Blog · November 4, 2026

Aetna small business plans in California: 2027 rates are up 7% to 19%

If your company has an Aetna PPO in California and renews in January, plan on paying about 19% more. If you have an Aetna HMO, plan on about 7%. The two plan types come from different Aetna companies, which file their rates separately.

How much is Aetna raising small business rates?

Aetna sells small business plans in California through two companies. Aetna Health of California offers HMOs and files its rates with the Department of Managed Health Care (DMHC), the state agency that oversees health plans. Aetna Life Insurance Company offers PPOs and is overseen by the California Department of Insurance, so its numbers here come from the federal rate review site. In California, a small business plan covers a company with 1 to 100 employees.

Both companies set new rates every quarter. The PPO filing counts 14,248 people as of December 2025, and the HMO company’s October 2026 filing with DMHC counts 9,417.

Aetna first filed 7.6% for its January HMO rates, and DMHC’s summary still lists that. It then sent an updated rate workbook to DMHC that comes to 7.1%, and the federal site lists 7.6% requested and 7.1% final. We use 7.1% here because it’s the latest figure. The PPO’s 18.7% is final on the federal site.

What Aetna small business plans cost in 2027

The HMO filing shows the average monthly premium after renewal, per person covered. That counts employees and any family members on the plan, and it’s the full premium before you split it with your employees. The filing counts 390 employer groups and 3,108 people renewing with Aetna’s HMOs between January and March.

An HMO keeps your employees in a set network of doctors and usually needs a referral to see a specialist. A PPO lets people see doctors outside the network, for a higher cost. Aetna’s HMO filing has 11 plans, from bronze to platinum. Bronze plans have the lowest premiums and the highest costs when people get care, and platinum plans the reverse.

Aetna doesn’t sell in every part of the state. California has 19 pricing regions. Aetna’s HMO actuarial memo says it stopped enrolling HMO members in regions 1 through 14 on January 1, 2026. That leaves Los Angeles, Orange, San Diego, Riverside, and San Bernardino counties. Its PPO memo projects members only in those same five regions plus San Francisco, Alameda, and the eight counties in regions 10 and 11, which include Fresno, San Joaquin, and Stanislaus.

Your own increase depends on your plan, your employees’ ages, and your location. Aetna’s PPO plans are going up 17.7% to 20.5%, and its HMO plans range from no change to 9.9%. Employees still move up an age band as they get older, and that’s on top of these numbers.

Why is Aetna raising rates?

For the PPO plans, it’s mostly the cost of care. Aetna’s filing summary expects medical costs to rise 9.3% a year and prescription drugs 10.1%, or 9.4% combined. It also updated its rates for recent claims across its small business PPO members and for new plan designs. Without the plan design changes, the increase would have been 20.1%.

The PPO memo also lists an updated estimate for risk adjustment among its reasons. That’s a federal program that moves money between insurers based on how healthy their members are. Aetna expects its PPO company to receive about $82 per member each month from it in 2027, while its HMO company expects to pay in about $66.

For the HMOs, the filing splits the 7.1% into parts. Recent claims and expected cost growth add about 9.2 points, and administrative costs about 2.2. Risk adjustment takes 3.6 points off. Smaller items, like plan changes, make up the rest. Aetna expects HMO costs to rise about 7.4% a year, with prescription drugs climbing fastest at 9.9%.

Hospital care is expensive for these plans. Aetna’s HMO members’ outpatient hospital costs ran about 2.9 times what Medicare pays for the same care, and inpatient costs about 2.2 times. Aetna’s HMO also pays many of its doctors a set amount per member each month instead of a fee for each visit. Those payments make up about 43% of the HMO’s medical and drug costs in the filing.

How Aetna compares with other California insurers

Aetna’s two companies sit at opposite ends of California’s January filings. Its HMO is near the bottom, and its PPO is near the top.

We’ve also written up the 2027 rates for Anthem Blue Cross, Blue Shield of California, Kaiser Permanente, and UnitedHealthcare. Across the country, the median small business increase insurers asked for in 2027 is 14%, according to KFF.

What to do before you renew

• Find your renewal notice and check whether you’re on an Aetna PPO or HMO. The two are going up by very different amounts.
• If you’re on the PPO, ask whether an HMO would work for your employees. It costs less, but it limits them to a set network and usually needs referrals.
• Check where your employees live and work. Aetna’s HMOs now cover only five Southern California regions.

Don’t Just Renew is not associated with, endorsed by, or sponsored by Aetna, Aetna Health of California, or Aetna Life Insurance Company. Aetna is a trademark of its owner, and we use the name only to report public rate data. This article is general information, not insurance advice. Figures are current as of November 4, 2026.