Premiums for standard, fully insured small-group health insurance climbed 11% in the average state between 2024 and 2025, according to a comparison of a new preliminary premium table from the Center for Consumer Information & Insurance Oversight with the comparable table published in 2025.
The average small-group premium in all states was $603 per month. The state-level averages ranged from $391, in Mississippi, up to $957, in Alaska.
Average premiums fell 15% or more in three states, and 24% in Mississippi.
But average premiums climbed 40% or more in five states.
In Georgia, the hardest-hit state, average premiums increased 72%, to $842.
What it means: Small employers in some states are losing access to affordable, fully insured health coverage.
The data: CCIIO, the agency that compiles the state health insurance premium tables, is the Centers for Medicare and Medicaid Services division that oversees HealthCare.gov and other ACA rules and programs that affect the commercial health insurance market.
CCIIO creates the premium tables to support administration of an ACA risk-adjustment program that's supposed to use cash from plans with low-risk patients to support plans with high-risk patients.
In addition to state small-group market premium data, the tables include state premium data for the individual major medical market and for the market for bare-bones "catastrophic" coverage. Catastrophic policies pay only 50% of the actuarial value of the standard package of health benefits until the insureds reach their annual out-of-pocket spending maximum.
Massachusetts and Maine combine their individual and small-group markets, and CCIIO also publishes a separate premium table for those two states.
The tables published in March provide preliminary data and are subject to change.
The preliminary table for 2025 does not yet include small-group data for Delaware or Ohio.
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