2015 Employer Health Benefits Survey
Section Five: Market Shares of Health Plans
Enrollment remains highest in PPO plans, covering just over half of covered workers, followed by HDHP/SOs, HMO plans, POS plans, and conventional plans. Enrollment distribution varies by firm size: for example, PPOs are relatively more popular for covered workers at large firms (200 or more workers) than small firms (56% vs. 41%) and POS plans are relatively more popular among small firms than large firms (19% vs. 6%). While enrollment in HDHP/SO plans (24%) is statistically unchanged from 2014 (20%), it has increased from 13% in 2010. Enrollment in PPOs declined significantly from 58% in 2014 to 52% in 2015.
- Fifty-two percent of covered workers are enrolled in PPOs, followed by HDHP/SOs (24%), HMOs (14%), POS plans (10%), and conventional plans (1%) (Exhibit 5.1). More workers are enrolled in HDHP/SO plans than in HMOs in both small firms (3 to 199 workers) and large firms (Exhibit 5.2).
- The percentage of covered workers enrolled in HDHP/SOs in both large firms (200 or more workers) and small firms is similar to last year. Enrollment in HDHP/SOs increased significantly from 2009 to 2012 (Exhibit 5.1).
- Enrollment in HDHP/SOs is higher for covered workers employed at firms with many low-wage workers (at least 35% of workers earn $23,000 per year or less) than firms with fewer low-wage workers. Enrollment in HDHP/SOs is similar between large firms (200 or more workers) and small firms (Exhibit 5.2).
- Enrollment in HMOs is similar to 2014, but declined significantly from 3 years ago (16% in 2012) and 5 years ago (20% in 2009). PPO enrollment declined to just 52% after many years of growth or steady enrollment.
- Plan enrollment patterns vary by firm size. Workers in large firms (200 or more workers) are more likely than workers in small firms to enroll in PPOs (56% vs. 41%). Workers in small firms are more likely than workers in large firms to enroll in POS plans (19% vs. 6%) (Exhibit 5.2).
- Plan enrollment patterns also differ across regions.
- HMO enrollment is significantly higher in the West (23%) and significantly lower in the South (10%) and Midwest (7%) (Exhibit 5.3).
- Workers in the South (58%) are more likely to be enrolled in PPOs than workers in other regions; workers in the West (44%) are less likely to be enrolled in a PPO (Exhibit 5.3).
- Enrollment in HDHP/SOs is higher among workers in the Midwest (30%) than in all other regions (Exhibit 5.3).
- Plan enrollment patterns differ by industry as well.
- Covered workers in the state/local government industry (10%) and health care (18%) are significantly less likely to be enrolled in an HDHP/SO plan than covered workers in other industries (Exhibit 5.3).
Distribution of Health Plan Enrollment for Covered Workers, by Plan Type, 1988-2015
Distribution of Health Plan Enrollment for Covered Workers, by Plan Type and Firm Size, 2015
Distribution of Health Plan Enrollment for Covered Workers, by Firm Size, Region, and Industry, 2015
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Exhibit 5.1
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Exhibit 5.2
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