Trends in Premiums, Claims, and Enrollment for Fully Insured Large Group, Small Group, and Individual Health Plans From 2011 to 2021

Abstract

In 2021, more than 20% of the US population was covered by fully insured large group, small group, and individual private health insurance plans. These plans are purchased from insurers by large employers, small employers, and individuals, respectively. In contrast, in self-insured plans, employers bear the risk for covered health care claims of employees and dependents enrolled in plans. Prior research for fully insured group plans is scarce, while studies of individual plans have shown rising premiums and fluctuating enrollment. This study compares the 11-year trends (2011-2021) in premiums, claims, and enrollment across fully insured large group, small group, and individual plans nationwide and for each state.