A new study from the Employee Benefit Research Institute (“EBRI”) has found that the percentage of all private-sector establishments offering at least one self-insured health plan has recently fallen.
The EBRI explained in a statement that, in 2016, 40.7 percent of private-sector establishments reported that they self-insured at least one of their health plans, up from 26.5 percent in 1999.
By 2018, however, the percent of private-sector establishments reporting that they self-insured at least one of their health plans fell to 38.7 percent.
“The post-[Affordable Care Act (‘ACA’)] changes in the availability of, and enrollment in, self-insured health plans among various sizes of private-sector establishments seem to be reversing course,” said Paul Fronstin, director of the Health Research and Education Program at EBRI. “The availability of self-insured plans is now increasing among large establishments, has started to fall among small establishments, and might be stabilizing among medium-sized establishments. The data lead to more questions — why is the use of self-insured plans falling in small companies, and is the growing use of self-insured plans among large companies a new trend?”
Between 2013 and 2016, the percentages of small and medium-sized establishments offering at least one self-insured plan both increased. For small establishments, the percentage increased 31 percent, from 13.3 percent to 17.4 percent, with most of the increase occurring in 2016. For medium-sized establishments, the percentage increased 15.4 percent, from 25.3 percent to 29.2 percent.
By 2018, however, the percentage of small establishments self-insuring at least one health plan fell back to a pre-ACA level of 13.2 percent. The percentage of medium-sized establishments offering a self-insured plan fell to 29 percent.
Self-insured plans from large establishments experienced a continued decline between 2013 and 2017, falling from 83.9 percent to 75.9 percent. A rebound, however, may have started in 2018 as the percentage offering a self-insured plan increased to 78.7 percent.
The percentage of workers in self-insured plans fell in every establishment size, except for those in firms with 1,000 or more employees. Despite the fact that many more employees work for large establishments, the increase in self-insurance among large establishments was not large enough to offset the decline among small and medium-sized establishments, resulting in an overall decrease in the percentage of covered workers enrolled in self-insured plans.
Between 2017 and 2018, the percentage of enrollees fell from 59.4 percent to 58.7 percent, the EBRI found.
Learn more: www.ebri.org.
Victoria Spears
Victoria Prussen Spears is senior vice president of Meyerowitz Communications Inc., a law firm marketing communications consulting company. A graduate of Sarah Lawrence College and Brooklyn Law School, Ms. Spears was an attorney at a leading New York City law firm before joining Meyerowitz Communications. She may be contacted at [email protected].