Section 5: Market Shares of Health Plans

The distribution of enrollment among types of health plans has remained fairly constant over the past several years. The majority of covered workers are enrolled in PPO plans (55%), followed by HMO plans (25%) (Exhibit 5.1).

Although annual changes in plan enrollment have been moderate, enrollment in PPO plans has grown by nine percentage points since 2001.

• More than half of covered workers (55%) are enrolled in PPO plans, an increase from 46% in 2001 (Exhibit 5.1). Conventional plan enrollment has remained fairly minimal since 2000, comprising less than ten percent of total enrollment.
• There are slight regional differences in plan enrollment. PPO plans have higher enrollment in the Midwest (64%) and the South (64%). HMO enrollment is consistently highest in the West (36%). POS plans tend to have higher enrollment in the Northeast compared to other regions (23%) (Exhibit 5.2).
• PPO enrollment is particularly strong in certain industries. Enrollment in PPO plans is high in the mining, construction, and wholesale industries (68%), and in the transportation, communications and utilities industries (65%) (Exhibit 5.2).
  • The percentage of workers enrolled in HMOs has remained steady since 2001 at approximately 25% (Exhibit 5.1).
  • Conventional plan enrollment remains low at five percent of covered workers (Exhibit 5.1).