Don’t just renew
Community Care Health small business plans: 11.5% for 2027, with EPOs rising faster for a third year
Community Care Health filed an 11.5% average increase for its California small business plans renewing in 2027. It’s the Fresno health plan’s third double-digit increase in a row. Its EPO plans go up 14.3% and its HMO plans 9.8%, and the EPOs have had the bigger increase in each of those three years.
Quick take
- The 2027 filing averages 11.5%: 9.8% for HMO plans and 14.3% for EPO plans. Single plans range from 7.1% to 15.0%.
- By our math, the last three January renewals add up to about 62% for the EPO plans and about 37% for the HMO plans.
- After renewal, the average premium is about $710 a month per person on an EPO and about $657 on an HMO.
- In each line, the plan with the smallest increase gets the biggest jump in its out-of-pocket limit, up to $3,000.
Who Community Care Health covers
Community Care Health is a Fresno health plan. Its site says it serves members in Fresno and neighboring counties, and its small business plans are priced for one state pricing region: Fresno, Kings, and Madera counties. It files its rates with the Department of Managed Health Care (DMHC), the state agency that oversees health plans. Small business here means 1 to 100 employees.
It sells two kinds of plans on the same network. On the HMOs, each member picks a primary care doctor and needs a referral to see a specialist. On the EPOs, members do neither. Both cover emergency and urgent care outside the network. Our HMO vs PPO guide explains where EPOs fit among plan types.
The 2027 filing covers about 1,325 people in 71 renewing groups, with 838 people on HMOs and 487 on EPOs. One filing sets the rates for every renewal month in 2027. DMHC lists the average as 11.5%, as filed, and the federal rate review site lists 11.50%.
A rate cut, then three double-digit years
| Renewal year | Community Care Health small business plans |
|---|---|
| 2021 | 4.0% |
| 2022 | 6.0% |
| 2023 | 0.0% |
| 2024 | -6.5% |
| 2025 | 13.3% |
| 2026 | 14.2% |
| 2027 | 11.5% |
Sources: DMHC rate filings for Community Care Health Plan’s small business plans, checked November 9, 2026, and the federal rate review site. See the 2027 DMHC filing, the rate increase justification, and the actuarial memo. The 2027 figure is as filed. The earlier ones are final. For 2023, Community Care withdrew a 6% filing and refiled at 0%.
Community Care cut its small business rates 6.5% for 2024. Its next two filings reported sharp jumps in the cost of care. The 2025 filing said claim costs per member rose 18% from 2022 to 2023, and the 2026 filing said they rose 53% from 2023 to 2024, before risk adjustment.
By our math, the three increases since then add up to about 44%. Counting the 2024 cut, rates are about 35% above their 2023 level. Over the same three January renewals, only Aetna’s PPO line (about 51%) and Sutter Health Plan (about 45%) are up more among the California carriers we’ve covered. Kaiser Permanente is lowest, at about 21%.
Why do the EPO plans keep going up faster?
The EPO plans got the bigger increase in each of the last three filings:
| Renewal year | HMO plans | EPO plans |
|---|---|---|
| 2025 | 11.6% | 20.3% |
| 2026 | 12.2% | 17.7% |
| 2027 | 9.8% | 14.3% |
| Three years together (our math) | About 37% | About 62% |
From Community Care’s rate increase justifications for 2025, 2026, and 2027 on the federal rate review site, checked November 9, 2026. Figures are as filed. The 2025 and 2026 averages were approved at the filed amounts.
The filings don’t give a single reason. They say increases vary by plan because of changes in how each plan is priced compared with the others. You can see that in the base rates, the price before each person’s age is applied (our guide to how small business rates are set walks through it). For 2027, the Platinum 90 EPO 0/20 is priced about 17% above the Platinum 90 HMO 0/20/250, by our math from the filing, though both pay the same 92% share of costs for a typical member. For 2026, the gap was about 13%.
What a Community Care plan costs per person
The average premium after renewal is about $657 a month per person on an HMO and about $710 on an EPO, according to the filing’s rate workbook at DMHC. Backing out each increase, that’s about $59 more a month per person on an HMO, or about $707 a year, and about $89 more a month on an EPO, or about $1,064 a year, by our math.
Because one filing covers the whole year, your renewal month doesn’t change the rates. The average increase for groups renewing in a given month still ranges from 7.6% in July to 14.0% in September, depending on which plans those groups have.
Where the 11.5% comes from
The workbook splits the increase into parts that multiply together:
- Expected cost growth adds 5.9 points. Community Care assumes the cost of care rises about 5.9% a year, the lowest assumption among the California filings we’ve covered. Drugs are the exception, at about 11.9% a year, and they were about 24% of the cost of care in 2025, by our math.
- Updating the starting point, the claims the rates are built from, adds 4.0 points. The memo also says Community Care stopped blending in its large group claims this year, because they now run well below its small group claims.
- Risk adjustment adds 2.4 points. Like Chinese Community Health Plan, Community Care pays into this federal program, which moves money from plans with healthier members to plans with sicker ones. It expects to pay about $85 per member a month in 2027, up from about $71 in last year’s filing. The final figure for 2025 came in at about $103.
- Changes in plan mix and benefits take off 1.5 points. The profit and risk margin line adds 0.4, though the margin stays at 2% of premium.
Administrative costs stay flat at $88 per member a month, which includes $30.20 for commissions.
Four checks for a Community Care renewal
- Find your own plan’s increase on the notice. HMO plans run from 7.1% to 12.0% and EPO plans from 10.8% to 15.0%.
- On a Platinum plan, read the out-of-pocket maximum. The Platinum 90 HMO 0/20/250 goes from $3,000 to $5,500 and the Platinum 90 EPO 0/20 from $2,500 to $5,500, and both double the primary care copay from $10 to $20.
- On an EPO, ask for the matching HMO rates too, so you can see in dollars what skipping referrals costs your group.
- Plans marked INF include infertility coverage and are priced about 3.5% higher. Check which version your group is on.
Don’t Just Renew is not associated with, endorsed by, or sponsored by Community Care Health. Community Care Health 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 9, 2026.