Section 5: Market Shares of Health Plans
PPOs are the most common plan type, covering 44% 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-four percent of covered workers are enrolled in PPOs, followed by HDHP/SOs (30%), HMOs (19%), POS plans (7%), 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 16% over the past decade.
- A larger share of covered workers are enrolled in HDHP/SOs than in HMOs in large firms.
- Covered workers in large firms are more likely to be enrolled in PPOs and HDHP/SOs than covered workers in small firms [Figure 5.2]. Covered workers in small firms are much more likely than covered workers in large firms to be enrolled in POS plans (14% vs. 3%) [Figure 5.2].
- Plan enrollment patterns also differ across regions.
- HMO enrollment is significantly higher in the West (35%), and significantly lower in the South (11%) and Midwest (10%) [Figure 5.3].
- Covered workers in the Northeast (39%) are more likely to be enrolled in HDHP/SOs than workers in other regions, while covered workers in the West (20%) are less likely to be enrolled in HDHP/SOs [Figure 5.3].