PPOs are the most common plan type, covering 47% of covered workers, followed by HDHP/SOs, HMOs, POS plans, and conventional plans. The drop in the share of covered workers in PPOs in 2019 was not statistically significant.
Forty-seven percent of covered workers are enrolled in PPOs, followed by HDHP/SOs (31%), HMOs (13%), POS plans (8%), and conventional plans (1%) [Figure 5.1].
The percentage of covered workers enrolled in HDHP/SOs is similar to last year, but has increased over the past decade. The percentage of covered workers enrolled in PPOs decreased by 11% over the past decade.
The percentage of covered workers enrolled in HMOs (13%) is significantly lower than the percentage last year (19%) but not different from 2015 (14%). This percentage has moved over the last few years and we are unsure as to why. As noted above, we employed a new survey firm in 2020 and the change could represent a difference in interpretation of plan characteristics by new interviewers. There also may be measurement error in any of they years. We will continue to watch this topic.
A larger share of covered workers are enrolled in HDHP/SOs than in HMOs in small and large firms.
Covered workers in large firms are more likely to be enrolled in HDHP/SOs than covered workers in small firms (33% vs. 25%)[Figure 5.2]. Covered workers in small firms are much more likely than covered workers in large firms to be enrolled in POS plans (17% vs. 5%) [Figure 5.2].
Plan enrollment patterns also differ across regions.
HMO enrollment is significantly higher in the West (22%), and significantly lower in the Midwest (7%) [Figure 5.3].
Covered workers in the Midwest (39%) are more likely to be enrolled in HDHP/SOs than workers in other regions, while covered workers in the West (24%) are less likely to be enrolled in HDHP/SOs [Figure 5.3].
Figure 5.1: Distribution of Health Plan Enrollment for Covered Workers, by Plan Type, 1988-2020
Figure 5.2: Distribution of Health Plan Enrollment for Covered Workers, by Plan Type and Firm Size, 2020
Figure 5.3: Distribution of Health Plan Enrollment for Covered Workers, by Firm Size, Region, and Industry, 2020