Self Insuring Benefits Programs

Author : Paul Fronstin
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (137 download)

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Download or read book Self-Insured Health Plans written by Paul Fronstin and published by . This book was released on 2012 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This paper examines recent trends in self-insurance. Data come from the Medical Expenditure Panel Survey (MEPS) and are presented by establishment size among private-sector employers. State-level data are also presented, along with the correlation between state mandates and the prevalence of self-insurance. Offering a self-insured plan means the employer assumes the financial risk related to offering health insurance (as opposed to a fully insured plan, where the insurance company assumes the risk). Large employers are much more likely to offer health benefits on a self-insured basis than small employers. However, there is speculation that passage of the Patient Protection and Affordable Care Act of 2010 (PPACA) will result in an increasing number of smaller employers offering self-insured plans. Employers think that components of PPACA, such as the strict grandfathering requirements; the minimum-creditable-coverage requirement; the breadth of essential health benefits; taxes on insurers, medical-device manufacturers, and pharmaceutical companies; affordability requirements; and reinsurance fees will all drive up the cost of health coverage. Small employers concerned about the rising cost of providing health coverage may view self-insurance as a more attractive means to mitigate any expected cost increases. Some key findings include the following: The percentage of workers in private-sector self-insured health plans has been increasing. In 2011, 58.5 percent of workers with health coverage were in self-insured plans, up from 40.9 percent in 1998. Large employers (with 1,000 or more workers) have driven the upward trend in overall self-insurance. The percentage of workers in self-insured plans in firms with fewer than 50 employees has been close to 12 percent in most years examined. The prevalence in self-insured plans varies by state, with Massachusetts having the third-highest prevalence of self-insurance in the small-group market (behind Hawaii and Alaska). Overall, 58.5 percent of workers were in self-insured plans in 2011, but the percentage ranged by state, from a low of 30.5 percent to a high of 73.8 percent. Massachusetts, the only state to have enacted health reform similar to PPACA, has seen an increase in the percentage of workers in self-insured plans among all firm-size cohorts, except among workers in firms with fewer than 50 employees. The PDF for the above title, published in the November 2012 issue of EBRI Notes, also contains the fulltext of another November 2012 EBRI Notes article abstracted on SSRN: “All or Nothing? An Expanded Perspective on Retirement Readiness.”