2021 Employer Health Benefits Survey

PPOs are the most common plan type, covering 46% of covered workers, followed by HDHP/SOs, HMOs, POS plans, and conventional plans. All of these percentages are similar to the enrollment percentages in 2020.

• Forty-six percent of covered workers are enrolled in PPOs, followed by HDHP/SOs (28%), HMOs (16%), POS plans (9%), and conventional plans (1%) [Figure 5.1].
• The percentage of covered workers enrolled in HDHP/SOs is similar to the percentages last year (31%) and five years ago (29%), but higher than the percentage 10 years ago (17%). The percentage of covered workers enrolled in PPOs decreased 9% over the past decade [Figure 5.1].
• The percentage of covered workers enrolled in HMOs (16%) is similar to the percentages last year (11%) and five years ago (15%). This percentage has moved around over the last few years and we are unsure as to why. We will continue to watch this topic.
• A larger share of covered workers are enrolled in HDHP/SOs than in HMOs in small and large firms [Figure 5.2].
• Covered workers in large firms are more likely to be enrolled in HDHP/SOs than covered workers in small firms (30% vs. 23%) [Figure 5.2]. Covered workers in small firms are much more likely than covered workers in large firms to be enrolled in POS plans (17% vs. 5%) [Figure 5.2].
• Plan enrollment patterns also differ across regions.
  • HMO enrollment is significantly higher in the West (34%), and is significantly lower in the Midwest (8%) and in the South (10%) [Figure 5.3].
  • Covered workers in the Midwest (39%) are more likely to be enrolled in HDHP/SOs than workers in other regions, while covered workers in the West (19%) are less likely to be enrolled in HDHP/SOs [Figure 5.3].