI, lower back | 7 | $1,377 | $306–$5,830 | Higher | $4,152 |
| MRI, knee | 7 | Locked | Locked | Higher | Locked |
| CT, head | 6 | Locked | Locked | Higher | Locked |
| CT, abdomen and pelvis | 6 | Locked | Locked | Higher | Locked |
| Screening mammogram | 5 | Locked | Locked | Higher | Locked |
| Colonoscopy, diagnostic | 17 | Locked | Locked | Higher | Locked |
| Upper GI endoscopy with biopsy | 16 | Locked | Locked | Higher | Locked |
| Knee arthroscopy | 16 | Locked | Locked | Higher | Locked |
| Cataract surgery | 18 | Locked | Locked | Higher | Locked |
| Gallbladder removal, laparoscopic | 19 | Locked | Locked | Higher | Locked |
| Knee replacement, outpatient | 17 | Locked | Locked | Lower | Locked |
| Emergency visit, level 4 | 9 | $3,173 | $137–$5,756 | Lower | $5,017 |
| Comprehensive metabolic panel | 9 | Locked | Locked | Higher | Locked |
| Complete blood count | 10 | Locked | Locked | Higher | Locked |
Hospitals with the most published Blue Cross Blue Shield rates
| Hospital | Joint replacement | MRI lower back | CT abdomen | Colonoscopy | ER level 4 | Vaginal delivery |
|---|---|---|---|---|---|---|
| Arrowhead Regional Medical Center | – | Locked | Locked | Locked | Locked | Locked |
| Clovis Community Medical Center | $11,310 | Locked | Locked | Locked | Locked | Locked |
| Community Regional Medical Center-fresno | $11,310 | Locked | Locked | Locked | Locked | Locked |
| Foothill Regional Medical Center | $18,895 | Locked | Locked | Locked | Locked | Locked |
| Fresno Heart And Surgical Hospital | $11,310 | Locked | Locked | Locked | Locked | Locked |
| Los Robles Hospital And Medical Center | $20,164 | Locked | Locked | Locked | Locked | Locked |
| Oroville Hospital | – | Locked | Locked | Locked | Locked | Locked |
| Riverside Community Hospital | – | Locked | Locked | Locked | Locked | Locked |
| St. Francis Medical Center | $20,958 | Locked | Locked | Locked | Locked | Locked |
| Thousand Oaks Surgical Hospital | $20,164 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 25%, fee schedules 60%, per diem 3%, percent of billed charges 8%, other 4% of Blue Cross Blue Shield's published commercial rates for these services in California.
Employers: see all 17 services and every hospital near your people in a Plan Cost Benchmark →
Hospital facility rate only: physician, anesthesia and implant charges are separate. Rates are what hospitals publish, not claims paid, and are not weighted by use.
Carriers in California
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Kaiser Permanente | 3,845 | 59% | $7,918 | 4.6% |
| Anthem (Elevance Health) | 1,448 | 22% | $7,794 | 5.2% |
| Blue Cross Blue Shield | 1,178 | 18% | $8,573 | 5.3% |
| Other insurers (regional and local plans) | 1,165 | 18% | $6,939 | 5.0% |
| Cigna | 945 | 14% | $4,568 | 6.4% |
| UnitedHealthcare | 849 | 13% | $6,155 | 5.2% |
| Aetna | 800 | 12% | $7,192 | 5.0% |
| Humana | 19 | 0% | $749 | 11.6% |
Blue Cross Blue Shield in other states
FAQ
How many California employers have Blue Cross Blue Shield health insurance?
1,178 employer health plans in California reported a Blue Cross Blue Shield major-medical contract in their 2024 filings, covering 503,677 persons. Self-funded plans that Blue Cross Blue Shield only administers are not counted.
What is Blue Cross Blue Shield's share of the California insured employer market?
18% of insured large employer health plans, 3rd of 8 carrier groups by plan count.
How much do brokers earn on Blue Cross Blue Shield plans in California?
Where broker or agent pay was reported, the median was 5.3% of premium (5.0% across all carriers in California).
Can I see the figures for a specific employer?
Yes. Brokers can request an Employer Account Brief on one employer, or a Prospect List for this market. Employers can request a Plan Cost Benchmark for their own plan. Use the request form on this page.
About these numbers
- Plans counted: the 1,178 California employer health plans with a Blue Cross Blue Shield major-medical contract in their 2024 filings. Self-funded plans that Blue Cross Blue Shield only administers are not counted here.
- Premium and broker figures: 925 contracts with 20+ persons covered and a reported premium; broker percentages use the 823 contracts that reported broker or agent pay.
- Network rates: BCBS: BS CA, professional fees only, from a sample of providers.
- Hospital prices: Blue Cross Blue Shield commercial rates at California hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.