Skip to main content

Some Tidbits on the Employer Health Benefits Market

By September 3, 2023Commentary

Mark Farrah Associates collects, analyzes and releases excellent data on the health insurance marketplace.  A recent brief summarizes interesting facts about the employer-based portion of that marketplace.  These employer-based plans are governed by a law called the Employee Retirement and Income Security Act and employers have to file regular reports with the Department of Labor.  According to those reports about 86,000 employers offer some health benefit.  The plans with the largest number of members are Amazon at about 2.9 million and Walmart at about 2.4 million.  Two teachers unions, the NEA and the AFT collectively have about 4.4 million covered persons.  Your tax dollars at work.  Another union, the Teamsters, has about 1.5 million members.  Target and AT & T are other firms in the top ten for membership.

Large employers tend to be self-funded, that is, they take the risk of the health costs, but they typically contract with a health plan company to administer the plan–have a network of providers, do medical management and pay claims.  Among plans that offer actual insured health plans to employers, Kaiser covers the most people, about 4.7 million and receives around $23 billion in premiums for this line of business.  UnitedHealth and Aetna (now part of CVS)  are other large issuers of fully-insured coverage.  In terms of self-funded coverage, UnitedHealth receives the most in fees for administration, about $1.8 billion, followed by Elevance (formerly Anthem) and Aetna.  And now here is where some of the surprising spending related to health plans comes in.  Brokers and agents receive over $3 billion in fees for helping arrange coverage.  (MFA Brief)

Leave a comment