Blue Cross Blue Shield employer health plans in Hawaii
Who Blue Cross Blue Shield insures among Hawaii 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 Hawaii at a glance
What the data shows
Blue Cross Blue Shield insures 91 employer health plans in Hawaii (40% of 225 insured large plans), 3rd of 8 carrier groups; Kaiser Permanente (167) hold more.
Blue Cross Blue Shield has shrunk 4% in Hawaii since 2020, from 95 plans, as insured plans moved carrier or to self-funding.
Most of these plans cover 100–499 people (45 plans); 12 cover 1,000 or more.
Median premium per person covered was $7,221, 8% above the Hawaii all-carrier median of $6,681. Benefit design and group mix differ, so this is not a price comparison.
19% of these plans reported broker or agent pay on their Blue Cross Blue Shield contracts; where paid, the median was 1.7% of premium (middle half 0.7%–2.7%).
In BCBS: BCBS HI, 13 of the 50 Employer 50 services have a Hawaii benchmark, at a median of 154% of Medicare across those services.
At Hawaii hospitals, Blue Cross Blue Shield's commercial rates run higher than other carriers' at the same hospital for 3 of 3 services; a hip or knee replacement stay has a median rate of $27,373 across 6 hospitals.
Blue Cross Blue Shield plans in Hawaii, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 95 | 72,882 | 41% | $6,279 |
| 2021 | 102 | 75,953 | 40% | $6,641 |
| 2022 | 96 | 74,779 | 39% | $6,597 |
| 2023 | 99 | 69,255 | 40% | $6,911 |
| 2024 | 91 | 67,744 | 40% | $7,221 |
| 2025 (partial) | 58 | 56,196 | 37% | $7,603 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 21 | 23% |
| 100–499 | 45 | 49% |
| 500–999 | 13 | 14% |
| 1,000–4,999 | 10 | 11% |
| 5,000 or more | 2 | 2% |
Premiums and broker pay
| Measure | Blue Cross Blue Shield | All carriers, Hawaii |
|---|---|---|
| Median premium per person covered | $7,221 | $6,681 |
| Premium per person, middle half | $5,342–$9,536 | $5,541–$8,021 |
| Plans reporting broker or agent pay | 19% | 59% |
| Median broker pay, % of premium | 1.7% | 3.2% |
| Broker pay, middle half | 0.7%–2.7% | 2.4%–3.5% |
| Median broker pay per person covered | $74 | $200 |
Industries
Blue Cross Blue Shield's Hawaii employer clients are concentrated in health care and social assistance (12 plans) and finance and insurance (12), followed by retail trade (10).
| Industry | Plans | Share |
|---|---|---|
| Health care and social assistance | 12 | 13% |
| Finance and insurance | 12 | 13% |
| Retail trade | 10 | 11% |
| Accommodation and food services | 9 | 10% |
| Construction | 8 | 9% |
| Professional and technical services | 6 | 7% |
Blue Cross Blue Shield employer clients in Hawaii
86 employers in Hawaii have a Blue Cross Blue Shield major-medical contract, 12 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 Hawaii →
What the Blue Cross Blue Shield network pays physicians in Hawaii
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $171 | $171–$171 | 230% | $100 | 23 |
| Abdominal ultrasound, complete | 76700 | $53 | $53–$53 | 142% | $51 | 15 |
| Bone density scan (DXA), axial | 77080 | $20 | $20–$20 | 213% | $13 | 15 |
| CT abdomen and pelvis with contrast | 74177 | $158 | $158–$158 | 189% | $115 | 15 |
| CT chest without contrast | 71250 | $75 | $75–$75 | 153% | $68 | 15 |
| MRI brain without and with contrast | 70553 | $154 | $154–$154 | 147% | $147 | 15 |
| MRI cervical spine without contrast | 72141 | $105 | $105–$105 | 154% | $98 | 15 |
| MRI knee (lower-extremity joint) without contrast | 73721 | $91 | $91–$91 | 145% | $89 | 15 |
| MRI lumbar spine without contrast | 72148 | $97 | $97–$97 | 142% | $97 | 15 |
| MRI shoulder (upper-extremity joint) without contrast | 73221 | $91 | $91–$91 | 144% | $90 | 15 |
| Pelvic ultrasound, complete (non-obstetric) | 76856 | $45 | $45–$45 | 140% | $43 | 15 |
| Screening mammography, bilateral (incl. CAD) | 77067 | $49 | $49–$49 | 141% | $48 | 15 |
| Surgical pathology, tissue exam (level IV) | 88305 | $131 | $131–$131 | 187% | $95 | 76 |
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 Hawaii
Blue Cross Blue Shield commercial rates are on record at 8 Hawaii 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 3 of 3 services and lower for 0. For Hip or knee replacement (hospital stay), the rate runs from $24,828 to $32,345 across 6 hospitals.
| Service | Hospitals | Median rate | Range (P10–P90) | vs other carriers, same hospitals | Cash price, median |
|---|---|---|---|---|---|
| Hip or knee replacement (hospital stay) | 6 | $27,373 | $24,828–$32,345 | – | – |
Hospital-by-hospital Blue Cross Blue Shield rates for Hawaii are in the Plan Cost Benchmark; this page shows them once 15 or more hospitals' files include them.
How the contracts are written: case rates 63%, fee schedules 30%, per diem 4%, percent of billed charges 0%, other 4% of Blue Cross Blue Shield's published commercial rates for these services in Hawaii.
Employers: request hospital prices 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 Hawaii
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Kaiser Permanente | 167 | 74% | $6,738 | 3.4% |
| Other insurers (regional and local plans) | 121 | 54% | $6,454 | 3.0% |
| Blue Cross Blue Shield | 91 | 40% | $7,221 | 1.7% |
| Humana | 6 | 3% | $784 | 15.7% |
| UnitedHealthcare | 5 | 2% | $6,940 | 3.6% |
| Cigna | 4 | 2% | $5,004 | 10.0% |
| Aetna | 2 | 1% | $5,972 | 1.2% |
| Anthem (Elevance Health) | 1 | 0% | $5,325 | 4.4% |
Blue Cross Blue Shield in other states
FAQ
How many Hawaii employers have Blue Cross Blue Shield health insurance?
91 employer health plans in Hawaii reported a Blue Cross Blue Shield major-medical contract in their 2024 filings, covering 67,744 persons. Self-funded plans that Blue Cross Blue Shield only administers are not counted.
What is Blue Cross Blue Shield's share of the Hawaii insured employer market?
40% 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 Hawaii?
Where broker or agent pay was reported, the median was 1.7% of premium (3.2% across all carriers in Hawaii).
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 91 Hawaii 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: 87 contracts with 20+ persons covered and a reported premium; broker percentages use the 17 contracts that reported broker or agent pay.
- Network rates: BCBS: BCBS HI, professional fees only, from a sample of providers.
- Hospital prices: Blue Cross Blue Shield commercial rates at Hawaii hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.