View the Latest: Small Group Coverage
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Essential Health Benefits: Balancing Affordability and Adequacy
Event Date:EventUnder the Patient Protection and Affordable Care Act (PPACA), insurance plans offered through state insurance exchanges as well as non-grandfathered plans offered in the individual and small group markets - will be required to cover a set of health benefits and services called the "essential health benefits" package.
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KFF Examines Key Considerations for the Implementation of Insurance Coverage for Over-the-Counter Contraceptives
News ReleaseWith federal regulators seeking public input on the potential benefits, costs, and implementation considerations of requiring private health insurance plans to cover over-the-counter preventive products without a prescription, a new KFF post explores the issues relevant to covering over-the-counter contraceptives.
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Health Insurer Financial Performance in 2023
Issue BriefUsing health insurer financial data for 2023, we find that in 2023, per enrollee gross margins were highest in the Medicare Advantage market, and medical loss ratios were lowest in the individual insurance market. Across most markets, gross margins have been relatively stable in recent years.
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How Much and Why Premiums are Going up for Small Businesses in 2026
Issue BriefThis analysis of preliminary rate filings from 318 insurers across all 50 states and DC finds that small businesses with Affordable Care Act (ACA)-compliant plans could face a median premium increase of 11% for 2026.
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Recent Trends in Commercial Health Insurance Market Concentration
Issue BriefCommercial health insurance markets remain highly concentrated across coverage types. However, the individual market, which consists mostly of the ACA Marketplaces, has attracted more insurers and witnessed greater insurer competition across a variety of measures since the implementation of the enhanced premium tax credits in 2021, according to a new Healthy System Tracker analysis.
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Tariffs Are Driving up Premiums for Small Businesses
Policy WatchSome insurers in the ACA’s small group market are citing tariffs, particularly those affecting prescriptions drugs, as a reason for higher-than-expected premium increases.