EBRI: More small employers embrace self-insured health plans, but the number of large employers doing so dips

Health insurance forms
More small employers are offering self-insured health plans, but the trend is reversing among large employers, according to a new report. (Getty/vinnstock)

More smaller employers are offering self-insured health plans to their staffers, but the number of large firms doing the same is on the decline, according to a new report. 

The Employee Benefit Research Institute tracked (PDF) trends in self-insured health plans between 1996 and 2016 and found that enrollment in self-insured plans decreased from 60% to 57.8              % between 2015 and 2016, largely on the back of a drop in the number of large employers offering such plans. 

The number of large employers—those with 500 employees or more—offering self-insured plans decreased from 80.4% to 78.5% between 2015 and 2016, according to the report. During that same window the number of small firms with fewer than 100 employees offering such plans increased from 14.2% to 17.4%. 

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The number of midsized employers, with between 101 and 499 employees, offering these plans also took a dip between 2015 and 2016, decreasing from 30.1% to 29.2%, according to the report. 

Experts and analysts predicted that more employers of all sizes would turn to self-insured health plans as the Affordable Care Act took full effect, as these plans may be less expensive to offer. 

"While these data are consistent with the perspective set forth ... that the ACA would cause more small employers to adopt self-insured plans, there are now questions as to why the recent movement to self-insured plans in the midsized market may be reversing itself," according to the report. 

RELATED: Surveys suggest a slowdown in HSA-eligible health plan enrollment growth 

Another recent report from EBRI found that more midsize and small employers are offering health plans to their staffers, despite many cutting back coverage offerings in the early years of the ACA. 

EBRI found a slight increase in the number of employers with between 10 and 999 employees offering coverage, though the rate did decrease slightly among firms with just 10 or fewer staffers. Premium increases were relatively low in 2016 compared to years prior, EBRI found, and the job market stabilized significantly, likely leading to the increase. 

What comes next for the employer insurance market likely depends on what happens next for health policy in Washington. If the ACA's marketplaces mature and offer robust coverage choices for consumers, then more employers are likely to pull their sponsored insurance, according to that report. 

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