Group Health Insurance Market

CMS chops short-term, limited duration plan length to 4 months

March 29, 2024 - The Biden administration has reduced the timeframe of short-term limited duration insurance plans, also known as “STLDI” or “junk” plans, in an effort to curb underinsurance, CMS announced. “HHS is cracking down on junk insurance plans to help consumers make informed choices and avoid mistakenly paying for a plan that...

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Health Insurance Costs Are Growing Too Expensive for Small Businesses

by Kelsey Waddill

While small businesses know the advantages of providing health insurance, many employers are concerned about the rising costs of health benefits, with most businesses that do not offer health insurance...

How the Top 4 Disruptive Insurtechs Have Evolved Since Their IPOs

by Kelsey Waddill

The insurtechs that saw the greatest success after the start of the coronavirus pandemic have faced a tumultuous path since their initial public offerings (IPOs). In 2021, four insurtechs achieved their IPO. Their goal was to disrupt the...

5 Chronic Diseases Plague High Spending Group Health Plan Members

by Kelsey Waddill

Group health insurance plan members with high healthcare spending often have one or more of the same five chronic diseases, according to a fast facts sheet from the EBRI Center for Research on Health...

KFF: Payers Will Issue $1.1B in Medical Loss Ratio Rebates in 2023

by Victoria Bailey

Payers will issue around $1.1 billion in medical loss ratio (MLR) rebates across commercial markets in 2023, KFF projected. In the individual and small group markets, payers must spend at least...

How Health Insurance Coverage Varies Across, Within Families

by Victoria Bailey

The Affordable Care Act (ACA) increased access to Medicaid and group health insurance, but the family glitch created a barrier to non-group coverage, leading to variations in health insurance coverage...

No Surprises Act Leads to 9M Averted Surprise Bills, 275K Arbitration Claims

by Kelsey Waddill

The No Surprises Act effectively averted surprise bills for 9 million Americans in the first nine months of 2022, but the federal independent dispute resolution process is overwhelmed, according to a...

Cigna + Oscar Extends Small Business Health Plan to Philadelphia

by Sarai Rodriguez

Cigna and Oscar Health will be extending their small business health plan footprint into Philadelphia, increasing access to care for small business owners and employees. During the pandemic, many...

Payers Expected to Issue $1B in Medical Loss Ratio Rebates in 2022

by Victoria Bailey

Payers will issue about $1 billion in medical loss ratio rebates across the individual market, small group market, and large group market in 2022, according to research from the Kaiser Family...

How The No Surprises Act Seeks to Change Surprise Billing

by Kelsey Waddill

The No Surprises Act used a couple of methods to reduce surprise billing, though the need for some modifications may remain, according to a resource from AHIP. “The real problem of surprise...

Commercial Health Plan Trends Reveal High Turnover, Reenrollment Rates

by Victoria Bailey

Around 20 percent of commercial health plan members disenrolled from their plans each year, but a third of those members returned to the plan within five years, suggesting that payers may benefit from...

How The Affordable Care Act Impacted Small Group Coverage Trends

by Kelsey Waddill

From 2013 to 2020, small group coverage has maintained a fairly stable environment, researchers from the Urban Institute found. The researchers used the Medical Expenditure Panel Survey Insurance...

Top 5 Insurers With The Highest Market Shares In The Most States

by Kelsey Waddill

Payers that hold the highest market shares nationwide may not have the greatest predominance in a single state, a HealthCareInsider analysis found. UnitedHealth Group is considered the company with...

Medicaid, ACA Enrollment Growth Attended Level Uninsurance in 2020

by Kelsey Waddill

During 2020, a stable uninsurance rate attended enrollment growth in Medicaid and the Affordable Care Act marketplace, according to a report from the Assistant Secretary for Planning and Evaluation...

CO Will Add LGBTQ+ Care As Marketplace Essential Health Benefit

by Kelsey Waddill

Updated 10/13/21: This article has been updated to include a statement from Andy Marra, executive director of the Transgender Legal Defense & Education Fund (TLDEF). Colorado has received...

Top 5 Largest Health Insurers in the US by National Market Share

by Kelsey Waddill

Overall, the list of the top five largest health insurers at the national level has remained stable over the past six years, but the list experienced some small shifts in 2020, according to data from...

4 Employer Health Benefit Strategies That Lower Healthcare Costs

by Kelsey Waddill

As employers seek to lower costs, a few key employer health benefit strategies are showing positive results. Healthcare costs are on an unsustainable trajectory, according to employer respondents in a...

Highmark Will Distribute $12.3M in Affordable Care Act Rebates

by Kelsey Waddill

Highmark Blue Cross Blue Shield Delaware will distribute more than $12.3 million in Affordable Care Act rebates, the state’s insurance commissioner announced. “With decreased utilization...

Pros, Cons of Small Employers Joining Association Health Plans

by Kelsey Waddill

Association health plans have been presented as an option for small employers that struggle to afford health insurance. But are association health plans the right solution for these...

Top Trends In Small Business Health Insurance During COVID-19

by Kelsey Waddill

Small business health insurance gravitated toward level-funding and self-funding and did not shift toward significantly toward the individual health insurance marketplace during the coronavirus...

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