Blue Cross Blue Shield employer health plans in Rhode Island
Who Blue Cross Blue Shield insures among Rhode Island employers and what those plans pay in premium and broker compensation, and what the Blue Cross Blue Shield network pays physicians.
Blue Cross Blue Shield employer health plans in Rhode Island at a glance
What the data shows
Blue Cross Blue Shield is the largest insurer of employer health plans in Rhode Island: 115 plans held a Blue Cross Blue Shield major-medical contract in form year 2024, 72% of the state's 159 insured large plans, ahead of UnitedHealthcare with 25.
Blue Cross Blue Shield has shrunk 7% in Rhode Island since 2020, from 124 plans, as insured plans moved carrier or to self-funding.
Most of these plans cover 100–499 people (73 plans); 14 cover 1,000 or more.
Median premium per person covered was $7,313, 1% above the Rhode Island all-carrier median of $7,209. Benefit design and group mix differ, so this is not a price comparison.
89% of these plans reported broker or agent pay on their Blue Cross Blue Shield contracts; where paid, the median was 1.8% of premium (middle half 1.2%–2.6%).
In BCBS: BCBS RI, 21 of the 50 Employer 50 services have a Rhode Island benchmark, at a median of 112% of Medicare across those services.
Blue Cross Blue Shield plans in Rhode Island, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 124 | 60,505 | 73% | $6,170 |
| 2021 | 123 | 75,911 | 74% | $6,385 |
| 2022 | 126 | 75,955 | 73% | $6,626 |
| 2023 | 139 | 81,776 | 73% | $7,000 |
| 2024 | 115 | 64,399 | 72% | $7,313 |
| 2025 (partial) | 78 | 47,963 | 69% | $8,038 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 13 | 11% |
| 100–499 | 73 | 63% |
| 500–999 | 15 | 13% |
| 1,000–4,999 | 13 | 11% |
| 5,000 or more | 1 | 1% |
Premiums and broker pay
| Measure | Blue Cross Blue Shield | All carriers, Rhode Island |
|---|---|---|
| Median premium per person covered | $7,313 | $7,209 |
| Premium per person, middle half | $6,404–$9,122 | $5,844–$9,287 |
| Plans reporting broker or agent pay | 89% | 81% |
| Median broker pay, % of premium | 1.8% | 2.2% |
| Broker pay, middle half | 1.2%–2.6% | 1.4%–3.1% |
| Median broker pay per person covered | $138 | $153 |
Industries
Blue Cross Blue Shield's Rhode Island employer clients are concentrated in health care and social assistance (26 plans) and manufacturing (18), followed by finance and insurance (16).
| Industry | Plans | Share |
|---|---|---|
| Health care and social assistance | 26 | 23% |
| Manufacturing | 18 | 16% |
| Finance and insurance | 16 | 14% |
| Professional and technical services | 10 | 9% |
| Retail trade | 8 | 7% |
| Wholesale trade | 8 | 7% |
Blue Cross Blue Shield employer clients in Rhode Island
114 employers in Rhode Island have a Blue Cross Blue Shield major-medical contract, 14 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 Rhode Island →
What the Blue Cross Blue Shield network pays physicians in Rhode Island
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Diagnostic heart catheterization with coronary angiography | 93458 | $349 | $297–$349 | 122% | $496 | 19 |
| Echocardiogram, transthoracic complete with Doppler | 93306 | $80 | $68–$95 | 119% | $128 | 19 |
| Electrocardiogram (EKG), complete | 93000 | $14 | $14–$14 | 93% | $29 | 17 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $82 | $75–$89 | 110% | $112 | 18 |
| Treadmill stress test, complete | 93015 | $88 | $88–$141 | 119% | $142 | 11 |
| Skin biopsy, single lesion (tangential) | 11102 | $104 | $104–$104 | 109% | $143 | 13 |
| Colonoscopy (diagnostic, with biopsy, with polyp removal) | 45378 | $349 | $349–$349 | 212% | – | 14 |
| Upper GI endoscopy (diagnostic, with biopsy) | 43235 | $273 | $273–$273 | 247% | $152 | 14 |
| Cataract removal with lens implant | 66984 | $642 | $642–$642 | 139% | $869 | 31 |
| Chemotherapy IV infusion administration, first hour | 96413 | $216 | $184–$216 | 162% | $184 | 13 |
| Surgical pathology, tissue exam (level IV) | 88305 | $72 | $72–$72 | 102% | $71 | 27 |
| Arthroscopic rotator cuff repair | 29827 | $1,279 | $1,279–$1,279 | 131% | $1,902 | 12 |
| Carpal tunnel release, open | 64721 | $561 | $561–$561 | 133% | $746 | 12 |
| Large joint injection or aspiration (knee, shoulder) | 20610 | $78 | $78–$78 | 113% | $110 | 12 |
| Lumbar spinal fusion, one level | 22612 | $1,875 | $1,875–$1,875 | 128% | $2,815 | 12 |
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.
Carriers in Rhode Island
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Blue Cross Blue Shield | 115 | 72% | $7,313 | 1.8% |
| UnitedHealthcare | 25 | 16% | $7,660 | 2.6% |
| Other insurers (regional and local plans) | 24 | 15% | $6,202 | 4.2% |
| Kaiser Permanente | 10 | 6% | $5,790 | 2.7% |
| Cigna | 8 | 5% | $6,862 | 5.3% |
| Aetna | 7 | 4% | $2,352 | 0.7% |
Blue Cross Blue Shield in other states
FAQ
How many Rhode Island employers have Blue Cross Blue Shield health insurance?
115 employer health plans in Rhode Island reported a Blue Cross Blue Shield major-medical contract in their 2024 filings, covering 64,399 persons. Self-funded plans that Blue Cross Blue Shield only administers are not counted.
What is Blue Cross Blue Shield's share of the Rhode Island insured employer market?
72% of insured large employer health plans, 1st of 6 carrier groups by plan count.
How much do brokers earn on Blue Cross Blue Shield plans in Rhode Island?
Where broker or agent pay was reported, the median was 1.8% of premium (2.2% across all carriers in Rhode Island).
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 115 Rhode Island 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: 110 contracts with 20+ persons covered and a reported premium; broker percentages use the 102 contracts that reported broker or agent pay.
- Network rates: BCBS: BCBS RI, professional fees only, from a sample of providers.
- Full method and limits: how the employer health plan data is built.