Health Care Service Corp. recorded a net loss of more than $1.9 billion in 2025, a sharp reversal from the prior two years, according to regulatory filings.
The Chicago-based organization, which operates the Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas, posted a net income of $659 million in 2024 and $1.4 billion in 2023.
HCSC reported total revenue of $66.8 billion in 2025, up from $62.8 billion the prior year. Benefit expenses, however, rose to $63.1 billion from $57 billion, and the company’s net underwriting loss widened to $3.5 billion from $572 million in 2024. HCSC attributed membership and revenue growth to its purchase of the Cigna Group’s Medicare and CareAllies businesses for $3.3 billion last year.
“2025 was affected by headwinds consistent across the managed care industry associated with elevated utilization of healthcare services and higher acuity levels caused by more complex health needs across all of our lines of business,” an HCSC spokesperson told Becker’s.
In early 2025, Moody’s downgraded HCSC’s insurance financial strength rating to A3 from A2 following the company’s acquisition of Cigna’s Medicare business. Moody’s cited likely challenges with integrating the MA business into HCSC’s primarily commercial insurance operations, along with ongoing headwinds within the MA industry more broadly. Moody’s did change HCSC’s rating outlook from negative to stable, noting the company’s significant commercial scale, solid capital position, low financial leverage, and high percentage of tangible equity.
HCSC has 27.3 million members and managed $150.4 billion in medical spend in 2025. The company reported total assets of $42.7 billion at year-end 2025, with liabilities of $20.7 billion and capital and surplus of $22 billion.
Medicaid was the company’s largest line of business by direct premiums written, totaling approximately $12.3 billion. Medicare followed at roughly $7.9 billion, with the Federal Employees Health Plan at approximately $3 billion, Medicare supplement at $1.7 billion and dental at $779 million.
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