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Self-funded employer health plans continued to take share away from fully insured group health plans, according to a new analysis from Mark Farrah Associates.
The health coverage data firm found that health insurers and other companies active in the "administrative services only" market covered 132 million people in the third quarter, or 1.8% more people than they were covering in the third quarter of 2023.
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Enrollment in fully insured group health plans, a segment that included the Federal Employees Health Benefits program, fell 3%, to 50 million.
The number of people with private individual insurance increased to 23%, to 25 million.
Related: ICHRAs might be adding to individual health sales: Mark Farrah
Fully insured group plans now cover only about one-third as many people as self-funded plans do, and the fully insured group market is now just twice as big as the individual market.
Fully insured plans must comply with state health insurance mandates. The Employee Retirement Income Security Act preempts state efforts to regulate self-funded plans and puts those plans under the jurisdiction of the U.S. Labor Department.
Some people included in the Mark Farrah data have coverage from more than one source, and the figures include information about 319 million plan enrollments.
Mark Farrah notes that the beginning and ending of federal programs played a big role in shaping enrollment trends at some types of payers.
Medicaid program enrollment fell, for example, because of the expiration of special emergency provisions adopted during the COVID-19 pandemic, and individual enrollment increased because of the expiration of the pandemic emergency Medicaid rules and the continuation of temporary, pandemic-related individual health insurance premium subsidies. The extra individual health subsidies are set to expire at the end of 2025.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
