2013 Employer Health Benefits Survey

Section Five: Market Shares of Health Plans

Enrollment remains highest in PPO plans, covering more than half of covered workers, followed by HDHP/SOs, HMO plans, POS plans, and conventional plans.  Enrollment distribution varies by firm size, for example, PPOs are relatively more popular for covered workers at large firms (200 or more workers) than smaller firms (62% vs. 47%)  and POS plans are relatively more popular among smaller firms than large firms (16% vs. 5%) (Exhibit 5.2).

• Fifty-seven percent of covered workers are enrolled in PPOs, followed by HDHP/SOs (20%), HMOs (14%), POS plans (9%), and conventional plans (<1%) (Exhibit 5.1).

• After years of significant annual increases in the percentage of covered workers enrolled in HDHP/SO plans (8% in 2009, 13% in 2010, and 17% in 2011), there has been a similar level of enrollment over the past two years (19% in 2012 and 20% in 2013) (Exhibit 5.1).

• Enrollment in HMO plans is similar to 2012, but has declined significantly since 2011.

• Plan enrollment patterns vary by firm size.  Workers in large firms (200 or more workers) are more likely than workers in small firms (3-199 workers) to enroll in PPOs (62% vs. 47%).  Workers in small firms are more likely than workers in large firms to enroll in POS plans (16% vs. 5%) (Exhibit 5.3).

• Plan enrollment patterns also differ across regions.
  • HMO enrollment is significantly higher in the West (25%) and significantly lower in the South (10%) and Midwest (7%) (Exhibit 5.3).
  • Workers in the South (66%) are more likely to be enrolled in PPO plans than workers in other regions; workers in the West (49%) are less likely to be enrolled in a PPO (Exhibit 5.3).
  • Enrollment in HDHP/SOs is higher among workers in the Midwest (27%) than in other regions (Exhibit 5.3).

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Section Five: Market Shares of Health Plans

exhibits

Distribution of Health Plan Enrollment for Covered Workers, by Plan Type, 1988-2013

Download Exhibit 5.1

Distribution of Health Plan Enrollment for Covered Workers, by Plan Type and Firm Size, 2013

Download Exhibit 5.2

Distribution of Health Plan Enrollment for Covered Workers, by Firm Size, Region, and Industry, 2013

Download Exhibit 5.3