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Anticipated Small Group Medical Rates - 2025



Blue Cross Blue Shield of Michigan / Blue Care Network have announced today they have filed their 2025 Small Group Medical rates for the first quarter and pending regulatory approval.



 

For Q1 2025:

  • PPO plans will see an average statewide increase of 12.1 percent.

  • HMO plans will see an average statewide increase of 11.2 percent.

  • Blue Cross will continue to evaluate emerging claims experience to determine if any re-filing is needed for 2Q, 3Q, or 4Q over the coming months.

 

In a statement by Blue Cross they have indicated maintaining a long history of rate moderation for small employer customers, with the average rate increase being approximately 5 percent over the past four years. The rate increases for 2025 were greatly impacted by the following:

 

  • Increased cost for inpatient and outpatient services, driven by surgical and medical spend categories.

  • Increased utilization of professional services, including psychiatric services and office administered drugs.

  • Increase in the overall utilization and price of specialty and brand drugs.  Specific categories driving trend include GLP-1 agonists (for diabetic therapy) and auto-immune drugs.

Blue Cross further notes that “while medical and pharmacy trends have played a significant role in rate adjustments across the industry, our teams are engaged in strategic approaches to minimize the impact of drug costs and emerging therapies on our customers and members including appropriateness of treatments and a focus on lowest net cost. Maintaining affordable, predictable rates for small business customers is important and we remain vigilant on the pressure that both medical and pharmacy costs are having on small employer premiums. “


It's important to note that the specific rate adjustments will vary by region, and the figures mentioned above represent statewide averages across Q1 2025. Blue Cross is currently awaiting regulatory approval for these rate changes but does not anticipate encountering any significant obstacles.


AJM Associates, Inc. will monitor these small group rate filings for 2025 and will prepare accordingly to review alternative carriers and options come our clients 2025 Small Group Renewals.


Any questions regarding this recent announcement by Blue Cross, please do not hesitate to give us a call.

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