Combined profit margins across BCBS plans sank to 1.4% as of third-quarter 2025, according to a Jan. 29 analysis of Mark Farrah Associates’ Health Coverage Portal.
The report covered BCBS Association licensees and unaffiliated plans. The team compared composite third-quarter 2025 with the same period in previous years.
Here are three things to know about BCBS trends:
1. As of Sept. 30, BCBS plans account for 37.2% of U.S. health insurance enrollment, or 119.1 million members.
2. Profit margins have been trending downward in recent years. While third-quarter 2023 saw a jump to 3.5% from 3.1% in 2022, third-quarter 2024 saw a dip to 2.1%.
3. Out of the top five leading BCBS plans by members, Elevance Health had the highest profit margin at 3.9%. However, the only plan out of the five to see year-over-year profit margin improvement from 2024 to 2025 was BCBS Michigan, even though the value was still negative.
And here are how the five biggest plans performed:
Elevance Health
Q3 2025: 3.9%
Q3 2024: 4.6%
Highmark
Q3 2025: -1.3%
Q3 2024: 1.7%
GuideWell
Q3 2025: 0.4%
Q3 2024: 1.6%
Health Care Service Corp.
Q3 2025: -1.1%
Q3 2024: 1.0%
BCBS Michigan
Q3 2025: -0.8%
Q3 2024: -3.5%
